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Editorials: POINT/COUNTERPOINT EDITORIALS |

Counterpoint: Are Donors After Circulatory Death Really Dead, and Does It Matter? No and Not Really

Robert D. Truog, MD; Franklin G. Miller, PhD
Author and Funding Information

From the Division of Critical Care Medicine, Department of Anesthesia (Dr Truog), Children’s Hospital Boston; the Division of Medical Ethics, Department of Global Health and Social Medicine (Dr Truog), Harvard Medical School; and the Department of Bioethics (Dr Miller), National Institutes of Health.


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

The opinions expressed are the views of the author and do not necessarily reflect the policy of the National Institutes of Health, the Public Health Service, or the US Department of Health and Human Services.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(1):16-18. doi:10.1378/chest.10-0657
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From at least 1968 until the present, prevailing ethical thinking about organ donation has been shaped by the perceived need to conform to the so-called Dead Donor Rule (DDR), which states that vital organs may be removed from patients only after they have been declared dead. Elsewhere, we have argued against the fiction that individuals diagnosed as brain dead are dead because they maintain an extensive range of biologic functioning of the organism as a whole.1-3 The determination of death in the case of donation after the circulatory determination of death (DCDD) relies on a more subtle fudging of the truth: Although imminently dying, donors under DCDD protocols are not known to be dead at the time that organs are procured.

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