scholarly journals Does It Matter How We Die? Ethical and Legal Issues Raised by Combining Euthanasia and Organ Transplantation

2019 ◽  
Vol 86 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Margaret Somerville
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Human Dignity ◽  
Healthcare Professionals ◽  
Conflicts Of Interest ◽  
Human Life ◽  
Definition Of Death ◽  
Dead Donor Rule ◽  
Ethical And Legal Issues ◽  
Definition Of

If, in jurisdictions with legalized euthanasia, obtaining organs for transplant from euthanized people is allowed, must their organs be taken only after death or should euthanasia be allowed to be performed by removal of vital organs? Asked another way, if “Donation after Death” is practiced, why not “Death by Donation?” The article addresses two questions. First, “What issues does connecting euthanasia and organ donation raise?” They include dealing with uncertainty regarding the definition of death, defining what constitutes conscientiously objecting healthcare professionals' involvement in euthanasia, and whether connecting euthanasia and transplantation makes conflicts of interest for healthcare professionals unavoidable. Additional issues raised by death by donation include breach of the “dead-donor rule”; what would constitute informed consent to it; and what impact its acceptance would have on important foundational societal values, especially respect for human dignity and human life. The second question is “Why might some people who agree with euthanasia and even organ donation after death by euthanasia find death by donation ethically unacceptable?” Considerations again include its harmful impact on upholding respect for human dignity and human life and that the “wisdom of repugnance” could be informing these people's reaction. It is concluded that in order to avoid serious breaches of ethics, organ transplantation and euthanasia should not be linked in any way.

scholarly journals Controversy in the Determination of Death: The Definition and Moment of Death

2019 ◽  
Vol 86 (4) ◽  
pp. 366-380
Author(s):  
Frederick J. White
Keyword(s):  
Organ Transplantation ◽  
Deceased Donor ◽  
Determination Of Death ◽  
Bodily Integrity ◽  
Donor Organ ◽  
Definition Of Death ◽  
Dead Donor Rule ◽  
The Moment ◽  
Definition Of

This essay reviews recent controversy in the determination of death, with particular attention to the definition and moment of death. Definitions of death have evolved from the intuitive to the pathophysiologic and the medicolegal. Many United States jurisdictions have codified the definition of death relying on guidance from the Uniform Determination of Death Act (UDDA). Flaws in the structure of the UDDA have led to misunderstanding of the physiologic nature of death and methods for the determination of death, resulting in a bifurcated concept of death as either circulatory/respiratory or neurologic. The practice of organ donation after circulatory determination of death (DCDD) raises a number of ethical questions, most prominently revolving around the moment of death and manifested as an expedited time to determination of death, a departure from the unitary concept of death, a violation of the dead donor rule, and a challenge to the standard of irreversibility. Attempts to redefine the determination of death from an irreversibility standard to a permanence standard have significant impact on the social contract upon which deceased donor organ transplantation rests, and must entail broad societal examination. The determination of death is best reached by a clear, strict, and uniform irreversibility standard. In deceased donor organ transplantation, the interests of the donor as a person are paramount, and no interest of organ recipients or of the greater society can justify negation of the rights and bodily integrity of the person who is a donor, nor conversion of the altruism of giving into the calculus of taking.

scholarly journals In defense of a pluralistic policy on the determination of death

2018 ◽  
Vol 8 (3-4) ◽  
pp. 179-188 ◽  
Author(s):  
Vilius Dranseika ◽  
Ivars Neiders
Keyword(s):  
Organ Transplantation ◽  
Peter Singer ◽  
Definition Of Death ◽  
Sanctity Of Life ◽  
Dead Donor Rule ◽  
Reasonable Range ◽  
Definition Of ◽  
Death Determination ◽  
Two Alternatives

Abstract In his paper “The challenge of brain death for the sanctity of life ethic”, Peter Singer advocates two options for dealing with death criteria in a way that is compatible with efficient organ transplantation policy. He suggests that we should either (a) redefine death as cortical death or (b) go back to the old cardiopulmonary criterion and scrap the Dead Donor Rule. We welcome Singer’s line of argument but raise some concerns about the practicability of the two alternatives advocated by him. We propose adding a third alternative that also – as the two previous alternatives – preserves and extends the possibility of organ transplantation without using anyone without their consent. Namely, we would like to draw readers’ attention to a proposal by Robert Veatch, formulated 42 years ago in his 1976 book “Death, dying, and the biological revolution” and developed further in his later publications. Veatch argues for a conscience clause for the definition of death that would permit people to pick from a reasonable range of definitional options. This autonomy-based option, we believe, is more likely to be practicable than the two options advocated by Singer. Furthermore, we present data from a study with Lithuanian participants that suggest that there is quite pronounced variation of preferences concerning death determination.

