Cases Abusing Brain Death Definition in Organ Procurement in China

Area of Science:

• Medical Ethics
• Transplantation Surgery
• Public Health Policy

Background:

• Organ donation after brain death has been practiced in China since 2003 without specific legislation.
• China's brain death criteria align with international standards, including coma, absent brainstem reflexes, and apnea testing.

Purpose of the Study:

• To investigate discrepancies in brain death declarations and organ procurement practices in China.
• To examine whether organ harvesting procedures in China adhere to established brain death criteria.

Main Methods:

• Review of publications in Chinese medical journals detailing organ donation cases.
• Analysis of reported diagnostic procedures, including apnea tests and organ procurement timing.
• Identification of cases where organ procurement procedures commenced without complete brain death determination.

Main Results:

• Publications indicate organ donors declared brain dead were sometimes not subjected to the mandatory apnea test.
• Organ procurement procedures, including intratracheal intubation for mechanical ventilation, were initiated prior to confirmed brain death diagnosis in some instances.
• Two publications explicitly mention induced cardiac arrest using cardioplegic solutions without prior brain death determination, suggesting organs may have been procured from living individuals.

Conclusions:

• The definition of brain death appears to be manipulated in China for organ harvesting purposes.
• There is a critical need for a systematic investigation into organ donation practices following brain death in China to ensure ethical and legal compliance.
• Current practices raise serious ethical concerns regarding the definition and application of brain death in organ donation.