ORIGINAL ARTICLE

Defining death in non-heart beating organ donors

N Zamperetti¹, R Bellomo² and C Ronco³

¹ Department of Anaesthesia and Intensive Care Medicine, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy
² Department of Intensive Care, Austin & Repatriation Medical Center, Heidelberg, Victoria, Australia
³ Department of Nephrology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy

Correspondence to:
Correspondence to:
Dr N Zamperetti, Department of Anaesthesia and Intensive Care Medicine, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy;
zamperetti.n{at}medicivi.org

Protocols for retrieving vital organs in consenting patients in cardiovascular arrest (non-heart beating donors, NHBD) rest on the assumptions that irreversible asystole a) identifies the instant of biological death, and b) is clinically assessable at the time when retrieval of vital organs is possible. Unfortunately both assumptions are flawed. We argue that traditional life/death definitions could be actually inadequate to represent the reality of dying under intensive support, and we suggest redefining NHBD protocols on moral, social, and antrhopological criteria, admitting that irreversible (however defined) asystole can only equate a clinically determinable point of no return in the process of dying, where organ retrieval can be morally and socially accepted in previously consenting patients.

Keywords: organ donation; definition of death; non-heart beating organ donors

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This article has been cited by other articles:

• Joffe, A. R., Anton, N. R., deCaen, A. R. (2008). Survey of Pediatricians' Opinions on Donation After Cardiac Death: Are the Donors Dead?. Pediatrics 122: e967-e974 [Abstract] [Full Text]  
• Bagheri, A (2007). Individual choice in the definition of death. J. Med. Ethics 33: 146-149 [Abstract] [Full Text]  
• Savulescu, J (2003). Death, us and our bodies: personal reflections. J. Med. Ethics 29: 127-130 [Full Text]  

eLetters:

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The return to the heart definition of death

Celio Levyman

JME Online, 7 Oct 2003 [Full text]

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JME Online, 21 Nov 2003 [Full text]