Does normothermic regional perfusion harm donors after circulatory death?

Area of Science:

• Medical Ethics
• Transplantation Medicine
• Organ Donation

Background:

• Controlled donation after circulatory death (cDCD) aims to increase organ availability.
• Normothermic regional perfusion (NRP) is an extracorporeal membrane oxygenation technique used in cDCD.
• Critics argue NRP violates the dead donor rule, framing the debate as a binary choice.

Purpose of the Study:

• To challenge the binary framework of the NRP debate.
• To evaluate the ethical permissibility of NRP based on donor harm.
• To determine if NRP aligns with moral obligations to organ donors.

Main Methods:

• Ethical analysis of NRP in the context of donor moral status.
• Assessment of obligations to organ donors: preventing harm, protecting futures, and satisfying critical interests.
• Evaluation of NRP against these ethical obligations in cDCD.

Main Results:

• NRP, when performed correctly, does not violate the moral obligations owed to organ donors.
• The ethical permissibility of NRP should not be judged against the dead donor rule alone.
• NRP does not cause harm to organ donors in controlled DCD when standardized protocols are adhered to.

Conclusions:

• Resisting the binary framework allows for a nuanced ethical evaluation of NRP.
• NRP is ethically permissible in controlled DCD as it upholds moral obligations to donors.
• Standardized protocols are crucial for ensuring NRP does not harm organ donors.