title: Abandoning the dead donor rule? A national survey of public views on death and organ donation.
abstract: Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the 'dead donor rule', which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma.
authors.affiliation: Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Nair-Collins
authors.affiliation: Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA.
authors.forename: Sydney R
authors.initials: SR
authors.lastname: Green
authors.affiliation: Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA.
authors.forename: Angelina R
authors.initials: AR
authors.lastname: Sutin
mesh_terms: D000328:Adult; D000368:Aged; D001293:Attitude to Death / Q000208:ethnology; D001926:Brain Death; D003430:Cross-Sectional Studies; D003643:Death; D004522:Educational Status; D005260:Female; D006801:Humans; D020407:Internet; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D012067:Religion; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000592:standards; D014481:United States / Q000453:epidemiology
keywords: Attitudes Toward Death; Dead donor rule; Definition/Determination of Death; Donation/Procurement of Organs/Tissues; Vital organ donation