title: Is heart transplantation after circulatory death compatible with the dead donor rule?
abstract: Dalle Ave et al (2016) provide a valuable overview of several protocols for heart transplantation after circulatory death. However, their analysis of the compatibility of heart donation after circulatory death (DCD) with the dead donor rule (DDR) is flawed. Their permanence-based criteria for death, which depart substantially from established law and bioethics, are ad hoc and unfounded. Furthermore, their analysis is self-defeating, because it undercuts the central motivation for DDR as both a legal and a moral constraint, rendering the DDR vacuous and trivial. Rather than devise new and ad hoc criteria for death for the purpose of rendering DCD nominally consistent with DDR, we contend that the best approach is to explicitly abandon DDR.
authors.affiliation: 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: Weill Cornell Medical College, Chevy Chase, Maryland, USA.
authors.forename: Franklin G
authors.initials: FG
authors.lastname: Miller
mesh_terms: D001926:Brain Death / Q000145:classification / Q000175:diagnosis*; D028663:Ethical Theory; D016027:Heart Transplantation / Q000941:ethics* / Q000331:legislation & jurisprudence; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D009626:Terminology as Topic; D020858:Tissue and Organ Harvesting / Q000941:ethics* / Q000331:legislation & jurisprudence; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000331:legislation & jurisprudence
keywords: Dead donor rule; Definition/Determination of Death; Vital organ donation