The institute of medicine on non-heart-beating organ transplantation

Cambridge Quarterly of Healthcare Ethics

Volumn 17, Issue 1, 2008, Pages 75-86

  Browne, Alister ^a  

^a UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ATTITUDE TO DEATH; BREATHING; CARDIOVASCULAR FUNCTION; DEATH; DECISION MAKING; ETHICS; HUMAN; INFORMED CONSENT; METHODOLOGY; ORGAN TRANSPLANTATION; ORGANIZATION; REVIEW; STANDARD; UNITED STATES;

ATTITUDE TO DEATH; CARDIOVASCULAR PHYSIOLOGY; DEATH; HUMANS; INFORMED CONSENT; INSTITUTE OF MEDICINE (U.S.); JUDGMENT; ORGAN TRANSPLANTATION; RESPIRATION; UNITED STATES;

EID: 37349026340     PISSN: 09631801     EISSN: 14692147     Source Type: Journal    
DOI: 10.1017/S0963180108080080     Document Type: Review

References (28)

1. See further Doig CJ, Rocker G. Retrieving organs from non-heart-beating organ donors: A review of medical and ethical issues. Canadian Journal of Anesthesia 2003;50(10):1069-76.
2. Institute of Medicine. Non-Heart-Beating Organ Transplantation. Washington, D.C.: National Academy Press; 2000.
3. Shermie SD, Baker AJ, Knoll G, Wall W, Rocker G, Howes D, et al. Donation after cardiocirculatory death in Canada. Canadian Medical Association Journal 2006;175(8, suppl.):S1-24. Also available from the Canadian Council for Donation and Transplantation web site at www.ccdt.ca.
4. See note 2, Institute of Medicine 2000:108.
5. Institute of Medicine. Non-Heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement. Washington, D.C.: National Academy Press; 1997.
6. See note 2, Institute of Medicine 2000:24.
7. See note 2, Institute of Medicine 2000:16.
8. See note 2, Institute of Medicine 2000:22.
9. See note 2, Institute of Medicine 2000:21-2.
10. The President's Commission for the Study of Ethical problems in Medicine and Biomedical and Behavioral Research. Defining Death: A Report on the Medical, Legal and Ethical Issues in the Determination of Death. Washington, D.C.: US Government Printing Office; 1981:16-7.
11. See note 2, Institute of Medicine 2000:24. The reference in the quotation is to Menikoff J. Doubts about death: The silence of the Institute of Medicine. Journal of Law, Medicine & Ethics 1998;26:157-65.
12. See note 2, Institute of Medicine 2000:24-5.
13. This analysis of irreversibility was suggested to me by the discussion of absolute concepts in Dretske FI. Knowledge and the Flow of Information. Cambridge, Mass: The MIT Press; 1981:107-11.
14. Nor is this just my ear. Similar linguistic intuitions are expressed, for example, by Younger SJ and Arnold RM. Non-heart-beating cadavers: The beat goes on. In: Spielman B, ed. Organ and Tissue Donation: Ethical, Legal, and Policy Issues. Carbondale and Edwardsville: Southern Illinois University Press; 1996:73; note 12, Menikoff 1998:158;
15. Brock DW. The role of the public in public policy on the definition of death. In: Younger SJ, Arnold RM, Schapiro R, eds. The Definition of Death: Contemporary Controversies. Baltimore, Md.: The Johns Hopkins Press; 1999:297-9.
16. It is sometimes denied that irreversibility is part of the meaning of death. See, for example, Cole DJ. The reversibility of death. Journal of Medical Ethics 1992;18(1):26-30. This does not seem right. It is true that some dictionaries (e.g., the Concise Oxford) make no mention of irreversibility in the definition of death. But others (e.g., the OED, New Shorter Oxford, Webster's New World, Collins) variously define death as the "final" or "irreversible" or "permanent" end of life. The fact is that sometimes we allow death to be reversible, as in miracle or medical stories of people "coming back from death." But in other contexts, as in the present one, where calling someone dead has behavioral significance, ordinary language requires us to treat death as an irreversible state.
17. See note 3, Shermie et al. 2006:S6.
18. Public surveys on whether non-heart-beating transplantation will adversely affect the process of providing optimal end-of-life care will also be invalidated by the absence of this information. For a fine-print understanding of the criteria for the determination of death may well make a difference to people's perceptions of the quality of end-of-life care.
19. Kant I. Foundations of the Metaphysics of Morals. Royal Prussian Academy edition. Berlin: G. Reimer; 1902-1942:429.
20. Mill JS. On Liberty. London; 1859:Ch. 1, para. 9.
21. The classic statement of this is Meiklejohn A. Political Freedom. Part One: Free Speech and its Relation to Self-Government. New York: Oxford University Press; 1965:3-28. See also note 14, Brock 1999;303-4.
22. This has been long acknowledged in the utilitarian tradition. See Sidgwick H. The Methods of Ethics, 7th ed. London: MacMillan & Co. Ltd; 1907, 1962:429-30.
23. See note 11, Menikoff 1998:162, and the references in footnotes 53 and 54 of his article.
24. See note 2, Institute of Medicine 2000:18, 24.
25. For an exposition and critique of the Kansas statute, see Capron A, Kass L. A statutory definition of the standards for determining human death: An appraisal and a proposal. University of Pennsylvania Law Review 1972;121(87): esp. sect. VI, 108-11.
26. Truog R. Is it time to abandon brain death? Hastings Center Report 1997;27(1):34-5.
27. Burt RA. Where do we go from here? In: Younger SJ, Arnold RM, Schapiro R, eds. The Definition of Death: Contemporary Controversies. Baltimore, Md.: The Johns Hopkins Press; 1999:335. For a helpful discussion of Burt's article and the possibility of deception see note 14, Brock 1999:293-307.
28. See note 2, Institute of Medicine 2000:26.