Nair-Collins Michael
Department of Medical Humanities and Social Sciences, Florida State University College of Medicine, USA.
Kennedy Inst Ethics J. 2013 Mar;23(1):53-104. doi: 10.1353/ken.2013.0002.
The controversy surrounding the dead donor rule and the adequacy of neurological criteria for death continues unabated. However, despite disagreement on fundamental theoretical questions, I argue that there is significant (but not complete) agreement on the permissibility of organ retrieval from heart-beating donors. Many disagreements are rooted in disputes surrounding language meaning and use, rather than the practices of transplant medicine. Thus I suggest that the debate can be fruitfully recast in terms of a dispute about language. Given this recasting, I argue that the language used to describe organ donation is misleading and paternalistic. Finally, I suggest that the near-agreement on the permissibility of heart-beating organ retrieval ought to be reconsidered. If the paternalism is not justified, then either the language used to describe organ transplantation must change radically, or it would seem to follow that much of the transplant enterprise lacks ethical justification.
围绕死亡捐献者规则以及死亡神经学标准的充分性的争议仍未平息。然而，尽管在基本理论问题上存在分歧，但我认为，对于从心跳停止的捐献者身上获取器官的可允许性，存在着显著（但并非完全一致）的共识。许多分歧源于围绕语言意义和用法的争论，而非移植医学的实践。因此，我建议可以将这场辩论富有成效地重新表述为一场关于语言的争论。基于这种重新表述，我认为用于描述器官捐献的语言具有误导性且家长式作风。最后，我建议应当重新审视关于心跳停止器官获取可允许性的近乎一致的看法。如果这种家长式作风没有正当理由，那么要么用于描述器官移植的语言必须进行彻底改变，要么似乎可以得出这样的结论：移植事业的大部分缺乏伦理依据。
