Postmortem donation — Post-Mortem Donation — is the donation of an organ after the death of the donor. It stands under the Dead Donor Rule and under the question of what counts as certain death. It comprises two subforms: donation after determined brain death (DBD) and donation after determined circulatory death (DCD).
Clinical-legal classification versus ontological assessment
The designation “postmortem donation” is a clinical-legal classification on the basis of the determination of death applicable in each case. The personal ontology advanced here distinguishes between this classification and the substance-ontological question of whether, in the given case, certain death has in fact occurred:
- Donation after brain death (DBD): presupposes the identification of irreversible loss of brain function with certain death. The ontology advanced here distinguishes both states of affairs and does not share this identification.
- Donation after circulatory death (DCD): bases the determination of death on the permanence of circulatory arrest. Substance-ontologically, permanence does not suffice for certain death.
Both subforms thus stand under the tension of the Dead Donor Rule and under the precautionary principle of Benedict XVI (2008): “Where certainty has not been attained, the principle of precaution must prevail.”
Ontological classification
Conceptual opposite: living donation — living donation avoids the Dead-Donor-Rule tension entirely.
Subclasses:
Chapter assignment: Chapter 4: What is human personhood? (German), Chapter 5: Oblivion of the Person (German)
Sources
Generated by querying the Personhood ontology.
Further sources:
Clinical-legal foundations
- Ad Hoc Committee of the Harvard Medical School (1968): A Definition of Irreversible Coma. JAMA 205(6): 337—340.
- President’s Commission for the Study of Ethical Problems in Medicine (1981): Defining Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death.
- Bundesärztekammer (2022): Richtlinie zur Feststellung des irreversiblen Hirnfunktionsausfalls (5th amendment).
- Greer, David M. et al. (2020): Determination of Brain Death/Death by Neurologic Criteria. The World Brain Death Project. JAMA 324(11): 1078—1097.
- German Transplantation Act (Transplantationsgesetz), §3.
Substance-ontological and ethical critique
- Jonas, Hans (1974): Against the Stream: Comments on the Definition and Redefinition of Death. In: Philosophical Essays: From Ancient Creed to Technological Man. Englewood Cliffs: Prentice-Hall.
- Shewmon, D. Alan (2001): The Brain and Somatic Integration. Journal of Medicine and Philosophy 26(5): 457—478.
- Truog, Robert D.; Robinson, Walter M. (2003): Role of Brain Death and the Dead-Donor Rule in the Ethics of Organ Transplantation. Critical Care Medicine 31(9): 2391—2396.
- Veatch, Robert M.; Ross, Lainie F. (2016): Defining Death: The Case for Choice. Washington: Georgetown University Press.
- President’s Council on Bioethics (2008): Controversies in the Determination of Death: A White Paper.
Magisterial position
- John Paul II (2000): Address to the 18th International Congress of the Transplantation Society.
- Benedict XVI (2008): Address to the International Congress on Organ Donation. Precautionary principle.
- Pius XII (1956): Address to the Italian Society of Anesthesiology. Living donation and the principle of totality.