Consciousness: The Most Critical Moral (Constitutional) Standard for Human Personhood

1987 ◽  
Vol 13 (2-3) ◽  
pp. 233-248 ◽  
Author(s):  
Ronald E. Cranford ◽  
David Randolph Smith
Keyword(s):  
Medical Profession ◽  
Human Life ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Major Premise ◽  
Definition Of Death ◽  
The Past ◽  
Appropriate Care ◽  
Life Itself ◽  
Definition Of

For the past two decades, the medical profession and society have debated the definition of death. Some reasonable consensus has been reached on this issue, in theory and in practice. In the last few years, however, a far more important debate has been evolving — the definition of human personhood. Human personhood has been discussed extensively in the past with respect to the abortion question and other issues concerning the beginning of life. More recently, however, the definition of personhood has been raised with respect to termination of treatment decisions at the end of life and, in particular, on the appropriate care of patients in a persistent vegetative state.Our major premise is that consciousness is the most critical moral, legal, and constitutional standard, not for human life itself, but for human personhood. There is nothing highly original in our approach to this particular issue; others have advanced similar arguments in recent years.

Ethical issues in Kidney Transplantation and “An” Islamic perspective

2021 ◽  
Vol 20 (2) ◽  
pp. 241-249
Author(s):  
Mohammad Yousuf Rathor ◽  
Azarisman SM Shah ◽  
Nur Raziana Bt Rozi ◽  
Che Rosle Draman ◽  
Wan Ahmad Syahril
Keyword(s):  
Kidney Transplantation ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Islamic Law ◽  
Ethical Issues ◽  
Human Life ◽  
Medical Science ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Living Kidney Donor

Kidney transplantation (KT) is currently the most realistic treatment option for patients with end-stage renal disease (ESRD) as it enables them to live longer and provides better quality of life post-transplantation. Before the 1960s, all these patients would die as there was no treatment available. It is the commonest solid organ transplantation carried out in the world at the moment. Organs are harvested from living or cadaveric donors, with living kidney donor organs generally functioning better and for longer periods of time compared to the latter. Issues surrounding organ transplantation in general and kidney transplantation in particular, are fraught with ethical dilemmas due to the shortage of organs, the logistics behind the acquisition of organs, use of living donors including minors and the black market that has sprouted thereof. Entwined in this quagmire are the legal, social and psychological consequences for the individuals involved and the society at large. It is further compounded by religious concerns, which have a significant influence on the society’s acceptance of the practice of organ donation. The practice of organ transplantation is generally accepted by most Islamic scholars as it is concordant to the objectives of Islamic Law (maqasid al Sharī’ah) which prioritize the preservation of human life. However, resistances do arise from some jurists and even physicians of the same Islamic faith despite a fatwas decreeing that organ and tissue transplantations are permissible in Islam under certain conditions. The take-up of organ-donation is still largely poor especially among Muslims. This article therefore hopes to explore the various moral and ethical issues surrounding KT as well as the Islamic viewpoints emanating from it. We hope that this knowledge and understanding will benefit both health-care personnel and the public in general. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.241-249

Islamic Views on Organ Donation

1998 ◽  
Vol 8 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Jaffer Syed
Keyword(s):  
North America ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Chronic Diseases ◽  
Medical Technology ◽  
Healthcare Professionals ◽  
Healthcare Setting ◽  
The Past ◽  
The North

As medical technology continues its advance, the use of organ transplantation for the palliation and cure of chronic diseases is rising. However, many barriers to organ donation exist, including religious ones. It has long been known that Muslims in North America tend not to donate organs. In the past this tendency has been attributed to religious prohibitions even though cultural views may also play a strong role. The purpose of this article is to explore and define the Islamic religious opinion on organ donation and transplantation to enhance healthcare professionals' understanding of Islamic views concerning brain death and organ donation. It is hoped that this knowledge and understanding may benefit both patients and caregivers in the North American healthcare setting.

Organismal death, the dead-donor rule and the ethics of vital organ procurement

2018 ◽  
Vol 44 (12) ◽  
pp. 868-871 ◽  
Author(s):  
Xavier Symons ◽  
Reginald Mary Chua
Keyword(s):  
Organ Procurement ◽  
Vital Organ ◽  
Definition Of Death ◽  
Dead Donor Rule ◽  
Total Brain ◽  
Brain Failure ◽  
The Dead ◽  
Definition Of ◽  
Donor Criteria ◽  
Human Death

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.

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