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November 24, 1989

'Brain Death' and Organ Retrieval-Reply

Author Affiliations

Case Western Reserve University School of Medicine Cleveland, Ohio

Case Western Reserve University School of Medicine Cleveland, Ohio

JAMA. 1989;262(20):2836-2837. doi:10.1001/jama.1989.03430200079025

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In Reply. —  The letter by Drs Kesterson and Benzel supports our finding that neurosurgeons oppose required request laws, and the authors offer an additional explanation, namely, their concern about potential conflict of interest when required request laws make "it mandatory for physicians to urge families to donate their loved ones' organs" when those families would be unduly upset by such requests. We agree that this concern is real and contributes not only to the opposition to required request laws but also to fewer families being given the donation option. Whether more families could be asked in a sensitive way that would both respect their feelings and increase organ procurement is an important question, but one we did not address in our study.Dr Tomlinson raises three concerns about our methods. First, he argues that the vagueness of the term "brain death" invalidates the responses to ourquestion about the correct