The Dead Donor Rule

Robertson, John A.

doi:10.2307/3527865

Cited by 298 publications

(120 citation statements)

References 11 publications

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“…33,34 The 'dead-donor' rule requires that a patient be considered as a potential donor only after the determination of death, [35][36][37] and was part of the impetus for the seminal development of formal brain death criteria. 38 Concerns over conflict of interest requires that the health care team responsible for declaring death and approaching families to ask for organ donation be distinct and separate from the health care team responsible for transplantation and management of potential recipients.…”

Section: Conclusion : Les Centres Canadiens Peuvent Apprendre à Partimentioning

confidence: 99%

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Doig

Rocker

2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : The increasing gap between numbers of individuals awaiting organ replacement surgery and the supply of organs available for transplant underpins attempts to increase the number of organs available. One practice, used in other countries, is the recovery of organs from non-heart-beating organ donors (NHBD). The purpose of this review is to discuss ethical issues surrounding the use of organs from these donors.S So ou ur rc ce e: : Narrative review from selected Medline references, and other published reports.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : NHBD protocols have been established in many countries including the United States. Despite numerous publications, and extensive debate in the literature, significant ethical issues remain unresolved in the retrieval of organs from donors that have died from cessation of cardiac activity. The ethical concerns primarily arise in the determination of death, the tension between the time constraints on recovering organs viable for transplantation, and procedures to enhance organ viability. Despite a concerted effort in the United States, less than half of the organ procurement organizations have NHBD protocols.

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Section: Conclusion : Les Centres Canadiens Peuvent Apprendre à Partimentioning

confidence: 99%

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Doig

Rocker

2003

Can J Anesth/J Can Anesth

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“…This permanence, it is argued, is functionally equivalent to irreversibility. 1,23,37,38 A second response is that although these patients do not meet the UDDA requirements, it is reasonable to consider these patients dead, as the UDDA is flawed 39 or should not be construed so strictly, given the unforeseeable advances in medical technology that have taken place since the UDDA was adopted in 1981. 40 The third and most radical response suggests eliminating the dead-donor rule.…”

Section: Ethical Concerns Regarding Controlled Dcdmentioning

confidence: 99%

“…This rule, which states that organ retrieval cannot cause death, is "the ethical linchpin of a voluntary system of organ donation, and helps maintain public trust in the organ procurement system." 23 It may not be immediately obvious how controlled DCD would violate this rule, as organs are not removed until after death is declared. The concern, however, arises from the way death is declared in these cases.…”

Section: Ethical Concerns Regarding Controlled Dcdmentioning

confidence: 99%

“…22,25,28 Nonetheless, some have argued that since the benefits of the intervention do not accrue to the patient who is being harmed, as they do in most other cases where the doctrine is applied, we cannot use this principle to justify harming our patient in these circumstances. 23,24,29 The final response to concerns about antemortem interventions, in particular to the worry that providers are not acting in their patients' interests, is that we should not take too narrow a view of patients' interests. As we noted earlier, if a patient wants to become a donor, then facilitating this can be in his or her interests just as much as extending his or her life, and thus we need not worry that in doing so we are acting solely in the interests of someone other than our patient.…”

Section: Ethical Concerns Regarding Controlled Dcdmentioning

confidence: 99%

“…21,22 Finally, argue supporters of DCD, such protocols allow the health care team to honor the wishes not only of patients, but also of family members who would like to donate the organs of their loved ones. 22,23 Because relatives of the deceased may derive comfort from knowing that their relatives became organ donors, there is ethical value in facilitating this process.…”

Section: Ethical Benefits Of Dcdmentioning

confidence: 99%

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Donation After Cardiac Death and the Emergency Department: Ethical Issues

Simon

Schears

Padela

2014

Academic Emergency Medicine

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Inconsistency in Brain Death Determination Should Not Be Tolerated

Barnes

Greer

2020

AMA Journal of Ethics

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Since it was proposed in 1980, the Uniform Determination of Death Act has provided the legal basis for determination of death by neurological criteria. The act contains language that allows for acceptable medical standards to be used to determine death. Since 1995, the American Academy of Neurology has provided guidelines for brain death determination (revised in 2010), but nationwide adherence to these guidelines has been incomplete. This variability could lead to misdiagnosis and erosion of public trust in this important medical practice. Physicians must work together as a profession to push for uniformity and accuracy in death diagnosis. Defining Brain DeathAlthough the concept of death is as old as life itself, the concept of brain death is a relatively young one. Only in the mid-20th century did technology advance to the point of allowing for organ support in the event that brain function ceased. With the advent of mechanical ventilation, artificial nutrition, and the modern intensive care unit, patients who suffered an irreversible intracranial catastrophe could continue to have their other organs supported and maintained. In 1968, a committee of physicians from Harvard Medical School published a report titled "A Definition of Irreversible Coma." 1 In 1980, the Uniform Determination of Death Act (UDDA) was proposed in order to establish a legal and uniform definition of death-determined by "acceptable medical standards"that was "clear and socially accepted," with the intention of its being adopted in every US jurisdiction. 2,3 This model statute provided the legal basis for death by neurological criteria, stating that an individual could now be determined to be dead if they had sustained "irreversible cessation of all functions of the entire brain, including the brain stem." 2 What "acceptable medical standards" meant was left to be determined by the medical community, leading to the creation of societal guidelines in subsequent years.Following the Harvard report and the UDDA, in 1995, the American Academy of Neurology (AAN) provided consensus practice parameters for the determination of death by neurological criteria in adults. 4 These guidelines stated that brain death has occurred when "the irreversible loss of function of the brain, including the brain stem," has been determined by the demonstration of complete loss of consciousness (coma), brain stem

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The Dead Donor Rule

Abstract: The scarcity of vital organs has prompted several calls to either modify the dead donor rule or interpret it more broadly. Given its symbolic importance, however, the rule should be changed only cautiously.

Cited by 298 publications

References 11 publications

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Donation After Cardiac Death and the Emergency Department: Ethical Issues

Inconsistency in Brain Death Determination Should Not Be Tolerated

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