The Ethics of Organ Transplants: The Current Debate

By Arthur L. Caplan; Daniel H. Coelho | Go to book overview

1. Defining and Redefining Death

Barbara B. Ott

The death of a critically ill patient is sad and stressful but not uncommon: consequently, critical care nurses are often confronted with the possibility of a patient's death. Technological advances have enabled nurses, physicians, and other healthcare professionals to rally around a patient to postpone death. This experience is stressful to all involved because personal philosophy, spirituality, and values are entangled within it. Death evokes universal feelings of fear, loss, and grief. Largely because of these universal feelings, society permits vast sums of money to be expended to prevent or postpone death. Yet a clear definition of death has not been determined.

The boundaries of life and death are not as clear today as in the past. ICU patients may be physiologically dependent on a left ventricular assist device, a pacemaker, a ventilator, dialysis, and vasoactive drugs. Some are immuno‐ suppressed, have a donated liver, paralyzed musculoskeletal system, and non-functioning gastrointestinal tract, and show no evidence of cerebral activity. What criteria will be used to determine their death?

The determination of death is important for personal, social, religious, legal, moral, and medical reasons. Certain rights, roles, and duties surround death. It would be ideal if there were consensus among healthcare professionals and society as a whole concerning the definition of death. The various definitions of death can cause distrust of healthcare professionals and an uneasiness in the community.

____________________
Reprinted with permission of Alternative Therapies in Health and Medicine, American Journal of Critical Care, 4, no. 6 ( November 1995): 476-80.

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