Death determination and donation after circulatory death: Can physicians reconcile cardiorespiratory death and irreversible loss of brain function?

Clinical Ethics 16 (4):307-314 (2021)
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Abstract

Declaration of cardiorespiratory death, as defined by the Uniform Determination of Death Act, requires irreversible cessation of circulatory and respiratory function. A physician’s ability to confidently declare death is paramount because death is both a biological and social construct, and can afford a dying patient the opportunity to be an organ donor via donation after circulatory death. Inconsistencies related to cardiorespiratory death and DCD include the specific language used in the UDDA, specifically the use of the word “irreversible”. Additionally, in DCD there is a large focus on the auto-resuscitative capacity of the heart, however recently some have argued that instead the focus should shift to the brain and a determination of how long it needs to be without circulation to cease functioning prior to declaring death. In this paper, I discuss inconsistencies with cardiorespiratory death as they pertain to organ donation and posit several possible solutions to mitigate these inconsistencies.

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References found in this work

Changing the Conversation About Brain Death.Robert D. Truog & Franklin G. Miller - 2014 - American Journal of Bioethics 14 (8):9-14.
The Dead Donor Rule.John A. Robertson - 1999 - Hastings Center Report 29 (6):6.
Delimiting the Donor: The Dead Donor Rule.John A. Robertson - 1999 - Hastings Center Report 29 (6):6-14.
A Defense of the Dead Donor Rule.David Magnus - 2018 - Hastings Center Report 48 (S4):36-38.

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