Vital Organ Donation without the Dead Donor Rule

Author(s):  
Franklin G. Miller ◽  
Robert D. Truog
2021 ◽  
pp. 002436392110381
Author(s):  
Thomas A. Cavanaugh

In “Double Effect Donation,” Camosy and Vukov argue that “there are circumstances in which it is morally permissible for a healthy individual to donate their organs even though their death is a foreseeable outcome”. They propose that a living donor could ethically donate an entire, singular, vital organ while knowing that this act would result in death. In reply, I argue that it is not ethical for a living person to donate an entire, singular, vital organ. Moreover, mutatis mutandis, it is not ethical for surgeons and others to perform such a deadly operation. For to do so is “intentionally to cause the death of the donor in disposing of his organs”. Such an act violates the dead donor rule which holds that an entire, singular, vital organ may be taken only from a corpse. Contrary to Camosy and Vukov’s claims, double-effect reasoning does not endorse such organ donation.


2020 ◽  
pp. 155-176
Author(s):  
James F. Childress

This chapter considers what we should do with the “dead donor rule” in transplantation in light of controversies about different ways of determining death. The system of voluntary deceased organ donation depends on public trust, based in part on adherence to the “Dead Donor Rule” (DDR). However, this rule presupposes that the line between life and death can be reliably drawn for purposes of removing vital organs for transplantation. Different but serious conceptual, scientific, and ethical questions surround deceased donation after neurological determination of death and after circulatory determination of death in either controlled or uncontrolled forms. This chapter examines the ethical implications of different approaches to the DDR and asks which public policy should be adopted: (1) abandon the DDR and move to living vital organ donation; (2) retain the DDR but view the determination of death as a legal fiction; (3) retain the DDR but expand individual/familial choices of conceptions of and criteria for determining death; or (4) retain and strengthen the DDR and ethically improve its operation. This chapter argues for the fourth option and for improving the process of individual and familial informed consent to deceased organ donation.


2014 ◽  
Vol 41 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Michael Nair-Collins ◽  
Sydney R Green ◽  
Angelina R Sutin

2018 ◽  
Vol 44 (12) ◽  
pp. 868-871 ◽  
Author(s):  
Xavier Symons ◽  
Reginald Mary Chua

Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death—namely, that death is equivalent to total brain failure—and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller’s argument and suggest that it may be necessary to look for alternative biological markers that reliably indicate the death of a human being. We reject the suggestion that we should abandon the dead-donor criteria for organ donation. Rather than weaken the ethical standards for vital organ procurement, it may be necessary to make them more demanding. The aim of this paper is not to justify the dead donor rule. Rather, we aim to explore the perspective of those who agree with critiques of the whole brain and cardiopulmonary definitions of death but yet disagree with the proposal that we should abandon the dead-donor rule. We will consider what those who want to retain the dead-donor rule must argue in light of Nair-Collins and Miller’s critique.


2019 ◽  
Vol 20 (3) ◽  
pp. 163-173 ◽  
Author(s):  
Lila de Tantillo ◽  
Juan M. González ◽  
Johis Ortega

Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule—as may be already occurring—or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.


2007 ◽  
Vol 8 (5) ◽  
pp. 507-509 ◽  
Author(s):  
Martha A. Q. Curley ◽  
David K. Urion ◽  
Tamara Vesel ◽  
Charlotte H. Harrison ◽  
Peter C. Laussen

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