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Article
June 2, 1993

Ethical, Psychosocial, and Public Policy Implications of Procuring Organs From Non—Heart-Beating Cadaver Donors

Author Affiliations

The Johns Hopkins Medical Institutions, Baltimore, Md; University of Minnesota, Minneapolis; University of Virginia, Charlottesville; University of Minnesota at Duluth; University of Pittsburgh (Pa); University of Pennsylvania, Philadelphia; University of Pittsburgh (Pa); University of Pittsburgh (Pa); Dartmouth Medical Center, Hanover, NH; Delaware Valley Transplant Program, Philadelphia, Pa; University of Texas at Austin; University of Nebraska Medical School, Omaha; University of Pittsburgh (Pa); Michigan State University, East Lansing; University of Wisconsin-Madison; LaSalle University and Albert Einstein Medical Center, Ardmore, Pa.
From the Division of General Internal Medicine, Department of Medicine, and Clinical Ethics Program, University Hospitals of Cleveland, and The Center for Biomedical Ethics, Case Western Reserve University, Cleveland, Ohio (Dr Youngner); and Division of General Internal Medicine, Department of Medicine, Center for Medical Ethics, University of Pittsburgh (Pa) (Dr Arnold).

JAMA. 1993;269(21):2769-2774. doi:10.1001/jama.1993.03500210069034
Abstract

A SHORTAGE of transplantable organs is a constant and frustrating reality. With continued progress in organ transplantation, the demand for transplants, and thus the need for organs, has increased markedly. The result is an increasing shortage of organs and longer waiting lists for transplantation. As of May 7, 1993, there were 31 303 people awaiting organ transplants (Dave Lohrey, United Network for Organ Sharing Data Base, oral communication, May 7,1993). One third of patients awaiting liver or heart transplants currently will die awaiting an organ, while patients awaiting renal transplants must tolerate a less acceptable quality of life undergoing dialysis.1

Most organs come from patients who have been declared dead by neurological criteria—ie, they have irreversibly lost all brain function and their bodies are being maintained on ventilators in intensive care units. They are commonly referred to as heart-beating cadaver donors (HBCDs) because their hearts are beating at the

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