The New Definitions of Death for Organ Donation

Nguyen, Doyen

doi:10.3726/b13472

Cited by 14 publications

(26 citation statements)

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“…Lewis condescendingly dismisses my assertions that Jahi does not fulfill the California statutory definition of death and that the Guidelines do not comport with the UDDA. Apart from the specifics of Jahi's case, the Guidelines explicitly allow for some retained brain functions (including some that would qualify as "critical" according to Bernat's distinction [20], or as "clinical" according to the insistence of Bernat, Wijdicks and others [20,21]) [3,11,22,23]. Therefore, the Guidelines, by their own wording, do not identify the "irreversible cessation of all functions of the entire brain" required by the UDDA [6, p. 73], despite having become, through political decree within professional societies, the "accepted medical standards" that the UDDA defers to.…”

Section: Because Of [My "Philosophical Beliefs"] It Is Worth Noting Tmentioning

confidence: 99%

Truly Reconciling the Case of Jahi McMath

Shewmon

2018

Neurocrit Care

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This article clarifies some issues raised by Dr. Ariane Lewis in her recent "Current Opinion/Arguments" article on the case of Jahi McMath. Review of case materials. Jahi's case most likely represents an instance of global ischemic penumbra (GIP) mimicking brain death (BD), with intracranial blood flow too low to support neuronal function or to be detected by radionuclide scan but sufficient to prevent widespread necrosis. Her MRI scan 9 months after the ischemic insult showed gross preservation of cortical and internal structures, incompatible with there ever having been a period of completely absent blood flow. Regarding Jahi's alleged intermittent responsiveness, the set of videos, unsystematic as they are, constitutes convincing evidence that her movements in seeming response to command are not of spinal cord origin and are indeed voluntary responses, placing her in the category of minimally conscious state (MCS). In the absence of serial examinations by experts in MCS, the benefit of the doubt should be given. Unfortunately, her death on June 22, 2018, 4½ years after the diagnosis of BD, precludes such examinations. During those 4½ years, Jahi underwent menarche, with three documented menstrual periods, and ongoing pubertal development. Her case is an important example of false-positive diagnosis of BD, demonstrating the inability of current diagnostic standards to distinguish true BD from potentially reversible brain nonfunction due to GIP. The incidence of such mimicry is impossible to determine, because in most cases a BD diagnosis becomes a self-fulfilling prophecy.

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Section: Because Of [My "Philosophical Beliefs"] It Is Worth Noting Tmentioning

confidence: 99%

Truly Reconciling the Case of Jahi McMath

Shewmon

2018

Neurocrit Care

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“…The discussion that follows to address the question raised above is a brief summary of Nguyen’s critical analysis of John Paul II’s (2000) Address (Nguyen 2017, 2018, 241–346). The pope’s statement, which reflects his moral judgment about the use of the neurological criteria, rests on several presuppositions or conditions, all of which must be fulfilled if the conclusion (i.e., the pope’s judgment) is to follow.…”

Section: Two Approaches For An Ethical Revision Of the Uniform Declarmentioning

confidence: 99%

“…No amount of rigorous application can compensate for such inherent inadequacy. “If the diagnostic criteria are insufficient to establish the complete and irreversible loss of all brain activity, then in what way can they secure adequate moral certainty” (Nguyen 2018, 471–72) to declare the patent/donor dead and proceed with organ harvesting?…”

Section: Two Approaches For An Ethical Revision Of the Uniform Declarmentioning

confidence: 99%

Does the Uniform Determination of Death Act Need to Be Revised?

Nguyen

2020

Linacre Q

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Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues’ revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust. Summary: This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.

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“…By contrast, Catholic teaching on brain death simply has not yet attained the same definitive status. As Nguyen (2018) notes in her recent book on brain death and organ donation (p. 457), Donum Veritatis teaches thatWhen it comes to the question of interventions in the prudential order, it could happen that some Magisterial documents might not be free from all deficiencies. Bishops and their advisors have not always taken into immediate consideration every aspect or the entire complexity of a question.…”

Section: Magisterial Teaching On Brain Deathmentioning

confidence: 99%

“…Unlike the Church’s teaching on contraception referenced above, the magisterium lacks definitive guidance on brain death in the first place, so we naturally lack any “repeated” teaching on this matter. Furthermore, Nguyen (2018) thinks Benedict XVI’s 2008 address is significant insofar as he did not reference John Paul II’s 2000 address or mention the neurological criteria by name (p. 484). For Nguyen, Benedict XVI’s omission and explicit emphasis on “true death” indicates that the debate on brain death was far from settled for Benedict XVI.…”

Section: Magisterial Teaching On Brain Deathmentioning

confidence: 99%

Brain Death and the Formation of Moral Conscience

Ostertag

Karches

2019

Linacre Q

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In this article, we provide an update to Catholic ethicists and clinicians about the current status of Catholic teaching and practice regarding brain death. We aim to challenge the notion that the question has been definitively settled, despite the widespread application of this concept in medical practice including at Catholic facilities. We first summarize some of the notable arguments for and against brain death in Catholic thought as well as the available magisterial teachings on this topic. Although Catholic bishops, theologians, and ethicists have generally signaled at least tentative approval of the neurological criteria for the determination of death, we contend that no definitive magisterial teaching on brain death currently exists; therefore, Catholics are not currently bound to uphold any position on these criteria. In the second part of the article, we describe how Catholics, particularly Catholic medical practitioners, must presently inform their consciences on this issue while awaiting a more definitive magisterial resolution. Summary: Some prominent Catholic theologians and physicians have argued against the validity of brain death; however, most Catholic ethicists and physicians accept the validity of brain death as true human death. In this paper, we argue that there is no definitive magisterial teaching on brain death, meaning that Catholics are not bound to uphold any position on brain death. Catholics in general, but especially Catholic medical practitioners, should inform their consciences on this intra-Catholic debate on brain death while awaiting more definitive magisterial teaching.

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The New Definitions of Death for Organ Donation

Cited by 14 publications

References 0 publications

Truly Reconciling the Case of Jahi McMath

Truly Reconciling the Case of Jahi McMath

Does the Uniform Determination of Death Act Need to Be Revised?

Brain Death and the Formation of Moral Conscience

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