This paper examines some of the ethical dilemmas posed to the medical community by the practice of organ donation after cardiac death (DCD) and whether it violates any of the basic ethical principles of medicine. Cardiac death can only be declared on the basis of cardiopulmonary criteria of permanent cessation of circulatory and respiratory function and not on the basis of neurological criteria of irreversible loss of all functions of the entire brain, which is used to declare brain death. In the landmark trial of Dr. Hootan Roozrahk; Dr. Roozrahk was charged with prescribing unnecessary and inappropriate doses of drugs, in an apparent attempt to quicken the death of a patient slated for organ donation after cardiac death. From this trial new standardization practices were drafted by Organ Procurement and Transplant Network and the United Network for Organ Sharing (OPTN/UNOS) and adopted by all 257 transplant hospitals in the United States. When deciding if organ donation after cardiac death is an ethically acceptable practice, all aspects of biology, medicine, technology, society and culture should be taken into account.
The Ethics Organ Donation after Cardiac Death
Organ donation over the past twenty years has almost more than doubled, but the fact remains that the demand of organs is still dwarfed by the supply. For about 75% of organs that are transplanted, those organs come from deceased donors. Most recently, the highest increase in organ recovery has come from donors that have suffered cardiac death. Cardiac death is declared on the basis of cardiopulmonary criteria of permanent cessation of circulatory and respiratory function and not on the basis of neurological criteria of irreversible loss of all functions of the entire brain, used to declare brain death (Steinbrook, 2007). According to the ‘dead donor rule’ donation should not cause or quicken death, because of the way donation after cardiac death is practiced, it unavoidably raises more concerns...
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