Death cannot be viewed properly as either an event or a configuration. Indeed, multiple parts of the body can continue to live long after the disintegration of its central organization is recorded. Instead of collapsing at a moment in time, technological mechanisms are capable of sustaining the major bodily processes indefinitely — all designed to allow for the harvesting of needed organs for transplantation. State legislative efforts have been undertaken in America to define those specific circumstances when death occurs legally. Although always allowed to exercise reasonable discretion in their decision making, attending physicians will nonetheless be aided by these laws that not only limit their legal liability but assure for the patient that his final choices will be honored consistent with basic principles of self-determination. The Law Reform Commission of Canada recommended in 1987 that criminal liability be rejected for the offenses of helping, advising, or inciting a person to commit suicide. This is an exceedingly wise and humane position to follow. Instead of being held captive to words such as “rational suicide” or “euthanasia”, what is needed is an acceptance of more contemporary watchwords such as autonomy and self-determination. When at all possible, final choices about death should be made by the patient's family and their medical advisers — and not be subjected to judicial scrutiny.
of Advanced Study conferred a citation of merit upon Professor Smith for his "path-breaking interdisciplinary research and writing on medical and biological issues as they relate to the norms oflaw and ethics." The University also conferred a Distinguished Alumni Award upon him in 1985 and an honorary degree in 1998.
In the United States, as well as throughout the world, current demands for organ transplants far exceed the actual supply. Nonconsensual human donations, taken from minors, incompetents and prisoners are regulated carefully by the courts. The Uniform Anatomical Gift Act and the National Organ Transplant Act serve also as statutory frameworks for organ retrievals and allocations and place various restrictions upon each. Altruistically motivated donations at death continue to be an inadequate mechanism for meeting the growing demands of the market. Included among the various approaches to resolving the critical shortage of human organs for transplantation are post mortem harvesting, escheatage, prospective contingent sales and standard death benefit payments — with the latter being perhaps the most attractive in the United States. While ethical and moral principles can help develop a construct for resolving harvesting and transplantation conflicts, they must be tempered — in the final analysis — by a standard of practical need that recognizes unnecessary suffering and premature death from diseased and replaceable organs as undesirable.
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