These results are limited by a few factors. A major limitation was the tendency of studies to merge attitudes with knowledge. We suggest that attitudes relate more to socio-cultural values than to factual knowledge, although we have not identified any supporting data. Non-English literature was excluded from our review, but was able to convey different views than those reported here. Health care workers who are directly involved in organ donation and whose attitudes are more relevant to clinical practice have been poorly studied. We suggest that this issue be addressed in future studies. Despite our assessment of bias, the results of the studies in this review may still be subject to bias inherent in all questionnaire-based studies [54]. When adapting the pancreas and kidneys, the type of genetic tissue is also taken into account. A computerized list of waiting patients is provided to the CORE coordinator, who wishes to match organs with recipients in the core donation service area. If it is not possible to make a match for a particular organ of the CORE range, the organ is offered on a regional basis, then at the national level if necessary. My personal interest in this subject dates back to a period of medical training, which culminated in a project that analyzed the opinion of doctors on the concept of death [4]. At the time, the concept of death was in transition and controversial, but there was clear leadership from people like Dr. David Hume, a revolutionary transplant surgeon.
Dr. Hume wrote, « There is only one definition of death, irreversible brain damage. Stopping the heart rhythm does not constitute death unless it has caused irreversible brain damage. Clinical errors are sometimes made, of course, but general statistics on error rates do not refute the specific published cases we have cited. In addition, if we refer to the idea that clinical error is really the reason for prolonged survival after the declaration of brain death, then it must be admitted that similar errors occur in organ donors. It follows that the death donor rule is regularly violated. In fact, clinical error in the context of prolonged survival after brain death would be much less likely, as the possibility of multiple assessments over longer periods of time was given. Clinical errors would be more likely in determining eligibility for organ donation, given the relatively short period of time in which such a decision is actually made (from a few hours to a few days). If neurological standards are not (or cannot) be applied reliably and rigorously, changes to the eligibility criteria for organ donation are acceptable. Therefore, highlighting the role that clinical errors can play in the cases we describe may raise more problems than the one it is designed to solve.
If the family approves the donation, the legal guardian signs a donation authorization form. Once the family has approved the donation or the donor designation has been given, the CORE Coordinator, in coordination with hospital staff, provides medical care to the donor. In some cases, medical assistance is requested on the basis of a consultation. General exclusions are listed below: Aplastic anemia, agranulocytosis Current malignant neoplasms, other than non-melanoma skin cancers such as basal cell and squamous cell carcinoma and primary CNS tumors without obvious metastatic disease Previous malignant tumors with current metastatic disease A history of melanoma Hematological malignancies: Leukemia, Hodgkin`s disease, lymphoma, active fungal multiple myeloma, parasitic, viral or bacterial meningitis or encephalitis Cause of death not recognizable It is necessary to review the RDA and its foundation, because the ethical standard itself, while trying to protect vulnerable people and protect doctors, creates 2 notable problems: (1) it changes the definition of death; and (2) it does not allow some terminally ill patients who wish to donate their organs to do so. Although early transplants involved donors whose heart rate and breathing had stopped, brain death later became the predominant pathway to organ donation, as it increased both the reach and quality of donated organs. However, since about 2005, there has been a renewed interest in the use of donors who die after cardiorespiratory failure because (1) the growing demand for transplants far exceeded the supply of suitable organs from BD donors, and (2) the peri-mortem removal of vital organs to transplant people declared dead after circulatory failure, would not violate what has been called the « dead donor rule » (RDA) – the idea that vital organs can only be removed from people who have already been declared dead [8]. « Donation after circulatory determination of death » (DCDD) requires that organ removal occur quickly before irreversible ischemic damage can pass, but to confirm that death occurred before the start of ablation surgery, strict timelines are imposed for cardiorespiratory signs of death, depending on the likelihood of self-resuscitation. Therefore, for hylomorphic philosophers who define death as the end of integration, the soul cannot be identified with the brain, so fulfilling the criteria for brain death of an individual directly implies the death of that individual.
Nevertheless, proponents of brain death criteria may argue that brain death is enough to end integration. From this point of view, brain death criteria remain a reliable indicator of the end of integration, even if these criteria do not include the end of integration. for criminal purposes where death is a criterion for the commission of a criminal offence. As a result, a brain-dead person may appear « alive » even if they have suffered an irreversible loss of brain function. This situation can be confusing for loved ones, and it is important for doctors to explain the clinical certainty of brain death to help families understand and accept that the person will not return. Another notable feature was the tendency to attribute rejection or uncertainty about these concepts of death to a knowledge gap that could or should be filled by continuing education – a hypothesis recognized in health care and public policy debates known as the « knowledge deficit model » of public understanding of science. This is a problematic hypothesis, both because it does not recognize that disagreements can represent real differences in values, and because there is considerable evidence to suggest that while knowledge and education can predict the strength of attitudes toward scientific issues, the positivity of attitudes is weakly correlated with knowledge [52]. Therefore, according to Condic, even for those who define living organisms as an integrated whole, it is possible to deny that the cases we have presented are cases of integration. According to Condic, these cases do not speak against the criteria of death of the whole brain. Some of the implications of definitions of « personality » death do not seem likely to find public support. For example, such definitions would allow patients who are believed to be permanently unconscious to have their vital organs buried, cremated, or vital organs removed.40 According to Shann, « [p]aradoxically, some of the strongest oppositions to change, or even the discussion of the problems associated with it, come from the transplant lobby – which fears that any suggestion for change will be misinterpreted as an attempt to tear off organs, thereby undermining public confidence in the system. 41 Organs can be removed from a human body at all stages of life.
and at different stages of the death process.