Non-Heart-Beating Donor (NHBD)

Refers to the harvesting of organs for transplantation from individuals who are declared dead according to the circulatory-respiratory (CR) criteria recommended in the UDDA, some version of which the majority of states have adopted. The practice of NHBD has been met with some opposition by those who argue that brain death is essential to death. According to their thinking, CR criteria should not be used to declare death but only to infer brain death. A significant problem with this approach is that the inference of brain death from CR criteria requires at least a ten-minute wait. The ramification is that most of the body’s organs would be unusable for transplantation by the time the declaration of death is made, which is required under the dead-donor rule. It has been argued, however, that NHBD is an ethically legitimate practice on the basis that it is better to have a complex definition of death, with multiple criteria, than to abandon the dead-donor rule and as long as three criteria are met: (1) circulation and respiration have ceased; (2) these functions will not resume spontaneously; and (3) a physician should not attempt resuscitation. [Source: DuBois, JM, "Non-Heart-Beating Organ Donation: A Defense of the Required Determination of Death," Journal of Law, Medicine & Ethics 27 (1999): 126-36.]

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