An Official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death

• Published in: American journal of respiratory and critical care medicine 2013-07, Vol.188 (1), p.103-109
• Main Authors: GRIES, Cynthia J, WHITE, Douglas B, GLAZIER, Alexandra K, HIGGINS, Robert, LOVE, Robert, MASON, David P, NAKAGAWA, Thomas A, SHAPIRO, Ron, SHEMIE, Sam, TRACY, Mary Fran, TRAVALINE, John M, VALAPOUR, Maryam, TRUOG, Robert D, WEST, Lori, ZAAS, David, HALPERN, Scott D, DUBOIS, James, COSIO, Carmen C, DHANANI, Sonny, CHAN, Kevin M, CORRIS, Paul, DARK, John, FULDA, Gerald
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood & organ donations; Child; Clinical death. Palliative care. Organ gift and preservation; Consent; Critical care; Critical Care - ethics; Death; Decision making; Ethics; Ethics, Medical; Health Policy; Heart; Humans; Informed Consent - ethics; Intensive care medicine; Lung transplants; Medical sciences; Medicine; Organ Transplantation - ethics; Palliative care; Patients; Pediatrics; Pneumology; Societies, Medical - ethics; Terminal Care - ethics; Tissue and Organ Procurement - ethics; Tissue Donors - ethics; United States
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.201304-0714ST

Donation after circulatory determination of death (DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues. To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders. A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and developed a guiding framework for decision making by stakeholders. A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD. The information presented in this Statement is based on the current evidence, experience, and clinical rationale. New clinical research and the development and dissemination of new technologies will eventually necessitate an update of this Statement.