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  1. The ethical obligation of the dead donor rule.Anne L. Dalle Ave, Daniel P. Sulmasy & James L. Bernat - 2020 - Medicine, Health Care and Philosophy 23 (1):43-50.
    The dead donor rule (DDR) originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death (DCDD) programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We (...)
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  • Whither Brain Death?James L. Bernat - 2014 - American Journal of Bioethics 14 (8):3-8.
    The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human (...)
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  • The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols.James L. Bernat - 2024 - American Journal of Bioethics 24 (6):4-15.
    Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...)
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  • What's in a Name? Conceptual Confusion About Death and Consent in Donation After Cardiac Determination of Death.Mark D. Fox, Rachel Budavich, Scott Gelfand, Michael R. Gomez, Ric T. Munoz & Jan Slater - 2015 - American Journal of Bioethics 15 (8):12-14.
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  • The Impossibility of Obtaining Informed Consent to Donation After Circulatory Determination of Death.Don Marquis - 2015 - American Journal of Bioethics 15 (8):25-27.
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  • Harmonizing Standards for Death Determination in DCDD.James L. Bernat - 2015 - American Journal of Bioethics 15 (8):10-12.
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  • The Organism as a Whole in an Analysis of Death.Andrew P. Huang & James L. Bernat - 2019 - Journal of Medicine and Philosophy 44 (6):712-731.
    Although death statutes permitting physicians to declare brain death are relatively uniform throughout the United States, academic debate persists over the equivalency of human death and brain death. Alan Shewmon showed that the formerly accepted integration rationale was conceptually incomplete by showing that brain-dead patients demonstrated a degree of integration. We provide a more complete rationale for the equivalency of human death and brain death by defending a deeper understanding of the organism as a whole and by using a novel (...)
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  • Conceptual Issues in DCDD Donor Death Determination.James L. Bernat - 2018 - Hastings Center Report 48 (S4):26-28.
    Despite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long‐standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation (...)
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  • Donation After the Circulatory Determination of Death: Some Responses to Recent Criticisms.Andrew McGee & Dale Gardiner - 2018 - Journal of Medicine and Philosophy 43 (2):211-240.
    This article defends the criterion of permanence as a valid criterion for declaring death against some well-known recent objections. We argue that it is reasonable to adopt the criterion of permanence for declaring death, given how difficult it is to know when the point of irreversibility is actually reached. We claim that this point applies in all contexts, including the donation after circulatory determination of death context. We also examine some of the potentially unpalatable ramifications, for current death declaration practices, (...)
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  • Controlled Donation After Circulatory Determination of Death: A Scoping Review of Ethical Issues, Key Concepts, and Arguments.Nicholas Murphy, Charles Weijer, Maxwell Smith, Jennifer Chandler, Erika Chamberlain, Teneille Gofton & Marat Slessarev - 2021 - Journal of Law, Medicine and Ethics 49 (3):418-440.
    Controlled donation after circulatory determination of death (cDCDD) is an important strategy for increasing the pool of eligible organ donors.
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  • Declare Death or Attempt Experimental Resuscitation?James L. Bernat - 2017 - American Journal of Bioethics 17 (5):17-19.
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  • Donation after brain circulation determination of death.Anne L. Dalle Ave & James L. Bernat - 2017 - BMC Medical Ethics 18 (1):15.
    The fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD]. In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation (...)
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  • Addressing Consent Issues in Donation After Circulatory Determination of Death.Kim J. Overby, Michael S. Weinstein & Autumn Fiester - 2015 - American Journal of Bioethics 15 (8):3-9.
    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria, there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, (...)
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  • Acts that Kill and Acts that Do Not — A Philosophical Analysis of the Dead Donor Rule.Cheng-Chih Tsai - 2021 - European Journal of Analytic Philosophy 17 (1):A3-31.
    In response to recent debates on the need to abandon the Dead Donor Rule (DDR) to facilitate vital-organ transplantation, I claim that, through a detailed philosophical analysis of the Uniform Determination of Death Act (UDDA) and the DDR, some acts that seem to violate DDR in fact do not, thus DDR can be upheld. The paper consists of two parts. First, standard apparatuses of the philosophy of language, such as sense, referent, truth condition, and definite description are employed to show (...)
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  • When are you dead enough to be a donor? Can any feasible protocol for the determination of death on circulatory criteria respect the dead donor rule?Govert den Hartogh - 2019 - Theoretical Medicine and Bioethics 40 (4):299-319.
    The basic question concerning the compatibility of donation after circulatory death protocols with the dead donor rule is whether such protocols can guarantee that the loss of relevant biological functions is truly irreversible. Which functions are the relevant ones? I argue that the answer to this question can be derived neither from a proper understanding of the meaning of the term “death” nor from a proper understanding of the nature of death as a biological phenomenon. The concept of death can (...)
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  • Responding to cDCDD Ethical Challenges: Translating Analysis Into Policy Action.Jeffrey Kirby - 2015 - American Journal of Bioethics 15 (8):27-29.
    Overby and colleagues (2015) draw our critical attention to a variety of ethical challenges associated with the practice of controlled donation after circulatory determination of death (cDCDD). Alt...
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  • Changing the Conversation About Brain Death.Robert D. Truog & Franklin G. Miller - 2014 - American Journal of Bioethics 14 (8):9-14.
    We seek to change the conversation about brain death by highlighting the distinction between brain death as a biological concept versus brain death as a legal status. The fact that brain death does not cohere with any biologically plausible definition of death has been known for decades. Nevertheless, this fact has not threatened the acceptance of brain death as a legal status that permits individuals to be treated as if they are dead. The similarities between “legally dead” and “legally blind” (...)
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  • When are you dead enough to be a donor? Can any feasible protocol for the determination of death on circulatory criteria respect the dead donor rule?Govert Hartogh - 2019 - Theoretical Medicine and Bioethics 40 (4):299-319.
    The basic question concerning the compatibility of donation after circulatory death (DCD) protocols with the dead donor rule is whether such protocols can guarantee that the loss of relevant biological functions is truly irreversible. Which functions are the relevant ones? I argue that the answer to this question can be derived neither from a proper understanding of the meaning of the term “death” nor from a proper understanding of the nature of death as a biological phenomenon. The concept of death (...)
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  • Death, State by State.Sandra H. Johnson - 2014 - Hastings Center Report 44 (4):9-10.
    Although bioethicists do not always recognize it, death is not defined uniformly in the United States. It is defined primarily in state law, and as with any legislative effort that proceeds state by state, results may vary.
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