scholarly journals Brain Death and the Dutch Organ Donation Law

2020 ◽  
Vol 87 (2) ◽  
pp. 161-170
Author(s):  
Douwe J. Steensma
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Scientific Data ◽  
Reliable Information ◽  
Legal Systems ◽  
Biological Perspective ◽  
Brain Dead Patient ◽  
Brain Dead ◽  
The Right

According to many legal systems that regulate organ donation, such as Dutch law, a brain-dead patient is regarded as a mortal remains. In general, these systems do not take into account the fact that this definition is being heavily criticized and the far-reaching consequences thereof. In the case of organ transplantation, vital organs are procured from persons who, from a biological perspective, may not yet be dead. A government that values scientific data and wants to provide honest and reliable information to its citizens has to account for this critique of its policy as citizens have the right to be well-informed. Whoever makes the decision to donate organs performs a special act of human solidarity, but the readiness to donate organs in the case of brain death is not inherent to the demand to love one’s neighbor as one loves oneself. Summary: According to legislation on organ donation in many countries, a brain-dead patient is regarded as a mortal remains. The law disregards the fact, however, that this definition is being heavily criticized and that it has far-reaching consequences. In the case of organ transplantation, vital organs are procured from persons who, from a biological perspective, may not yet been dead. A government that values scientific data and wants to provide honest and reliable information to its citizens has to account for this critique in its policy. Citizens have the right to be well-informed.

scholarly journals Organ Donation in the Context of Brain Death in Muslim Countries: Bioethical Positions

2020 ◽  
Vol 5 (07) ◽  
pp. 222-224
Author(s):  
Alqahtani Ibtesam Mohammed
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Organ Procurement ◽  
Modern Medicine ◽  
Organ Transplants ◽  
Clear Cut ◽  
Muslim Countries ◽  
The Right ◽  
End Stage

One of the miracles of modern medicine for patients with end stage organ failure is organ transplantation. The Organ Procurement and Transplantation Network (OPTN) defines organ donation as giving an organ, tissue, cells, or part of an organ from a living or deceased person (i.e., the donor) to a living person in need (i.e., the recipient). In the last two decades, the number of organ transplants has gradually increased; however, the demand for organ transplantation exceeds the number of available donors. Organs from brain dead donors have been suggested as an alternative option for increasing donation rates when living donors are not available. This article explores the debate surrounding brain death organ donation in Muslim countries. Because organ transplantation is based on Ijtihad, Muslim jurists have no clear-cut text in the Holy Quran or Sunna to use as a foundation for judgment. This has made organ transplants an issue among Muslim scholars and researchers, splitting them into two opinion groups, with one side seeing organ transplantation as legal and the other believing it to be illegal. However, all individuals have the right to choose whether they want to help others by sacrificing parts of themselves and donating their organs. Autonomy, justice, and beneficence must be employed in organ transplantation decision-making.

Successful Organ Donation From Brain Dead Donors in a Chinese Organ Transplantation Center

2011 ◽  
Vol 11 (10) ◽  
pp. 2247-2249 ◽  
Author(s):  
W. G. Sui ◽  
Q. Yan ◽  
S. P. Xie ◽  
H. Z. Chen ◽  
D. Li ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Brain Dead ◽  
Transplantation Center

Brain Death and Organ Donation

2018 ◽  
Author(s):  
Thomas I. Cochrane
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Donation After Brain Death ◽  
Brain Death Determination ◽  
Brain Dead ◽  
American Academy Of Neurology ◽  
Death Determination

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.

Brain Death, Organ Donation, and Transplantation

2018 ◽  
pp. 276-285
Author(s):  
Hilary H. Wang ◽  
David M. Greer
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Apnea Test ◽  
Unit Management ◽  
Legal Context ◽  
History Of ◽  
Brain Death Determination ◽  
Brain Dead ◽  
Death Determination

This chapter reviews the history of brain death determination, current guidelines for performing the brain death examination including the apnea test, details of apnea testing, the role of brain dead donors in organ donation, physiologic changes seen in brain dead patients, and the relevant challenges in intensive care unit management of such patients for donor organ optimization. The goal of this chapter is to provide clear guidance for a critical care provider to perform an accurate and thorough brain death examination and to further the reader’s understanding of the historical and legal context surrounding brain death and organ donation in the United States.

The Organ Transplantation Act and Recent Trends in Korea

2013 ◽  
Vol 25 (2) ◽  
pp. 209-213 ◽  
Author(s):  
Ho No Joo
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Organ Allocation ◽  
Incentive System ◽  
Ethical Problems ◽  
Transplantation Act ◽  
Allocation Criteria ◽  
Recent Trends ◽  
Brain Dead

The Organ Transplantation Act, including transplantation of organs from brain-dead donors, entered into force in Korea on February 9, 2000. This article introduces the Organ Transplantation Act, focusing on scope of the Act, determination of brain death, removal of organs from brain-dead or deceased donors, removal from living donors, organ allocation, and prohibition of trade in human organs. Especially, some primary ethical dilemmas surrounding organ allocation arise from the shortage of available organs. The primary ethical problems surrounding organ allocation are as follows. A key purpose of the organ donation incentive system is to increase the number of organ transplants from brain-dead donors. In particular, the priority for kidney patient was allowed in consideration of doctor’s strong desire to increase the brain-dead donors. Also, the organ allocation criteria based on the organ donation incentive system appear unfair, especially for the kidney patient, because the criteria do not fit the principles of distributive justice. In the future, the organ donation incentive system itself may need to be reexamined.

Brain Death and Organ Donation

2017 ◽  
Author(s):  
Thomas I. Cochrane
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Donation After Brain Death ◽  
Brain Death Determination ◽  
Brain Dead ◽  
American Academy Of Neurology ◽  
Death Determination

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.

scholarly journals Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Ryan P. Watts ◽  
Ogilvie Thom ◽  
John F. Fraser
Keyword(s):  
Brain Injury ◽  
Brain Death ◽  
Organ Donation ◽  
Reperfusion Injury ◽  
Inflammatory Mediators ◽  
Ischaemia Reperfusion Injury ◽  
Donor Pool ◽  
Ongoing Research ◽  
Ischaemia Reperfusion ◽  
Brain Dead

Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient’s immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade.

Organ Donation, Brain Death and the Family: Valid Informed Consent

2015 ◽  
Vol 43 (2) ◽  
pp. 369-382 ◽  
Author(s):  
Ana S. Iltis
Keyword(s):  
Informed Consent ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donor ◽  
Public Understanding ◽  
Organ Procurement Organization ◽  
The Family ◽  
Driver's License ◽  
Brain Dead

In July 2013, parents in Ohio objected to their 21-year-old son becoming an organ donor. Elijah Smith was involved in an accident and pronounced dead using neurological criteria. The organ procurement organization (OPO) went to court and argued that because the young man was brain dead and because his driver's license indicated that he wished to be a donor, the court should allow them to use his organs. The mother argued that her son did not understand what he was signing when he signed his license and that his signature did not reflect an informed decision. The court disagreed with her, saying that he had indicated a wish to donate his organs and that no one but Elijah could revoke that wish. His organs were removed.Elijah's mother suspected that he did not understand what he was signing. She might have been right, given what we know about the process for obtaining permission for organ donation and the limited public understanding of brain death.

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