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Reflections on Non-Heartbeating Organ Donation: How 3 Years of Experience Affected the University of Pittsburgh's Ethics Committee's Actions

Published online by Cambridge University Press:  29 July 2009

Michael DeVita ,
James V. Snyder ,
Renéee C. Fox  and
Stuart J. Younger
Michael DeVita
Affiliation:
Assistant professor of Anestheslology/Critical Care Medicine and Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
James V. Snyder
Affiliation:
Professor of Anesthesiology/Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Renéee C. Fox
Affiliation:
Annenburg Professor of the Social Sciences, University of Pennsylvania, Philadelphia.
Stuart J. Younger
Affiliation:
Professor of Biomedical Ethics, Case Western Reserve University, and Director, Clinical Ethics Program, University Hospitals of Cleveland.
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Extract

In 1991, the University of Pittsburgh Medical Center (UPMC) implemented a policy that permitted the recovery of organs from cadavers pronounced dead using standardized cardiac criteria (Non-Heartbeating Cadavers or NHBC). This policy allowed families that had made a decision to forgo life sustaining treatment to then request organ donation. This entailed taking the patient to the operating room, discontinuing therapy (typically but not necessarily a ventilator), and after the patient is pronounced dead, procuring organs.

Type
Ethics Committees at Work
Information
Cambridge Quarterly of Healthcare Ethics , Volume 5 , Issue 2 , Spring 1996 , pp. 285 - 299
Copyright
Copyright © Cambridge University Press 1996

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References

Notes

1. University of Pittsburgh Medical Centers. Policy and Procedure Manual: Management of Terminally III Patients Who May Become Organ Donors After Death. Kennedy Institute of Ethics Journal 1992;3(2):A–l–5.Google Scholar

2. M, DeVita, Snyder, JV. Development of the University of Pittsburgh Medical Center policy for the care of terminally ill patients who may become organ donors After death following the removal of life support. Kennedy Institute of Ethics Journal 1993;3(2):131–43.Google Scholar

3. M, DeVita, Vukmir, R, Snyder, J, Graziano, C. Procuring organs from a non-heartbeating cadaver: a case report. Kennedy Institute of Ethics Journal 1993;3(4):371“85.Google Scholar

4. Lynn, J. Are the patients who become organ donors under the Pittsburgh protocol for “non-heartbeating donors” really dead? Kennedy Institute of Ethics Journal 1993;3(2):167–78.CrossRefGoogle Scholar

5. Fox, RC. “An ignoble form of cannibalism”: reflections on the Pittsburgh protocol for procuring organs from non-heartbeating cadavers. Kennedy Institute of Ethics Journal 1993;3(2):231–40.CrossRefGoogle ScholarPubMed

6. Caplan, AL. The telltale heart: public policy and the utilization of non-heartbeating donors. Kennedy Institute of Ethics Journal 1993;3(2):251–62.CrossRefGoogle Scholar

7. Weisbard, AJ. A polemic of principles: reflections of the Pittsburgh protocol. Kennedy Institute of Ethics Journal 1993;3(2):217–30.CrossRefGoogle ScholarPubMed

8. Robertson, JA. Policy issues in a non-heartbeating donor protocol. Kennedy Institute of Ethics Journal 1993;3(2):241–50.CrossRefGoogle Scholar

9. See note 5. Fox, . 1993;3(2):231–40.Google Scholar

10. Kolata, G. Organ shortage leads to nontraditional transplants and ethical concerns. New York Times 1993;06 2:16.Google Scholar

11. Coburn, D. Health: Changing the Life-and-Death Rules for Transplants. Washington Post, p10, 06 15, 1995.Google Scholar

12. UNOS. Non-heartbeating donation on the rise. Transplant community turning to original source of organs to meet demand. UNOS Update 1994;10(11):3–5.Google Scholar

13. See note 1. 1992;3(2):A-l–5.

14. The policy already has an exception to this ban—insertion of a femoral artery catheter (for which informed consent is obtained). The catheter might cause the patient some minimal discomfort but is needed to meet the policy's requirement that the patient have no pulse pressure for 2 minutes prior to the declaration of death.

15. Childress, JV. Non-heartbeating donors of organs: are the distinctions between direct and indirect effects and between killing and letting die relevant and helpful? Kennedy Institute of Ethics Journal 1993;3(2):203–16.CrossRefGoogle Scholar

16. See note 1. 1992;3(2):A-l–5.

17. DeVita, M. Organ donation from non-heartbeating cadavers: 1994. In: R, Arnold, Youngner, S, Schapiro, R, Spicer, C, Eds. Procuring Organs for Transplant: The Debate Over Non-Heartbeating Cadaver Protocols. Baltimore, Maryland: Johns Hopkins University Press, 1995.Google Scholar

18. See note 12. Unos, . 1994;10(11):3–5.Google Scholar

19. G, Koostra, Dae men, JW. Procurement of organs for transplantation from non-heartbeating cadaver donors in Europe. In: R, Arnold, Younger, S, Schapiro, R, Spicer, C, Eds. Procuring Organs for Transplant: The Debate Over Non-Heartbeating Cadaver Protocols. Baltimore, Maryland: Johns Hopkins University Press, 1995.Google Scholar

20. See note 6. Caplan, . 1993;3(2):251–62.Google Scholar

21. See note 5. Fox, . 1993;3(2):231–40.Google Scholar

22. See note 5. Fox, . 1993;3(2):231–40.Google Scholar

23. See note 5. Fox, . 1993;3(2):231–40.Google Scholar

24. RMH, Wijnen, Booster, MH, Stubenitsky, BM, et al. . Outcome of transplantation of non-heart-beating donor kidneys. Lancet 1995;345:1067–70.Google Scholar

25. S, Younger, Arnold, R. The working group on ethical, psychosocial, and public policy implications of procuring organs from non-heartbeating cadaver donors. Journal of the American Medical Association 1993;269(21):2769–74.Google Scholar

26. See note 7. Weisbard, . 1993;3:217–30.Google Scholar