Collins Mike
The Bioethics Program, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1108, New York, NY 10029, USA.
J Med Philos. 2010 Apr;35(2):154-79. doi: 10.1093/jmp/jhq009. Epub 2010 Feb 25.
The dead donor rule justifies current practice in organ procurement for transplantation and states that organ donors must be dead prior to donation. The majority of organ donors are diagnosed as having suffered brain death and hence are declared dead by neurological criteria. However, a significant amount of unrest in both the philosophical and the medical literature has surfaced since this practice began forty years ago. I argue that, first, declaring death by neurological criteria is both unreliable and unjustified but further, the ethical principles which themselves justify the dead donor rule are better served by abandoning that rule and instead allowing individuals who have suffered severe and irreversible brain damage to become organ donors, even though they are not yet dead and even though the removal of their organs would be the proximal cause of death.
死亡器官捐献规则为当前器官移植获取的实践提供了正当理由，并规定器官捐献者在捐献前必须已经死亡。大多数器官捐献者被诊断为脑死亡，因此根据神经学标准被宣布死亡。然而，自40年前这种做法开始以来，哲学和医学文献中都出现了大量的争议。我认为，首先，根据神经学标准宣布死亡既不可靠也不合理，但进一步而言，放弃该规则，转而允许遭受严重且不可逆转脑损伤的个体成为器官捐献者，尽管他们尚未死亡，尽管摘取他们的器官将是其死亡的直接原因，这样做更符合为死亡器官捐献规则提供正当理由的伦理原则。
