Defining death: Getting it wrong for all the right reasons

Texas Law Review

Volumn 93, Issue 7, 2015, Pages 1885-1914

  Truog, Robert D ^a  

^a BOSTON CHILDREN S HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84938532366     PISSN: 00404411     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (155)

1. Robert M. Veatch & Lainey F. Ross, Transplantation Ethics 45 (2015) (mentioning that public-policy debates regarding transplantation and the definition of death began in the 1960s after the first successful transplant).
2. John A. Robertson, The Dead Donor Rule, Hastings Center Rep., Nov.-Dec. 1999, at 6, 6 (identifying the dead donor rule-"the ethical and legal rule that requires that donors not be killed in order to obtain their organs"-as one of the factors preventing cadaveric organ donations from being sufficient to meet the needs of persons with end-stage organ disease).
3. John A. Robertson, The Dead Donor Rule, Hastings Center Rep., Nov.-Dec. 1999, at 6, 6 (identifying the dead donor rule-"the ethical and legal rule that requires that donors not be killed in order to obtain their organs"-as one of the factors preventing cadaveric organ donations from being sufficient to meet the needs of persons with end-stage organ disease).
4. Noting the relationship between the DDR and the laws and norms against homicide.
5. C.N. Barnard, The Operation: A Human Cardiac Transplant: An Interim Report of a Successful Operation Performed at Groote Schuur Hospital, Cape Town, 41 S. Afr. Med. J. 1271, 1271 (1967).
6. Christiaan Barnard, Reflections on the First Heart Transplant, 72 S. Afr. Med. J. xix, xix (1987) [hereinafter Barnard, Reflections] (describing the medical advances and steps that led Dr. Barnard to perform the first heart transplant).
7. Ad Hoc Comm. of the Harvard Med. Sch. to Examine the Definition of Brain Death, A Definition of Irreversible Coma, 205 JAMA 337, 337 (1968) [hereinafter A Definition] (examining the criteria for irreversible coma in part because "obsolete criteria for the definition of death can lead to controversy in obtaining organs for transplantation").
8. William H. Colby, Unplugged: Reclaiming Our Right to DIE IN America 74 (2006) (recounting the Dean's involvement in the formation of the Harvard Brain Death Committee and the subsequent report).
9. Ad Hoc Comm. of the Harvard Med. Sch. to Examine the Definition of Brain Death, A Definition of Irreversible Coma, 205 JAMA 337, 337 (1968) [hereinafter A Definition] (examining the criteria for irreversible coma in part because "obsolete criteria for the definition of death can lead to controversy in obtaining organs for transplantation").
10. C.N. Barnard, The Operation: A Human Cardiac Transplant: An Interim Report of a Successful Operation Performed at Groote Schuur Hospital, Cape Town, 41 S. Afr. Med. J. 1271, 1271 (1967).
11. President's Comm'n for the Study of Ethical Problems in Med. & Biomedical & Behavioral Research, Defining Death: A Report on the Medical. Legal and Ethical Issues in the Determination of Death 62 (1981).
12. Unif. Determination of Death Act (1980).
13. Ray D. Madoff. Immortality and The Law: The Rising Power of The American Dead 37 (2010) (noting that forty-three states have adopted the Uniform Definition of Death Act, while the other seven have adopted similar statutes or case law).
14. Unif. Determination of Death Act § 1 (1980).
15. D. W. McKeown et al., Management of the Heartbeating Brain-Dead Organ Donor, 108 Brit. J. Anaesthesia (Supplement 1) 196, i96 (2012).
16. A. R. Manara et al., Donation After Circulatory Death, 108 Brit. J. Anaesthesia (Supplement 1) i108, i108 (2012) (noting that DCD uses circulatory criteria for determining death whereas donation after brain death uses neurological criteria for determining death).
17. Dick Teresi, The Beating Heart Donors, Discover, May 2012, at 36, 40 (explaining that beating-heart cadavers are preferable for organ harvesting due to continual circulation of oxygen to the organs up to the point of removal).
18. Paul G Murphy, Optimizing Donor Potential in the UK, 6 Clinical Ethics 127, 127 (2011) ("The [after-brain-death] donor can offer heart, lung, liver, kidney, small bowel and pancreas for transplantation, and is viewed as the favoured donor by retrieval and transplantation teams.").
