Seeking to reconcile end-of-life organ procurement for transplantation with the uniform determination of death act

2010 ◽  
Vol 38 (6) ◽  
pp. 1499
Author(s):  
James L. Bernat ◽  
Alexander M. Capron
Keyword(s):  
End Of Life ◽  
Organ Procurement ◽  
Determination Of Death

Seeking to reconcile end-of-life organ procurement for transplantation with the uniform determination of death act

2010 ◽  
Vol 38 (6) ◽  
pp. 1498-1499 ◽  
Author(s):  
Mohamed Y. Rady ◽  
Joseph L. Verheijde ◽  
Joan L. McGregor
Keyword(s):  
End Of Life ◽  
Organ Procurement ◽  
Determination Of Death

Non-Heart-Beating Organ Donation: A Defense of the Required Determination of Death

1999 ◽  
Vol 27 (2) ◽  
pp. 126-136 ◽  
Author(s):  
James M. DuBois
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Function ◽  
Medical Treatment ◽  
Organ Donation ◽  
Organ Procurement ◽  
Determination Of Death ◽  
Heart Beating ◽  
The Family ◽  
Transplant Team

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, it is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved.Many people now consider such cases of non-heart-beating organ donation to be ethically permissible. However, widespread disagreement persists as to how such practices are to be justified and whether such practices are compatible with the Uniform Declaration of Death Act (UDDA). In this paper, I argue that non-heart-beating organ donation can be ethically justified, that in the justified cases the patients are in fact dead, and that the early declarations of death required for such donation do comply with the UDDA.

scholarly journals Organ Procurement Organization Survey of Practices and Beliefs Regarding Prerecovery Percutaneous Liver Biopsy in Donation After Neurologic Determination of Death

2017 ◽  
Vol 101 (4) ◽  
pp. 821-825 ◽  
Author(s):  
Joseph Benton Oliver ◽  
Andrea Fleisch Marcus ◽  
Mark Paster ◽  
Joseph Nespral ◽  
Advaith Bongu ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Organ Procurement ◽  
Determination Of Death ◽  
Percutaneous Liver Biopsy ◽  
Organ Procurement Organization

Conflict in the Parameters Denning Life and Death in Missouri Statutes

1990 ◽  
Vol 16 (4) ◽  
pp. 555-580 ◽  
Author(s):  
Wendy L. Schoen
Keyword(s):  
End Of Life ◽  
State Legislatures ◽  
Functional Approach ◽  
Determination Of Death ◽  
Life And Death

Over the last twenty years, state legislatures have enacted statutes incorporating medically and legally established criteria to be utilized in the determination of death. Similarly consistent criteria for determining the onset of life have yet to be established. As a result, unacceptably conflicting statutory language defining life and the state's interest in that life exists. This conflict can be resolved by a functional approach that consistently applies criteria used to define the end of life to the beginning of life.

scholarly journals Acts that Kill and Acts that Do Not

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Cheng-Chih Tsai
Keyword(s):  
Waiting Time ◽  
Philosophy Of Language ◽  
Organ Procurement ◽  
Truth Condition ◽  
Definite Description ◽  
Vital Organ ◽  
Determination Of Death ◽  
Dead Donor Rule ◽  
Reduction Problem

In response to recent debates on the need to abandon the Dead Donor Rule (DDR) to facilitate vital-organ transplantation, I claim that, through a detailed philosophical analysis of the Uniform Determination of Death Act (UDDA) and the DDR, some acts that seem to violate DDR in fact do not, thus DDR can be upheld. The paper consists of two parts. First, standard apparatuses of the philosophy of language, such as sense, referent, truth condition, and definite description are employed to show that there exists an internally consistent and coherent interpretation of UDDA which resolves the Reduction Problem and the Ambiguity Problem that allegedly threaten the UDDA framework, and as a corollary, the practice of Donation after the Circulatory Determination of Death (DCDD) does not violate DDR. Second, an interpretation of the DDR, termed ‘No Hastening Death Rule’ (NHDR), is formulated so that, given that autonomy and non-maleficence principles are observed, the waiting time for organ procurement can be further shortened without DDR being violated.

