Are DCD donors dead?

Hastings Center Report

Volumn 40, Issue 3, 2010, Pages 24-31

  Marquis, Don ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DEATH; DONOR; ETHICS; HUMAN; LIVING WILL; RESUSCITATION; STANDARD; TIME; TRANSPLANTATION;

ADVANCE DIRECTIVE ADHERENCE; DEATH; HUMANS; RESUSCITATION ORDERS; TIME FACTORS; TISSUE AND ORGAN HARVESTING; TISSUE DONORS;

EID: 77953590871     PISSN: 00930334     EISSN: 1552146X     Source Type: Journal    
DOI: 10.1353/hcr.0.0270     Document Type: Article

References (27)

1. J.M. Drazen, "Cardiac Transplantation in Infants," New England Journal of Medicine 359 (2008): 749-750
2. M.M. Boucek et al., "Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death," New England Journal of Medicine 359 (2008): 709-714.
3. J. Bernat et al., "Report of a National Conference on Donation after Cardiac Death," American Journal of Transplantation 6 (2006): 281-291
4. Jim Bernat pointed out this to me in conversation. See his "The Boundaries of Organ Donation after Circulatory Death," in New England Journal of Medicine 359 (2008): 669-671, and the discussion in Curfman, Morissey, and Drazen, "Cardiac Transplantation in Infants."
5. There are reasons for skepticism concerning both the dead donor rule and this definition of death. However, I shall take both for granted in the main analysis of this essay.
6. R.M. Veatch, "Donating Hearts after Cardiac Death - Reversing the Irreversible," New England Journal of Medicine 359 (2008): 672-673
7. J. Robertson, "The Dead Donor Rule," Hastings Center Report 29, no.6 (1999): 12.
8. J. Bernat, C.M. Culver, and B. Gert, "On the Definition and Criterion of Death," Annals of Internal Medicine 94 (1981): 389-394
9. and J. Bernat, "A Defense of the Whole-Brain Concept of Death," Hastings Center Report 28, no.2 (1998): 18.
10. Bernat no longer holds this view. See his "Are Organ Donors After Cardiac Death Really Dead?" Journal of Clinical Ethics 17 (2006): 122-132
11. Others have indicated that in DCD cases, permanence is what counts in declaring death. See M.A. DeVita, "The Death Watch: Certifying Death Using Cardiac Criteria," Progress in Transplantation 11 (2001): 59
12. and Bernat et al., "Report on a National Conference on Donation after Cardiac Death."
13. S.J. Youngner, R.M. Arnold, and M.A. DeVita, "When Is 'Dead'?" Hastings Center Report 29, no.6 (1999): 16
14. quoting with approval T. Tomlinson, "The Irreversibility of Death: Reply to Cole," Kennedy Institute of Ethics Journal 3 (1993): 157.
15. Robertson, "The Dead Donor Rule." The bracketed explanation is mine.
16. Obviously, what counts as "circumstances that could obtain" needs analysis. That difficult analysis would take us too far afield because the subject of this essay is not the nature of dispositional properties.
17. R.M. Veatch, "The Death of Whole-Brain Death: The Plague of the Disaggregators, Somaticists, and Mentalists," Journal of Medicine and Philosophy 30 (2005): 353-378 and elsewhere.
18. T. Tomlinson, "The Irreversibility of Death," 161. My bracketed comment.
19. This is too simple, but the complications are unnecessary here. I believe that a case can be made for the view that we have obligations to those who do not exist now but will exist at a later time, and for the view that we have obligations to those who do not exist now but have existed in the past. These obligations are transtemporal obligations. These special cases concern obligations of existing beings (at one time) to existing beings (at another time). Therefore, they are not counterexamples to the above claim.
20. J.T. Potts, Jr., et al., "Commentary: Clear Thinking and Open Discussion Guide IOM's Report on Organ Donation," Journal of Law, Medicine and Ethics 26 (1998): 167
21. responding to Jerry Menikoff's objections to the DCD protocol in "Doubts About Death: The Silence of the Institute of Medicine," Journal of Law, Medicine and Ethics 26 (1998): 157-165
22. F. Miller and R. Truog, "Rethinking the Ethics of Vital Organ Donations," Hastings Center Report 38, no.6 (2008): 38-46.
23. Bernat, "Are Organ Donors after Cardiac Death Really Dead?"
24. Menikoff, "Doubts about Death: The Silence of the Institute of Medicine."
25. D. Marquis, "Why Abortion Is Immoral," Journal of Philosophy 86 (1989): 183-202.
26. P. Lee and R.P. George, Body-Self Dualism in Contemporary Ethics and Politics (Cambridge, U.K.: Cambridge University Press, 2008), at 82
27. and F.J. Beckwith, Defending Life (Cambridge, U.K.: Cambridge University Press, 2007), at 161-162