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Canadian Journal of Anesthesia 51:280 (2004)
© Canadian Anesthesiologists' Society, 2004

Correspondence

REPLY

Christopher Doig, MD MSc FRCPC

Calgary, Alberta

We appreciate the comments of Drs. Doyle and Robichaud. We agree that there are many patients who suffer massive brain injury and who do not meet neurologic criteria (either clinical or radiographic) to establish death. Under current clinical and professional norms, and as understood by the general public, these individuals cannot become solid organ ‘heart beating’ donors. The ethical norm that guides a gift of donation is ‘the dead-donor’ rule: that organs and tissues are retrieved from individuals only after death.

Individuals who suffer massive brain injuries that die determined by cardiac and not neurologic criteria can give a gift of donation. A donation of tissue such as skin, heart valves, corneas etc. also provides life-enhancing benefit to recipients. A gift of tissue donation is as important as a gift of organ donation; the altruism by the family is the same in both circumstances. It may be that organs should also be retrieved from individuals that die from cardiac criteria (non-heart beating organ donation), but at best this may only modestly increase the supply of ‘life-enhanching’ organs such as kidneys, and less so increase ‘life-saving’ organs such as livers. It will not increase the supply of ‘life-saving’ organs such as hearts or lungs.

Whether the ‘dead-donor’ rule should be abandoned in favour of less restrictive criteria for donation is a topic beyond the scope of our review.1

Reference

1 Doig CJ, Burgess E. Brain death: resolving inconsistencies in the ethical declaration of death. Can J Anesth 2003; 50: 725–31.[Abstract/Free Full Text]


Related articles in CJA:

Inconsistencies in the ethical declaration of death
D. John Doyle and Allyson Robichaud
CJA 2004 51: 280. [Full Text]  




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