Controlled Donation After Circulatory Determination of Death

2016 ◽  
Vol 32 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Anne L. Dalle Ave ◽  
David M. Shaw
Keyword(s):  
Informed Consent ◽  
End Of Life ◽  
Conflict Of Interest ◽  
End Of Life Care ◽  
Ethical Issues ◽  
Conflicts Of Interest ◽  
Life Care ◽  
Determination Of Death ◽  
The Family

Controlled donation after circulatory determination of death (cDCDD) concerns donation after withdrawal of life-sustaining therapy (W-LST). We examine the ethical issues raised by W-LST in the cDCDD context in the light of a review of cDCDD protocols and the ethical literature. Our analysis confirms that W-LST procedures vary considerably among cDCDD centers and that despite existing recommendations, the conflict of interest in the W-LST decision and process might be difficult to avoid, the process of W-LST might interfere with usual end-of-life care, and there is a risk of hastening death. In order to ensure that the practice of W-LST meets already well-established ethical recommendations, we suggest that W-LST should be managed in the ICU by an ICU physician who has been part of the W-LST decision. Recommending extubation for W-LST, when this is not necessarily the preferred procedure, is inconsistent with the recommendation to follow usual W-LST protocol. As the risk of conflicts of interest in the decision of W-LST and in the process of W-LST exists, this should be acknowledged and disclosed. Finally, when cDCDD programs interfere with W-LST and end-of-life care, this should be transparently disclosed to the family, and specific informed consent is necessary.

scholarly journals Thoracic Organ Procurement during Multi-Organ Retrieval

2021 ◽  
Author(s):  
Suresh Keshavamurthy ◽  
Vipin Dulam ◽  
Eros Leotta ◽  
Mohammed A. Kashem ◽  
Yoshiya Toyoda
Keyword(s):  
Brain Death ◽  
Organ Procurement ◽  
Determination Of Death ◽  
En Bloc ◽  
Arterial Revascularization ◽  
Organ Retrieval ◽  
Donation After Brain Death ◽  
Donor Shortage ◽  
Thoracic Organ

Procurement of thoracic organs can be divided into two major categories- donation after brain death (DBD) or donation after circulatory determination of death (DCDD). In this section we will focus primarily on DBD, which is the commoner of these two or at times referred to as standard procurement. DCDD is a relatively new and promising field that has helped ameliorate donor shortage, aided by the latest advances in medical technology. However, DBD continues to be the major avenue of organ donation. There are several different combinations of thoracic procurement surgeries: heart, double lung, single lung/ 2-single lungs, heart-lung en bloc for transplantation, Double Lung procurement for Bronchial arterial revascularization, Heart and Lung procurement in DCDD donors with the OCS, NRP or Lungs for EVLP.

Determination of Death in Execution by Lethal Injection in China

2018 ◽  
Vol 27 (3) ◽  
pp. 459-466
Author(s):  
NORBERT W. PAUL ◽  
ARTHUR CAPLAN ◽  
MICHAEL E. SHAPIRO ◽  
CHARL ELS ◽  
KIRK C. ALLISON ◽  
...  
Keyword(s):  
Organ Procurement ◽  
Medical Science ◽  
The United States ◽  
Determination Of Death ◽  
Brain Functions ◽  
Common Criteria ◽  
Level Data ◽  
Postmortem Blood ◽  
Lethal Injection

Abstract:Since 1997, execution in China has been increasingly performed by lethal injection. The current criteria for determination of death for execution by lethal injection (cessation of heartbeat, cessation of respiration, and dilated pupils) neither conform to current medical science nor to any standard of medical ethics. In practice, death is pronounced in China within tens of seconds after starting the lethal injection. At this stage, however, neither the common criteria for cardiopulmonary death (irreversible cessation of heartbeat and breathing) nor that of brain death (irreversible cessation of brain functions) have been met. To declare a still-living person dead is incompatible with human dignity, regardless of the processes following death pronouncement. This ethical concern is further aggravated if organs are procured from the prisoners. Analysis of postmortem blood thiopental level data from the United States indicates that thiopental, as used, may not provide sufficient surgical anesthesia. The dose of thiopental used in China is kept secret. It cannot be excluded that some of the organ explantation surgeries on prisoners subjected to lethal injection are performed under insufficient anesthesia in China. In such cases, the inmate may potentially experience asphyxiation and pain. Yet this can be easily overlooked by the medical professionals performing the explantation surgery because pancuronium prevents muscle responses to pain, resulting in an extremely inhumane situation. We call for an immediate revision of the death determination criteria in execution by lethal injection in China. Biological death must be ensured before death pronouncement, regardless of whether organ procurement is involved or not.

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