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Archived Comments for: Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

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  1. Ending the Deception

    Michael Potts, Methodist University

    1 May 2012

    The article by Ari R. Joffe and his colleagues (1) is a welcome corrective to misleading attempts to defend the moral acceptability of donation after cardiac death (DCD). They correctly point out the conflation by advocates of DCD of irreversibility and permanence, a confusion that abrogates one of their main arguments for DCD being ethical. They also reject the radical nominalism of DCD proponents who support a radical constructivism regarding the determination of death and ignore the physiology of death. Death is, as Joffe, et al. notes, an ontological concept that must be tested by external reality, not a pseudo reality that human beings impose on a malleable world. Their references to cases of autoresuscitation in the Lazarus Phenomenon suffice to refute the DCD advocates argument that autoresuscitation is impossible after the time allotted for total loss of blood flow before organ retrieval begins. They make a point too often ignored in discussions of organ donation: The physician discussing withdrawal of life support will be aware of the future option of DCD and will not be able to prevent this from influencing his/her opinion. But it should be pointed out that this bias is also present when physicians declare a person brain dead before organ retrieval; undue influence is not limited to DCD. These and other arguments are more than enough to support a ban on the practice of DCD.

    References

    1. Joffe AR, Carcillo J, deCaen A, et al. 2011. Donation after cardiocirculatory death: a call for a moratorium pending pull disclosure and fully informed consent. Phil Eth Hum Med 6:17, doi: 10.1186/1747-5341-6-17.

    Competing interests

    none

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