Defending Irreversibility and Brain Death in the Ethics of Heart Donation After Circulatory Death

Area of Science:

• Medical Ethics
• Organ Donation
• Neurology

Background:

• Donation after circulatory determination of death (DCDD) expands the donor pool but requires ethical clarity on death determination.
• Brain death, defined by irreversible cessation of brain function, is a medically and ethically valid criterion.

Purpose of the Study:

• To affirm the legitimacy of brain death as a criterion for organ donation.
• To promote Donation after Brain Circulation Determination of Death (DBCDD) as a unified approach.
• To advocate for safeguards in DCDD protocols.

Main Methods:

• Review of ethical frameworks for death determination.
• Analysis of DCDD protocols and their alignment with brain-based death criteria.
• Proposal of Donation after Brain Circulation Determination of Death (DBCDD).

Main Results:

• DBCDD ensures death is defined by permanent cessation of brain circulation, leading to irreversible loss of all brain function.
• Safeguards such as verifying circulatory arrest and excluding cerebral reperfusion are necessary for DCDD.
• These standards uphold the dead donor rule and public trust.

Conclusions:

• DCDD can be ethically grounded by unifying death determination under the brain criterion.
• DBCDD provides a framework that reinforces brain-based death determination across all clinical pathways.
• Implementing robust safeguards ensures the integrity of organ donation practices.