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J Med Ethics 2003;29:182-185 doi:10.1136/jme.29.3.182
  • Original Article

Defining death in non-heart beating organ donors

  1. N Zamperetti1,
  2. R Bellomo2,
  3. C Ronco3
  1. 1Department of Anaesthesia and Intensive Care Medicine, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy
  2. 2Department of Intensive Care, Austin & Repatriation Medical Center, Heidelberg, Victoria, Australia
  3. 3Department of Nephrology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy
  1. 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
  • Accepted 17 September 2002
  • Revised 17 September 2002

Abstract

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.

Footnotes

    Responses to this article

    • Response to C. Levyman
      • Nereo Zamperetti,
      • Rinaldo Bellomo and Claudio Ronco
      J Med Ethics published online November 21, 2003
    • The return to the heart definition of death
      • Celio Levyman
      J Med Ethics published online October 7, 2003

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