Double-Effect Donation Disputed

2021 ◽  
pp. 002436392110381
Author(s):  
Thomas A. Cavanaugh
Keyword(s):  
Organ Donation ◽  
Healthy Individual ◽  
Living Donor ◽  
Double Effect ◽  
Vital Organ ◽  
Dead Donor Rule ◽  
Knowing That ◽  
The Dead ◽  
Living Person ◽  
Do So

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.

Difficulties of Determining Death

2020 ◽  
pp. 155-176
Author(s):  
James F. Childress
Keyword(s):  
Organ Donation ◽  
Vital Organ ◽  
Determination Of Death ◽  
Life And Death ◽  
Ethical Implications ◽  
Legal Fiction ◽  
Dead Donor Rule ◽  
Deceased Organ Donation ◽  
The Dead

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.

scholarly journals Abandoning the dead donor rule? A national survey of public views on death and organ donation

2014 ◽  
Vol 41 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Michael Nair-Collins ◽  
Sydney R Green ◽  
Angelina R Sutin
Keyword(s):  
Organ Donation ◽  
National Survey ◽  
Dead Donor Rule ◽  
The Dead ◽  
Public Views

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.

The Imminently Dying Donor

2021 ◽  
pp. 261-284
Author(s):  
Lainie Friedman ◽  
J. Richard Thistlethwaite, Jr
Keyword(s):  
Organ Donation ◽  
Living Donor ◽  
Organ Procurement ◽  
Extreme Case ◽  
Living Donation ◽  
Ethical Norm ◽  
Dead Donor Rule ◽  
Healthy Donors ◽  
Donation Process ◽  
The Individual

As the supply-demand gap for organs for transplantation grows, transplant programs are more accepting of less healthy donors. This chapter focuses on the extreme case: whether and when individuals who have life-limiting conditions (LLC) should be considered for living organ donation. Two types of cases are examined: living donation by individuals with advanced progressive severe debilitating disease for whom there is no ameliorative therapy; and pre-mortem living donation by individuals who are imminently dying or would die of the donation process itself. With appropriate safeguards, some donations by individuals with LLC could be ethical. Pre-mortem donations challenge the dead donor rule (DDR), an ethical norm that prohibits organ procurement until after the individual is dead. The chapter argues that attempts to circumvent the DDR fail to respect the living donor as a patient in his or her own right.

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

2019 ◽  
Vol 20 (3) ◽  
pp. 163-173 ◽  
Author(s):  
Lila de Tantillo ◽  
Juan M. González ◽  
Johis Ortega
Keyword(s):  
United States ◽  
Health Care ◽  
Organ Donation ◽  
Brain Function ◽  
The United States ◽  
Health Care Facilities ◽  
Donation After Circulatory Death ◽  
Dead Donor Rule ◽  
The Dead ◽  
Circulatory Death

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.

Living Kidney Donation among Hispanics: A Qualitative Examination of Barriers and Opportunities

2008 ◽  
Vol 18 (4) ◽  
pp. 243-250 ◽  
Author(s):  
Eusebio M. Alvaro ◽  
Jason T. Siegel ◽  
Dana Turcotte ◽  
Nadra Lisha ◽  
William D. Crano ◽  
...  
Keyword(s):  
Organ Donation ◽  
Living Donor ◽  
Hispanic Americans ◽  
Spanish Language ◽  
Living Kidney Donation ◽  
Knowing That ◽  
Living Organ Donation ◽  
Donation Process ◽  
Barriers And Opportunities ◽  
Minimal Research

Context Despite their increasing need for kidneys and low nonliving donation rates, minimal research has been conducted to ascertain the perceptions of Hispanic Americans about living organ donation and the process of asking for such a donation. Objective To examine perceptions of Hispanics regarding barriers to and benefits of living donation as well as the process of asking someone to be a living donor. Design A qualitative study consisting of 10 focus groups conducted in 2 series. Participants Adult Spanish-language-dominant Hispanic members of the general population of Tucson, Arizona. Results The main barriers to living organ donation were a lack of knowledge or information and fear of the donation process. Knowing that one has helped save or improve another's life was the central benefit. Most participants reported being willing to ask a relative to be a living donor if they were ever in need. Two main responses typified these individuals: no concern about asking because of a strong desire to fight for one's health and for one's family, or asking despite difficulties and concerns about the process. A significant minority of participants indicated they would not ask for a donation, because of either a desire to avoid harming others or the expectation that a relative would initiate an offer.

Sign in / Sign up

Export Citation Format

Share Document