November 28, 2022

Is Nature campaigning to end dead-donor rule?

Editorial supports push by utilitarians
Has the
leading science journal Nature
launched a campaign to loosen the definition of death to expand the
number of organs available for transplant? Currently US law states
that "An individual who has sustained either (1) irreversible
cessation of circulatory and respiratory functions, or (2)
irreversible cessation of all functions of the entire brain,
including the brain stem, is dead."

But an
editorial in the latest issue of Nature
argues that it is impossible to see the bright line between life and
death. Nowadays transplant surgeons are obeying the spirit of the law
rather than its letter when they remove vital organs because
experience has shown that they cannot guarantee irreversibility or
that each and every function of the brain has ceased. Therefore,
lawmakers and doctors should reconsider “rigid definitions of
death”.

What is Nature
up to? Oddly enough, although this issue has been raised recently in
several journals and by the President’s Council on Bioethics, it
has ignored these. Instead it pegged its editorial on a statement by
“physicians, transplant surgeons and bioethicists” at the obscure
Italian
Festival of Health
.
These included the utilitarian British bioethicist John Harris and a
Harvard Medical school proponent of abolishing the dead-donor rule,
Robert Truog.

Nature
does not propose a solution to the problem, but the concluding
paragraph implies that it favours the abolition of the dead-donor
rule because of the impossibility of defining death and the fact that
doctors are said to routinely ignore the official guidelines. With so
many people in need of transplants, why worry about casuistic
definitions: “But concerns about the legal details of declaring
death in someone who will never again be the person he or she was
should be weighed against the value of giving a full and healthy life
to someone who will die without a transplant.”

No doubt there
will be more to come on this topic. Abolition of the dead donor rule
could be the next big battle in bioethics. ~ Nature,
Oct 1