Why DCD Donors Are Dead

Area of Science:

• Medical Ethics
• Philosophy of Medicine
• Organ Donation

Background:

• Organ donation after circulatory death (DCD) faces ethical challenges regarding the "dead-donor" rule.
• Critics argue that artificial restoration of circulation and respiration violates the irreversibility criterion for death.

Purpose of the Study:

• To defend organ donation after circulatory death against criticism.
• To propose an interpretation of "irreversibility" that supports DCD.
• To explore the relationship between death, consciousness, and medical technology.

Main Methods:

• Philosophical argumentation
• Ethical analysis
• Interpretation of medical-ethical principles
• Engagement with objections regarding the definition of death

Main Results:

• Interpreting "irreversibility" as permanent cessation of circulation and respiration aligns with medical-ethical considerations and respect for do-not-resuscitate orders.
• Loss of circulation and respiration leads to irreversible loss of consciousness, signifying the death of the person.
• Advances in medical technology necessitate a broader understanding of death beyond purely biological terms, incorporating ethical and ontological considerations.

Conclusions:

• Organ donation after circulatory death is ethically permissible when "irreversibility" is understood as permanent cessation of vital functions.
• Patient autonomy, particularly do-not-resuscitate orders, must be respected in the context of organ donation.
• The definition and determination of death are influenced by ethical and ontological factors, not solely biological ones, especially with modern medical advancements.