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  1. The intractable problems with brain death and possible solutions.Ari R. Joffe, Gurpreet Khaira & Allan R. de Caen - 2021 - Philosophy, Ethics and Humanities in Medicine 16 (1):1-27.
    Brain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny (...)
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  • Two Ways to Kill a Patient.Ben Bronner - 2018 - Journal of Medicine and Philosophy 43 (1):44-63.
    According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die—an important distinction, according to some. I argue that killing can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.
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  • How (not) to think of the ‘dead-donor’ rule.Adam Omelianchuk - 2018 - Theoretical Medicine and Bioethics 39 (1):1-25.
    Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...)
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  • Determination of Death: A Scientific Perspective on Biological Integration.Maureen L. Condic - 2016 - Journal of Medicine and Philosophy 41 (3):257-278.
    Human life is operationally defined by the onset and cessation of organismal function. At postnatal stages of life, organismal integration critically and uniquely requires a functioning brain. In this article, a distinction is drawn between integrated and coordinated biologic activities. While communication between cells can provide a coordinated biologic response to specific signals, it does not support the integrated function that is characteristic of a living human being. Determining the loss of integrated function can be complicated by medical interventions that (...)
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  • Clinical and ethical perspectives on brain death.Michael Nair-Collins - 2015 - Medicolegal and Bioethics 5:69-80.
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  • Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent.Ari R. Joffe, Joe Carcillo, Natalie Anton, Allan deCaen, Yong Y. Han, Michael J. Bell, Frank A. Maffei, John Sullivan, James Thomas & Gonzalo Garcia-Guerra - 2011 - Philosophy, Ethics, and Humanities in Medicine 6:17.
    Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: (...)
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  • The Paradox of the Dead Donor Rule: Increasing Death on the Waiting List.Robert M. Sade & Andrea Boan - 2014 - American Journal of Bioethics 14 (8):21-23.
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  • Should We Scrap the Dead Donor Rule?John Robertson - 2014 - American Journal of Bioethics 14 (8):52-53.
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  • The Moral Insignificance of Death in Organ Donation.Walter Glannon - 2013 - Cambridge Quarterly of Healthcare Ethics 22 (2):192-202.
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  • Democratic Authority and the Separation of Church and State. [REVIEW]R. Child - 2013 - Analysis 73 (2):406-409.
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  • Decapitation and the definition of death.F. G. Miller & R. D. Truog - 2010 - Journal of Medical Ethics 36 (10):632-634.
    Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitation and brain death. Since a decapitated animal is obviously dead, and ‘brain (...)
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  • Brain Death: Can It Be Resuscitated?D. Alan Shewmon - 2009 - Hastings Center Report 39 (2):18-24.
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  • The Dead Donor Rule: A Defense.Samuel C. M. Birch - 2013 - Journal of Medicine and Philosophy 38 (4):426-440.
    Miller, Truog, and Brock have recently argued that the “dead donor rule,” the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are (...)
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  • How the Distinction between "Irreversible" and "Permanent" Illuminates Circulatory-Respiratory Death Determination.James L. Bernat - 2010 - Journal of Medicine and Philosophy 35 (3):242-255.
    The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...)
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  • The Dead Donor Rule: Can It Withstand Critical Scrutiny?F. G. Miller, R. D. Truog & D. W. Brock - 2010 - Journal of Medicine and Philosophy 35 (3):299-312.
    Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...)
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  • Death and legal fictions.S. K. Shah, R. D. Truog & F. G. Miller - 2011 - Journal of Medical Ethics 37 (12):719-722.
    Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...)
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  • A narrative review of the empirical evidence on public attitudes on brain death and vital organ transplantation: the need for better data to inform policy.Seema K. Shah, Kenneth Kasper & Franklin G. Miller - 2015 - Journal of Medical Ethics 41 (4):291-296.
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  • Ethics and the Acquisition of Organs.D. Marquis - 2013 - Analysis 73 (2):404-406.
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  • The Case for Kidney Donation Before End-of-Life Care.Paul E. Morrissey - 2012 - American Journal of Bioethics 12 (6):1-8.
    Donation after cardiac death (DCD) is associated with many problems, including ischemic injury, high rates of delayed allograft function, and frequent organ discard. Furthermore, many potential DCD donors fail to progress to asystole in a manner that would enable safe organ transplantation and no organs are recovered. DCD protocols are based upon the principle that the donor must be declared dead prior to organ recovery. A new protocol is proposed whereby after a donor family agrees to withdrawal of life-sustaining treatments, (...)
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  • Organ Markets and the Ends of Medicine.F. D. Davis & S. J. Crowe - 2009 - Journal of Medicine and Philosophy 34 (6):586-605.
    As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he (...)
