title: Is there a place for CPR and sustained physiological support in brain-dead non-donors?
abstract: This article addresses whether cardiopulmonary resuscitation (CPR) and sustained physiological support should ever be permitted in individuals who are diagnosed as brain dead and who had held previously expressed moral or religious objections to the currently accepted criteria for such a determination. It contrasts how requests for care would normally be treated in cases involving a brain-dead individual with previously expressed wishes to donate and a similarly diagnosed individual with previously expressed beliefs that did not conform to a brain-based conception of death. The paper first focuses narrowly on requests for CPR and then expands its scope to address extended physiological support. It describes how refusing the brain-dead non-donor's requests for either CPR or extended support would represent enduring harm to the antemortem or previously autonomous individual by negating their beliefs and self-identity. The paper subsequently discusses potential implications of policy that would allow greater accommodations to those with conscientious objections to currently accepted brain-based death criteria, such as for cost, insurance, higher brain formulations and bedside communication. The conclusion is that granting wider latitude to personal conceptions around the definition of death, rather than forcing a contested definition on those with valid moral and religious objections, would benefit both individuals and society.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Brown
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001926:Brain Death / Q000331:legislation & jurisprudence; D016887:Cardiopulmonary Resuscitation / Q000941:ethics; D003466:Cultural Characteristics; D004992:Ethics, Medical; D006801:Humans; D009014:Morals; D010344:Patient Advocacy / Q000941:ethics* / Q000331:legislation & jurisprudence; D011050:Policy Making; D012068:Religion and Medicine; D012297:Right to Die / Q000941:ethics* / Q000331:legislation & jurisprudence; D028761:Withholding Treatment / Q000941:ethics* / Q000331:legislation & jurisprudence
keywords: Attitudes Toward Death; Definition/Determination of Death; Human Dignity; Moral and Religious Aspects; Patient perspective