19. Srikanth Reddy et al., Liver Transplantation from Non-Heart-Beating Donors: Current Status and Future Prospects, 10 Liver Transplantation 1223, 1225 (2004).
20. Describing the problems associated with "prolonged warm ischemia" in non-heart-beating donors but stating that there is considerably more clinical experience with kidney transplantation in these donors.
21. Comm. on Non-Heart-Beating Transplantation II, Inst. of Med., NonHeart-Beating Organ Transplantation 8 (2000) [hereinafter Non-Heart-BEATING Organ Transplantation] (asserting that brain-dead donors have all but replaced DCD donors because of "improved outcomes").
22. Unif. Determination of Death Act § 1 (1980).
23. Med. Consultants on the Diagnosis of Death to the President's Comm. for the Study of Ethical Problems in Med. & Biomedical & Behavioral Research, Guidelines for the Determination of Death, 246 JAMA 2184, 2184-86 (1981).
24. Eelco F.M. Wijdicks, The Diagnosis of Brain Death, 344 New Eng. J. Med. 1215, 1215-18 (2001) (explaining the steps of a clinical examination to determine brain death).
25. Contending that determination of brain death must be based on, "neuroimaging … [and] confirmatory laboratory tests".
26. Eelco F.M. Wijdicks et al., Evidence-Based Guideline Update: Determining Brain Death in Adults, 74 Neurology 1911, 1914-16 (2010) [hereinafter Wijdicks, Evidence-Based Guideline Update] (detailing a brain-deathevaluation protocol).
27. Unif. Determination of Death Act § 1 (1980).
28. Eelco F.M. Wijdicks et al., Evidence-Based Guideline Update: Determining Brain Death in Adults, 74 Neurology 1911, 1914-16 (2010) [hereinafter Wijdicks, Evidence-Based Guideline Update] (detailing a brain-deathevaluation protocol).
29. Amir Halevy & Baruch Brody, Brain Death: Reconciling Definitions, Criteria, and Tests, 119 Annals Internal Med. 519, 520-21 (1993) (discussing the tension between the legal criterion and the standard clinical tests).
30. Robert D. Truog, Is It Time to Abandon Brain Death?, Hastings Center Rep., Jan.-Feb. 1997, at 29, 29 [hereinafter Truog, Is It Time to Abandon Brain Death?] ("[T]here is evidence that many individuals who fulfill all of the tests for brain death do not have the permanent cessation of functioning of the entire brain." (internal quotation marks omitted)).
31. Robert D. Truog, Brain Death-Too Flawed to Endure, Too Ingrained to Abandon, 35 J.L. Med. & Ethics 273, 273-78 (2007) [hereinafter Truog, Brain Death] (critiquing the existing "brain death" standard).
32. Robert D. Truog, Is It Time to Abandon Brain Death?, Hastings Center Rep., Jan.-Feb. 1997, at 29, 29 [hereinafter Truog, Is It Time to Abandon Brain Death?] ("[T]here is evidence that many individuals who fulfill all of the tests for brain death do not have the permanent cessation of functioning of the entire brain." (internal quotation marks omitted)).
33. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
34. David J Powner et al., Medical Diagnosis of Death in Adults: Historical Contributions to Current Controversies, 348 Lancet 1219, 1219 (1996) (reviewing the history of medical conceptions of death from the eighteenth century to modern day).
35. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
36. Steven J. Cooper, From Claude Bernard to Walter Cannon. Emergence of the Concept of Homeostasis, 51 Appetite 419, 420 (2008).
37. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
38. Leon R. Kass, Death as an Event: A Commentary on Robert Morison, 173 SCIENCE 698, 699-700 (1971) (arguing for an understanding of death as an event rather than a process).
39. Mark Harries, ABC of Resuscitation Near Drowning, 327 BMJ 1336, 1336 (2003).
40. Greg Johnson, Reviving the Dead, Penn Current, Jan. 20, 2011, http://www.upenn.edu/pennnews/current/node/3348.
41. archived at http://perma.cc/5PER-W6RS (describing the small window for resuscitation and suggesting that resuscitation at fifteen minutes of pulselessness is uncommon).
42. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
43. Suggesting the use of permanent loss of functioning of the whole brain as the criterion for death of an organism because once total brain failure occurs, vital subsystems quickly fail.
