Hastings Cent Rep. 2018 Nov;48 Suppl 4:S39-S42. doi: 10.1002/hast.952.
Since the 1960s, organ procurement policies have relied on the boundary of death-advertised as though it were a factual, value-free, and unobjectionable event-to foster organ donation while minimizing controversy. Death determination, however, involves both discoveries of facts and events and decisions about their meaning (whether the facts and events are relevant to establish a vital status), the latter being subjected to legitimate disagreements requiring deliberation. By revisiting the historical origin of the dead donor rule, including some events that took place in France prior to the report by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, I want to recall that those who first promoted the DDR did not take into account any scientific rationale to support the new proposed criteria to determine death. Rather, through a process of factual re-semantization, they authorized themselves to decide about the meaning of death in order to implicitly prioritize the interests of organ recipients over those of dying people.
自 20 世纪 60 年代以来，器官采购政策一直依赖于死亡宣告的边界——仿佛这是一个事实、无价值和无可非议的事件——以促进器官捐赠，同时将争议降到最低。然而，死亡的确定既涉及事实和事件的发现，也涉及对其含义的判断（这些事实和事件是否与确定生命状态有关），而后者则存在需要审议的合法分歧。通过重新审视死亡捐赠者规则的历史起源，包括哈佛医学院特别委员会报告之前法国发生的一些事件，我想提醒人们，最初推动 DDR 的人并没有考虑任何科学依据来支持新提出的确定死亡的标准。相反，他们通过事实重新语义化的过程，授权自己决定死亡的含义，以便含蓄地将器官接受者的利益置于临终者之上。
