Conceptual controversies in death determination
Bernat, James L.
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There is an intractable disagreement over whether the organ donor after the circulatory determination of death (DCDD) is dead at the time death is ordinarily declared. A rigorous analysis of death determination illuminates the cause of the controversy. Death determination can be conceptualized in two distinct ways: the biological approach in which cessation of vital functions must be irreversible and the medical approach in which cessation of vital functions must be permanent. The two noncongruent standards lead to determining death at different times and explain the current controversy over death determination in the DCDD donor. By the biological standard, the organ donor is not dead but by the medical standard, the organ donor is dead.