44. D. Alan Shewmon, Chronic "Brain Death": Meta-Analysis and Conceptual Consequences, 51 Neurology 1538, 1540 (1998) [hereinafter Shewmon, Chronic "Brain Death"].
45. Lois Romano, Riding Accident Paralyzes Actor Christopher Reeve, Wash. Post, June 1, 1995, at A1, available at http://www.washingtonpost.com/wp-dyn/articles/A99660-1995Jun1.html.
46. archived at http://perma.cc/BCY6-82CB.
47. DA Shewmon, Spinal Shock and 'Brain Death': Somatic Pathophysiological Equivalence and Implications for the Integrative-Unity Rationale, 37 Spinal Cord 313, 313-14 (1999) [hereinafter Shewmon, Spinal Shock and 'Brain Death'] (comparing the similarities in the body's response to acute spinal-cord injuries with brain death).
48. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
49. Compare D. Alan Shewmon, "Brainstem Death," "Brain Death" and Death: A Critical Re-Evaluation of the Purported Equivalence, 14 Issues L. & Med. 125, 141 (1998).
50. Compare D. Alan Shewmon, "Brainstem Death," "Brain Death" and Death: A Critical Re-Evaluation of the Purported Equivalence, 14 Issues L. & Med. 125, 141 (1998).
51. E Garshick et al., A Prospective Assessment of Mortality in Chronic Spinal Cord Injury, 43 Spinal Cord 408, 410 tbl.1 (2005) (reporting the results of a study of mortality in patients with spinal-cord injuries showing that 324 of the 361 patients studied survived their injury).
52. Jacque Wilson & Jen Christensen, Why Brain Dead Means Really Dead, CNN (Jan. 7, 2014), http://www.cnn.com/2014/01/06/health/brain-dead-basics/.
53. archived at http://perma.cc/8JQX-BG4W (quoting a doctor's assertion that "[n]o one who has met the criteria for brain death has ever survived").
54. Robert D. Truog & Franklin G. Miller, The Meaning of Brain Death: A Different View, 174 JAMA Intern. Med. 1215, 1216 (2014).
55. Jacque Wilson & Jen Christensen, Why Brain Dead Means Really Dead, CNN (Jan. 7, 2014), http://www.cnn.com/2014/01/06/health/brain-dead-basics/.
56. archived at http://perma.cc/8JQX-BG4W (quoting a doctor's assertion that "[n]o one who has met the criteria for brain death has ever survived").
57. Susan Repertinger et al., Long Survival Following Bacterial Meningitis-Associated Brain Destruction, 21 J. Child Neurology 591, 591-92 (2006).
58. Lee Romney, Tests Show Jahi McMath has Brain Activity, Lawyer Says, L.A. Times, Oct. 2, 2014, http://www.latimes.com/local/lanow/la-me-ln-medical-experts-jahi-mcmath-20141002-story.html.
59. archived at http://perma.cc/5BJA-RSQ7.
60. Robert D. Truog & Franklin G. Miller, The Meaning of Brain Death: A Different View, 174 JAMA Intern. Med. 1215, 1216 (2014).
61. Jason Wells, Jahi McMath's Mother Insists Brain-Dead Girl Is 'Not a Corpse,' L.A. Times, Feb. 21, 2014, http://articles.latimes.com/2014/feb/21/local/la-me-ln-brain-dead-jahi-mcmath-mother-update-20140221.
62. archived at http://perma.cc/9J29-LUKK.
63. Robert D. Truog & Franklin G. Miller, The Meaning of Brain Death: A Different View, 174 JAMA Intern. Med. 1215, 1216 (2014).
64. Liz Szabo, Ethicists Criticize Treatment of Brain-Dead Patients, Nat'l Catholic Rep., Jan. 10, 2014, http://ncronline.org/news/people/ethicists-criticize-treatment-brain-dead-patients.
65. archived at http://perma.cc/37DR-2BKP.
66. Lee Romney, Tests Show Jahi McMath has Brain Activity, Lawyer Says, L.A. Times, Oct. 2, 2014, http://www.latimes.com/local/lanow/la-me-ln-medical-experts-jahi-mcmath-20141002-story.html.