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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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  • 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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  • Going All the Way: Ethical Clarity and Ethical Progress.Franklin G. Miller & Robert D. Truog - 2012 - American Journal of Bioethics 12 (6):10-11.
    The American Journal of Bioethics, Volume 12, Issue 6, Page 10-11, June 2012.
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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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  • On Noncongruence between the Concept and Determination of Death.James L. Bernat - 2013 - Hastings Center Report 43 (6):25-33.
    A combination of emerging life support technologies and entrenched organ donation practices are complicating the physician's task of determining death. On the one hand, technologies that support or replace ventilation and circulation may render the diagnosis of death ambiguous. On the other, transplantation of vital organs requires timely and accurate declaration of death of the donor to keep the organs as healthy as possible. These two factors have led to disagreements among physicians and scholars on the precise moment of death. (...)
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  • Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences. [REVIEW]Joseph L. Verheijde, Mohamed Y. Rady & Joan McGregor - 2009 - Philosophy, Ethics, and Humanities in Medicine 4:1-8.
    Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed (...)
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  • Donation, Death, and Harm.Walter Glannon - 2011 - American Journal of Bioethics 11 (8):48-49.
    The American Journal of Bioethics, Volume 11, Issue 8, Page 48-49, August 2011.
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  • What We Argue About When We Argue About Death.Sean Aas - 2024 - Journal of Medicine and Philosophy 49 (4):399-413.
    The literature on the determination of death has often if not always assumed that the concept of human death should be defined in terms of the end of the human organism. I argue that this broadly biological conceptualization of human death cannot constitute a basis for agreement in a pluralistic society characterized by a variety of reasonable views on the nature of our existence as embodied beings. Rather, following Robert Veatch, I suggest that we must define death in moralized terms, (...)
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  • In Defense of Brain Death: Replies to Don Marquis, Michael Nair-Collins, Doyen Nguyen, and Laura Specker Sullivan.John P. Lizza - 2018 - Diametros 55:68-90.
    In this paper, I defend brain death as a criterion for determining death against objections raised by Don Marquis, Michael Nair-Collins, Doyen Nguyen, and Laura Specker Sullivan. I argue that any definition of death for beings like us relies on some sortal concept by which we are individuated and identified and that the choice of that concept in a practical context is not determined by strictly biological considerations but involves metaphysical, moral, social, and cultural considerations. This view supports acceptance of (...)
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  • Determination of Death and the Dead Donor Rule: A Survey of the Current Law on Brain Death.Nikolas T. Nikas, Dorinda C. Bordlee & Madeline Moreira - 2016 - Journal of Medicine and Philosophy 41 (3):237-256.
    Despite seeming uniformity in the law, end-of-life controversies have highlighted variations among state brain death laws and their interpretation by courts. This article provides a survey of the current legal landscape regarding brain death in the United States, for the purpose of assisting professionals who seek to formulate or assess proposals for changes in current law and hospital policy. As we note, the public is increasingly wary of the role of organ transplantation in determinations of death, and of the variability (...)
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  • Brain death: justifications and critiques.Robert D. Truog & Franklin G. Miller - 2012 - Clinical Ethics 7 (3):128-132.
    Controversies about the diagnosis and meaning of brain death have existed as long as the concept itself. Here we review the historical development of brain death, and then evaluate the various attempts to justify the claim that patients who are diagnosed as brain dead can be considered dead for all legal and social purposes, and especially with regard to procuring their vital organs for transplantation. While we agree with most commentators that death should be defined as the loss of integration (...)
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  • Donation After Circulatory Death: Burying the Dead Donor Rule.David Rodríguez-Arias, Maxwell J. Smith & Neil M. Lazar - 2011 - American Journal of Bioethics 11 (8):36-43.
    Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR (...)
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  • Dealing death and retrieving organs.James Lindemann Nelson - 2009 - Journal of Bioethical Inquiry 6 (3):285-291.
    It has recently been argued by Miller and Truog (2008) that, while procuring vital organs from transplant donors is typically the cause of their deaths, this violation of the requirement that donors be dead prior to the removal of their organs is not a cause for moral concern. In general terms, I endorse this heterodox conclusion, but for different and, as I think, more powerful reasons. I end by arguing that, even if it is agreed that retrieval of vital organs (...)
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  • Honouring the donor: in death and in life.Grant Gillett - 2013 - Journal of Medical Ethics 39 (3):149-152.
    Elective ventilation (EV) is ventilation—not to save a patient's life, but with the expectation that s/he will die—in the hope that organs can be retrieved in the best possible state. The arguments for doing such a thing rest on the value of the lives being saved by the donated organs, maximally honouring the donor's wishes where the patient can be reasonably thought to wish to donate, and a general principle in favour of organ donation where possible as an expression of (...)
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