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December 13, 1995

Anencephalic Infants as Organ Donors

Author Affiliations

Eastern Virginia Medical School Norfolk

JAMA. 1995;274(22):1758. doi:10.1001/jama.1995.03530220023013

To the Editor.  —The AMA Council on Ethical and Judicial Affairs1 has changed its previous position and now supports the use of live anencephalic infants as organ donors. However, in their report, fundamental issues relating to the definition of personhood and even the definition of life and death are not adequately addressed.In undermining the "dead donor"2 rule, the report seems to be arguing for "cortical death"—the absence of higher brain function as a new definition of death—without overtly stating this point. A circumstance in which higher brain function is not present and will never be possible is the defining feature of the reasoning used by the Council. This fundamental change in defining life and death needs open discussion and a broad-based consensus before being adopted.Other clinical situations occur in which an argument can be made for organ procurement from a living donor. A severely asphyxiated neonate

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