The anencephalic organ donor: a challenge to existing moral and statutory laws.
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.
Diaz
J H
JH
Department of Anesthesiology/Critical Care Medicine, Ochsner Clinic, New Orleans, LA 70121.
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