67. Robert S. Olick et al., Accommodating Religious and Moral Objections to Neurological Death, 20 J. Clinical Ethics 183, 184-85 (2009) (describing the protections provided by New York state law when a patient objects to a determination of death based on neurological criteria).
68. Robert S. Olick, Brain Death, Religious Freedom, and Public Policy: New Jersey's Landmark Legislative Initiative, 1 Kennedy Inst. Ethics J. 275, 277-78 (1991) (discussing a New Jersey law providing for a religious exemption to marking the uniform standard of death at the point of neurological death).
69. Ben A. Rich, Structuring Conversations on the Fact and Fiction of Brain Death, Am. J. Bioethics, Aug. 2014, at 31, 32.
70. Associated Press, Jahi McMath Remains on Ventilator in 'Home Environment' One Year After Being Declared Brain Dead, N.Y. Daily News (Dec. 12, 2014, 10:25 AM), http://www.nydailynews.com/life-style/health/jahi-mcmath-remains-ventilator-year-article-1.2042930.
71. archived at http://perma.cc/VCW8-MDN7.
72. Declaration of Calixto Machado, M.D., PhD, in Support of Plaintiff's Writ of Error at 6, McMath, No. RP13-707598 (Cal. Super. Ct. Alameda Cnty. Dec. 30, 2013), available at http://thaddeuspope.com/images/2014-10-14_Signed_Declaration_of_Dr_Calixto_Machado.pdf.
73. archived at http://perma.cc/M3V7-42H8.
74. Declaration of D. Alan Shewmon, Professor Emeritus of Neurology & Pediatrics, David Geffen Sch. of Med. at UCLA, to Christopher B. Dolan (Oct. 3, 2014), available at http://thaddeuspope.com/images/declaration_of_D_Alan_Shewmon,_2014-10-03.pdf.
75. archived at http://perma.cc/9949-KD3Y.
76. Liz Szabo, Ethicists Criticize Treatment of Brain-Dead Patients, Nat'l Catholic Rep., Jan. 10, 2014, http://ncronline.org/news/people/ethicists-criticize-treatment-brain-dead-patients.
77. archived at http://perma.cc/37DR-2BKP.
78. Margaret Lock, Twice Dead: Organ Transplants and the REINVENTION OF Death 243-44 (2002).
79. Alan Lane et al., Maternal Brain Death: Medical, Ethical, and Legal Issues, 30 Intensive Care Med. 1484, 1485 (2004) (describing a case of maternal brain death during pregnancy).
80. David J. Powner & Ira M. Bernstein, Extended Somatic Support for Pregnant Women After Brain Death, 31 Critical Care Med. 1241, 1241 (2003) (citing one organ-procurement program as discovering seven pregnant women among a group of brain-dead donors over a sixyear period).
81. David J Powner et al., Medical Diagnosis of Death in Adults: Historical Contributions to Current Controversies, 348 Lancet 1219, 1219 (1996) (reviewing the history of medical conceptions of death from the eighteenth century to modern day).
82. Jeffrey L. Ecker, Death in Pregnancy-An American Tragedy, 370 New Eng. J. Med. 889, 889-90 (2014).
83. Julie Gordon, Brain-Dead Canadian Woman Dies After Baby Boy Born, Reuters, Feb. 11, 2014, available at http://www.reuters.com/article/2014/02/11/canada-pregnantidUSL2N0LG1B8 20140211.
84. archived at http://perma.cc/NXE7-BP9Z.
85. Margaret Lock, Twice Dead: Organ Transplants and the REINVENTION OF Death 243-44 (2002).
86. D. Alan Shewmon, The Brain and Somatic Integration: Insights into the Standard Biological Rationale for Equating "Brain Death" with Death, 26 J. Med. & Phil. 457, 467-68 (2001).
87. Margaret Lock, Twice Dead: Organ Transplants and the REINVENTION OF Death 243-44 (2002).
88. Robert M. Veatch, The Whole-Brain-Oriented Concept of Death: An Outmoded Philosoph-ical Formulation, 3 J. Thanatology 13, 15 (1975).
89. Robert M. Veatch, The Impending Collapse of the Whole-Brain Definition of Death, Hastings Center Rep., July-Aug. 1993, at 18, 18-19 (1993).
