University of Oslo.
Am J Bioeth. 2024 Jun;24(6):27-33. doi: 10.1080/15265161.2024.2337403. Epub 2024 Jun 3.
The introduction of normothermic regional perfusion (NRP) in controlled donation after circulatory determination of death (cDCDD) protocols is by some regarded as controversial and ethically troublesome. One of the main concerns that opponents have about introducing NRP in cDCDD protocols is that reestablishing circulation will negate the determination of death by circulatory criteria, potentially resuscitating the donor. In this article, I argue that this is not the case. If we take a closer look at the concept of death underlying the circulatory criterion for determination of death, we find that the purpose of the criterion is to show whether the organism as a whole has died. I argue that this purpose is fulfilled by the circulatory criterion in cDCDD protocols, and that applying NRP does not negate the determination of death or resuscitate the donor.
在循环判定死亡后的控制捐献(cDCDD)方案中引入常温区域性灌注(NRP),一些人认为这是有争议的,在伦理上也存在问题。反对者对在 cDCDD 方案中引入 NRP 的主要担忧之一是,重新建立循环将否定通过循环标准确定的死亡,这可能会使供体复苏。在本文中,我认为事实并非如此。如果我们更仔细地研究循环标准确定死亡背后的死亡概念,我们会发现该标准的目的是表明整个机体是否已经死亡。我认为,cDCDD 方案中的循环标准实现了这一目的,并且应用 NRP 并不会否定死亡的判定或使供体复苏。