How Dead is Dead? End-of-Life Decisions and Organ Donation

Posted on March 28, 2012 by


One of the most important decisions a family member may face at the end of a loved one’s life is whether to donate organs for transplantation. As a pediatric surgeon I’m all in favor of organ transplantation and have participated in pediatric liver, kidney and heart transplants.

Recently, however, I came across an NPR piece that describes the use of cardiopulmonary bypass (the heart-lung machine) to extend the lives of organ donors who have been declared brain dead. This new application of the existing technology of bypass is controversial because it restarts and ensures the ongoing circulation of blood in the body, something that has usually ceased in a dead person.

Theoretically, the bypass machine could run for days and might also resuscitate or treat a patient who has been previously declared “dead.” This has many in the bioethics community stirred up and reminded me of Robin Cook’s Coma where comatose patients were warehoused for the purpose of organ harvest.

This news follows on the heels of the recent release of Dick Teresi’s new book, The Undead, which argues that brain death criteria is not always reliable in determining who, in fact, is dead. We are sure to hear more about these controversies as the shortage of organs for transplantation forces the application of technology to sustain donors.