90. Martin M. Monti et al., Willful Modulation of Brain Activity in Disorders of Consciousness, 362 New Eng. J. Med. 579, 580, 588 (2010) (observing that the rate of misdiagnosis of consciousness disorders is approximately 40% and advocating the use of functional magnetic resonance imaging to improve accuracy).
91. Adrian M. Owen et al., Detecting Awareness in the Vegetative State, 313 Science 1402, 1402 (2006) (recommending the use of functional neuroimaging to detect "conscious awareness in patients who are assumed to be vegetative yet retain cognitive abilities that have evaded detection using standard clinical methods").
92. Fred Charatan, Autopsy Supports Claim that Schiavo Was in a Persistent Vegetative State, 330 BMJ 1467, 1467 (2005).
93. George J. Annas, "Culture of Life" Politics at the Bedside-The Case of Terri Schiavo, 352 New Eng. J. Med. 1710, 1710 (2005).
94. Eelco F.M. Wijdicks et al., Evidence-Based Guideline Update: Determining Brain Death in Adults, 74 Neurology 1911, 1914-16 (2010) [hereinafter Wijdicks, Evidence-Based Guideline Update] (detailing a brain-deathevaluation protocol).
95. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
96. Compare D. Alan Shewmon, "Brainstem Death," "Brain Death" and Death: A Critical Re-Evaluation of the Purported Equivalence, 14 Issues L. & Med. 125, 141 (1998).
97. Franklin G. Miller & Robert D. Truog, Rethinking the Ethics of Vital Organ Donations, Hastings Center Rep., Nov.-Dec. 2008, at 38, 40 (arguing that withdrawing ventilation or life support "causes a patient's death").
98. President's Council on Bioethics, Controversies in the DETERMINATION OF Death, at xix (2008) [hereinafter Controversies in the Determination of Death].
99. Franklin G. Miller & Robert D. Truog, The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President's Council on Bioethics, 19 Kennedy Inst. Ethics J. 185, 188-89 (2009) (criticizing the Council's explication of the "vital work" criteria).
100. President's Council on Bioethics, Controversies in the DETERMINATION OF Death, at xix (2008) [hereinafter Controversies in the Determination of Death].
101. Comm. on Non-Heart-Beating Transplantation II, Inst. of Med., NonHeart-Beating Organ Transplantation 8 (2000) [hereinafter Non-Heart-BEATING Organ Transplantation] (asserting that brain-dead donors have all but replaced DCD donors because of "improved outcomes").
102. James L. Bernat et al., Report of a National Conference on Donation After Cardiac Death, 6 Am. J. Transplantation 281 (2006).
103. James L. Bernat, Are Organ Donors After Cardiac Death Really Dead?, 17 J. CLINICAL Ethics 122, 123 (2006).
104. Comm. on Non-Heart-Beating Transplantation II, Inst. of Med., NonHeart-Beating Organ Transplantation 8 (2000) [hereinafter Non-Heart-BEATING Organ Transplantation] (asserting that brain-dead donors have all but replaced DCD donors because of "improved outcomes").
105. James L. Bernat et al., The Circulatory-Respiratory Determination of Death in Organ Donation, 38 Critical Care Med. 963, 966 (2010).
106. Srikanth Reddy et al., Liver Transplantation from Non-Heart-Beating Donors: Current Status and Future Prospects, 10 Liver Transplantation 1223, 1225 (2004).
107. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
108. Greg Johnson, Reviving the Dead, Penn Current, Jan. 20, 2011, http://www.upenn.edu/pennnews/current/node/3348.
109. archived at http://perma.cc/5PER-W6RS (describing the small window for resuscitation and suggesting that resuscitation at fifteen minutes of pulselessness is uncommon).
110. James L. Bernat, How the Distinction Between "Irreversible" and "Permanent" Illuminates Circulatory-Respiratory Death Determination, 35 J. Med. & Phil. 242, 251 (2010).
111. Srikanth Reddy et al., Liver Transplantation from Non-Heart-Beating Donors: Current Status and Future Prospects, 10 Liver Transplantation 1223, 1225 (2004).
112. K. Hornby et al., A Systematic Review of Autoresuscitation After Cardiac Arrest, 38 Critical Care Med. 1246, 1250 (2010) (documenting that there are no studies reporting autoresuscitation in the absence of CPR).
113. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
114. Robert D. Truog & Franklin G. Miller, Counterpoint: Are Donors After Circulatory Death Really Dead, and Does It Matter? No and Not Really, 138 Chest 16, 16-17 (2010).
115. D. Gareth Jones, The Emergence of Persons, in From Cells to Souls-AND Beyond: Changing Portraits of Human Nature 11, 16-20 (Malcolm Jeeves ed., 2004) (describing the conflict between "biological" and "personalist" conceptions of death and taking the position that a personalist view is more compelling in the context of human existence).
116. Stuart J. Youngner & Robert M. Arnold, Philosophical Debates About the Definition of Death: Who Cares?, 26 J. Med. & Phil. 527, 532 (2001) (noting that "the definition and determination of death in our culture remains firmly embedded in a biological (as opposed to a spiritual, magical, or social) understanding of the world").
117. Unif. Determination of Death Act § 1 (1980).
118. James L. Bernat, Life or Death for the Dead-Donor Rule?, 369 New Eng. J. Med. 1289, 1291 (2013) ("[T]he DDR is an indispensable ethical protection for dying patients who plan to donate organs and one that strengthens public trust and confidence in our voluntary system of organ donation.").
119. John Robertson, Should We Scrap the Dead Donor Rule?, Am. J. Bioethics, Aug. 2014, at 52, 52 (warning of the implications of "scrapping the DDR in wholebrain death and [circulatory death]").
120. James L. Bernat et al., On the Definition and Criterion of Death, 94 Annals INTERNAL Med. 389, 389 (1981).
121. Robert D. Truog & Franklin G. Miller, The Dead Donor Rule and Organ Transplantation, 359 New Eng. J. Med. 674, 674 (2008) ("the reason [removing vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death] is ethical cannot be that we are convinced they are really dead").
122. Robert D. Truog et al., The Dead-Donor Rule and the Future of Organ Donation, 369 New Eng. J. Med. 1287, 1288 (2013) ("Allegiance to the DDR thus limits the procurement of transplantable organs by denying some patients the option to donate in situations in which death is imminent and donation is desired.").
123. President's Council on Bioethics, Controversies in the DETERMINATION OF Death, at xix (2008) [hereinafter Controversies in the Determination of Death].
124. Predicating a new justification for brain death on "the work of the organism as a whole".
125. Discussing the theoretical problem posed by the fact that some DCD donors could technically be resuscitated after withdrawal of life support, but ultimately coming to no definitive conclusions.
126. Darshak Sanghavi, When Does Death Start?, N.Y. Times Mag., Dec. 16, 2009, http://www.nytimes.com/2009/12/20/magazine/20organ-t.html?pagewanted=all&_r=1&.
127. archived at http://perma.cc/V2R6-UVK4.
128. Franklin G. Miller & Robert D. Truog, Death, Dying, and Organ TRANSPLANTATION 115 (2012).
129. Council on Ethical & Judicial Affairs, Am. Med. Ass'n, Code of MEDICAL Ethics of the American Medical Association: Current Opinions and ANNOTATIONS § 2.15 (2014) (delineating the protocols in place to ensure the donor's decision is voluntary and harm is minimized).
130. Requiring that medical staff identify "any serious risk to the potential donor's life or health" before "determin[ing] whether a potential living donor is an appropriate candidate".
131. David C. Magnus et al., Accepting Brain Death, 370 New Eng. J. Med. 891, 893 (2014).
132. Norman Fost, Reconsidering the Dead Donor Rule: Is it Important that Organ Donors Be Dead?, 14 Kennedy Inst. Ethics J. 249, 254 (2004) (noting "the reluctance of many transplant surgeons even to discuss in public the possibility of challenging the dead donor rule" due to strong public opinion in favor of the DDR).
133. Michael Nair-Collins et al., Abandoning the Dead Donor Rule? A National Survey of Public Views on Death and Organ Donation, 41 J. Med. Ethics 297, 298 (2015).
134. Tracy C. Schmidt, The Ohio Study in Light of National Data and Clinical Experience, 14 Kennedy Inst. Ethics J. 235, 236 (2004) (finding respondents in a national study were "consistent[ly] willing[]" to donate organs of persons who were severely injured but not brain-dead).
