Document Detail

Determining Death in Uncontrolled DCDD Organ Donors.
MedLine Citation:
PMID:  23315850     Owner:  NLM     Status:  In-Data-Review    
The most controversial issue in organ donation after the circulatory determination of death is whether the donor was truly dead at the moment death is declared. My colleagues and I further analyzed this issue by showing the relevance of the distinction between the "permanent" and the "irreversible" loss of circulatory functions. Permanent cessation means that circulatory function will not return because it will not be restored spontaneously and medical attempts to restore it will not be conducted. By contrast, irreversible cessation means that circulatory function cannot be restored using currently available technology. In this issue of the Report, Kevin Munjal and colleagues criticize the unjustified application of the permanent-irreversible distinction, which my colleagues and I developed for cDCDD, to their well-designed and carefully conducted experimental protocol of uncontrolled DCDD (uDCDD) in New York City, for which our analysis was not targeted. They claimed that to determine a donor's death in uDCDD, it is unnecessary to show that permanence is a valid surrogate indicator of irreversibility because the unsuccessful attempt to resuscitate the patient comprises prima facie evidence of circulatory irreversibility. Ironically, that potent justification defending death determination in uDCDD yields limitations that are similar to those created when our permanent-irreversible distinction is applied to death determination in cDCDD.
James L Bernat
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Hastings Center report     Volume:  43     ISSN:  0093-0334     ISO Abbreviation:  Hastings Cent Rep     Publication Date:    2013 Jan-Feb
Date Detail:
Created Date:  2013-01-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0410447     Medline TA:  Hastings Cent Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  30-3     Citation Subset:  E; IM    
Copyright Information:
© 2013 by The Hastings Center.
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