National Institutes of Health Clinical Center


Clinical Ethics

Death and Organ Donation

Various commentators have raised concerns over the past 15 years regarding whether patients diagnosed as brain dead and thus candidates for vital organ donation are in fact dead. The Departments work on this topic began with an effort to examine this problem systematically and develop an argument justifying vital organ transplantation based on the premise that the donors remain alive though permanently unconscious. Several subsequent papers, published in bioethics journals, medical journals, and a law review, explored various aspects of this topic concerning the definition and determination of death. This led to writing a book, Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, by Franklin G. Miller and Robert D. Truog, Oxford University Press, 2012. Book chapters focus on withdrawing life sustaining treatment, active euthanasia, death and the brain, donation after circulatory determination of death, and justifying vital organ transplantation without "the dead donor rule," and a legal fictions approach to vital organ donation. This book has received favorable reviews in The Journal of the American Medical Association, The Hastings Center Report, and The American Journal of Bioethics.

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