135. Laura A. Siminoff et al., Death and Organ Procurement: Public Beliefs and Attitudes, 14 Kennedy Inst. Ethics J. 217, 229 (2004) ("In any given scenario, 9.3 to 22.6 percent of respondents … would donate the organs of a person they had previously classified as living.").
136. 149 U.S. 304 (1893).
137. Seema K. Shah & Franklin G. Miller, Can We Handle the Truth? Legal Fictions in the Determination of Death, 36 Am. J.L. & Med. 540, 542 (2010) [hereinafter Shah & Miller, Determination of Death].
138. Seema K Shah, Robert D Truog & Franklin G Miller, Death and Legal Fictions, 37 J. Med. Ethics 719, 719 (2011) [hereinafter Shah, Truog & Miller, Death and Legal Fictions].
139. R. Alta Chara, Dusk, Dawn, and Defining Death: Legal Classifications and Biological Categories, in The Definition of Death: Contemporary Controversies 277 (Stuart J. Youngner et al. eds., 1999) (surveying various categories of legal fictions that "ignore[] or misconstrue[] biological facts to achieve some public purpose").
140. Seema K Shah, Robert D Truog & Franklin G Miller, Death and Legal Fictions, 37 J. Med. Ethics 719, 719 (2011) [hereinafter Shah, Truog & Miller, Death and Legal Fictions].
141. 42 U.S.C. § 416(i)(1)(B) (2012) (defining blindness to be "visual acuity of 20/200 or less in the better eye with the use of a correcting lens," for the purposes of Social Security disability insurance benefits).
142. 42 U.S.C. § 1382c(a)(2) (2012) (defining blindness to be the same for purposes of Social Security supplemental income for aged, blind, and disabled persons).
143. Seema K Shah, Robert D Truog & Franklin G Miller, Death and Legal Fictions, 37 J. Med. Ethics 719, 719 (2011) [hereinafter Shah, Truog & Miller, Death and Legal Fictions].
144. Darshak Sanghavi, When Does Death Start?, N.Y. Times Mag., Dec. 16, 2009, http://www.nytimes.com/2009/12/20/magazine/20organ-t.html?pagewanted=all&_r=1&.
145. Rob Stein, A Struggle to Define "Death" for Organ Donors, Shots, NPR (Mar. 28, 2012, 10:30 AM), http://www.npr.org/blogs/health/2012/03/27/149463045/a-struggle-to-define-death-for-organ-donors.
146. archived at http://perma.cc/SJ37-SU52 (discussing various points of view and issues surrounding how death is defined for organdonation purposes).
147. Nancy Norton Reitz & Clive O. Callender, Organ Donation in the African-American Population: A Fresh Perspective with a Simple Solution, 85 J. Nat'l Med. Ass'n 353, 354, 356 (1993) (listing "distrust of the medical community" as one of several reasons that African-Americans have significantly lower organ-donation rates and finding that the low donation rates are related to both race and class).
148. Umberto Maggiore et al., Strategies to Increase the Donor Pool and Access to Kidney Transplantation: An International Perspective, 30 Nephrology DIALYSIS Transplantation 217, 220-21 (2015) (discussing variations of DCD donation methods as a viable way to increase total organ donations).
149. Organ Procurement and Transplantation Network, U.S. Department Health & Hum. Services, http://optn.transplant.hrsa.gov.
150. archived at http://perma.cc/A8AU-Y8SW (showing the growing gap between organs donated and organs needed in the United States).
151. Thomas I. Cochrane, Letter to the Editor, Hastings Center Rep., May-June 2009, at 5, 5.
152. Robert M. Sade & Andrea D. Boan, The Paradox of the Dead Donor Rule: Increasing Death on the Waiting List, Am. J. Bioethics, Aug. 2014, at 21, 21-22.
153. Thomas S. Kuhn, The Structure of Scientific Revolutions 42 (2d ed. 1970) (positing that the scientist's concern for precision in understanding the world necessarily leads to scrutiny of himself and his peers).
154. Asserting that the scientific enterprise can "open up new territory, display order, and test long-accepted belief".
155. Mark Yarborough, Openness in Science is Key to Keeping Public Trust, 515 Nature 313, 313 (2014) (advocating for transparency and for scientists to question the status quo in order to secure the public's support and trust in the scientific enterprise).