title: The anencephalic organ donor: a challenge to existing moral and statutory laws.
abstract: OBJECTIVE
  To inform physicians of the critical shortage of neonatal heart donors and to provide arguments for and against selecting brain-absent anencephalics as heart donors for brain-normal infants who are dying of hypoplastic left heart syndrome.
  
  
  METHODS
  International scientific journals of medicine, genetics, epidemiology, bioethics, and public health; adjudicated U.S. civil court cases; and state regulations and statutes.
  
  
  METHODS
  Worldwide experience with anencephalics as homologous organ donors.
  
  
  METHODS
  Demographic and epidemiologic data on anencephalic births and natural histories; U.S. civil, district, and appellate court case decisions directing or prohibiting organ donation; state determination-of-death acts; state uniform-anatomical-gift acts.
  
  
  RESULTS
  Organization of all data into either moral challenges or legal challenges to anencephalic organ donation.
  
  
  CONCLUSIONS
  Statutory laws pose a greater challenge to anencephalic organ donation than moral laws. Case law reviews eliminate substituted judgment rulings in directing anencephalic organ donation. A redefinition of brain death applying only to human beings born without a brain would make more donor hearts available to brain-normal infants dying of hypoplastic left heart syndrome.
authors.affiliation: Department of Anesthesiology/Critical Care Medicine, Ochsner Clinic, New Orleans, LA 70121.
authors.forename: J H
authors.initials: JH
authors.lastname: Diaz
mesh_terms: D000757:Anencephaly / Q000175:diagnosis / Q000453:epidemiology; D001926:Brain Death / Q000175:diagnosis / Q000331:legislation & jurisprudence; D028601:Euthanasia, Active; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009014:Morals; D028723:Personhood; D011247:Pregnancy; D011296:Prenatal Diagnosis; D014019:Tissue Donors / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D035761:Wedge Argument