‘Dead-donor’ rule dangerously misleading, experts say

Doctors should abandon the “dangerously misleading” policy of having to declare donors dead before their organs can be extracted for transplant, and adopt a more honest policy that acknowledges some patients may still be technically alive, Canadian and Spanish experts suggest in a provocative new commentary.

They advocate replacing the current “dead-donor rule” with a policy that educates the public about the true nature of patients used in transplant, obtains informed consent — and ensures the donor does not suffer during the organ harvesting.

The authors, including Dr. Neil Lazar, director of the medical-surgical intensive care unit at Toronto General Hospital, say the focus should be on the well-being of donors rather than whether they are legally dead. That could mean giving anesthetics during organ harvesting.

“Because there is a general assumption that dead individuals cannot be harmed, veneration of the dead-donor rule is dangerously misleading,” they wrote. “Ultimately, what is important for the protection and respect of potential donors is not to have a death certificate signed, but rather to be certain they are beyond suffering and to guarantee that their autonomy is respected.”

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