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The Institute of Medicine on Non-Heart-Beating Organ Transplantation

Published online by Cambridge University Press:  18 December 2007

ALISTER BROWNE
Affiliation:
Faculty of Medicine, University of British Columbia, and Vancouver Hospital and GF Strong & George Pearson Centres

Extract

The current main source of transplantable organs is from heart-beating donors. These are patients who have suffered a catastrophic brain injury, been ventilated, declared dead by neurological criteria, and had their vital functions maintained mechanically until the point of transplantation. But the demand for organs far outstrips the supply, and these patients are not the only potential donors. The idea behind non-heart-beating transplantation is to expand the donor pool by including in it patients who are in hopeless conditions but who are not dying because of brain injury and hence will not suffer the neurological death necessary to become heart-beating donors. As long as we continue to hold the so-called dead donor rule, according to which dying donors cannot have their organs taken before they are dead, this requires that death be able to be declared by alternative criteria, specifically by cardiopulmonary criteria. The challenge is to find such criteria that will identify a state that the public will readily recognize as death and that will facilitate non-heart-beating transplantation.I am grateful to Don Brown for encouragement, advice, and stimulating discussion and to Michael Feld for reminding me just how resilient a theory utilitarianism is.

Type
SPECIAL SECTION: OPEN FORUM
Copyright
© 2008 Cambridge University Press

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