The no-touch period is the legally or guideline-based waiting time after observed asystole, during which no measure is taken on the donor — before the permanence of the circulatory arrest is determined and organ retrieval begins.
The length of this period operationalizes the positing of permanence quantitatively and is a central parameter of the precautionary-principle examination.
International comparison markers
| Country | Waiting time | Source |
|---|---|---|
| USA, UK | 5 minutes | Society of Critical Care Medicine; Bernat et al. 2010 |
| Australia | 2—5 minutes | national guideline |
| Spain | mostly 5 minutes | ONT practice |
| Italy | 20 minutes flat ECG | by law (Legge 578/1993) |
Italy thereby has the longest international no-touch period — an expression of a strict precautionary stance that makes the Italian program for donation after circulatory death economically more difficult, but secures the positing of permanence to the maximum.
Empirical basis: autoresuscitation
The five-minute convention rests on autoresuscitation research. Dhanani et al. (NEJM 384, 2021, pp. 345—352) documented, in a prospective multicenter study of 631 patients: the longest pulselessness before renewed electrical activity was 4 minutes 20 seconds. In no patient did sustained circulation or consciousness return. Hornby et al. (Canadian Journal of Anesthesia 70, 2023) confirm the finding in an updated systematic review.
The five-minute deadline is thereby empirically barely sufficient to exclude spontaneous return (autoresuscitation) — it makes of asystole a permanence, not an irreversibility.
Substance-ontological position
Even the longest no-touch period (Italy: 20 minutes) does not suffice for the determination of the ontological irreversibility — it only secures the permanence more highly. As long as a theoretical intervention could restore circulation, the waiting time remains a measure of probability, not of ontological certainty.
Ontological classification
Connected with: Permanence, Asystole, Autoresuscitation Observation, Five-Minute Observation, Donation after Circulatory Death
Sources
Sources: Generated by querying the Personhood ontology.
Further sources:
- Dhanani, Sonny et al. (2021): Resumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures. NEJM 384(4): 345—352. https://www.nejm.org/doi/full/10.1056/NEJMoa2022713
- Hornby, Krista L. et al. (2023): Autoresuscitation after circulatory arrest: an updated systematic review. Canadian Journal of Anesthesia 70(4): 699—712. https://link.springer.com/article/10.1007/s12630-023-02411-8
- Bernat, James L. (2010): How the Distinction between ‘Irreversible’ and ‘Permanent’ Illuminates Circulatory-Respiratory Death Determination. Journal of Medicine and Philosophy 35(3): 242—255. https://pubmed.ncbi.nlm.nih.gov/20439357/
- Legge 29 dicembre 1993, n. 578 (Italia): Norme per l’accertamento e la certificazione di morte. https://www.centrotrapianti.unipr.it/LEGISLAZIONE/L578-93.pdf