When Does Life Stop? A New Way of Harvesting Organs Divides Doctors.

A new organ retrieval method for hearts from donors is sparking a debate on the boundary between life and death in hospitals. NYU Langone Health supports the way, claiming to have been the first to try it in the U.S. in 2020. However, NewYork-Presbyterian Hospital, with the city's most extensive organ transplant program, has rejected it after an ethics committee review. 

The controversial technique involves expanding the pool of potential heart donors to include comatose patients not declared brain dead and whose families have withdrawn life support. The procedure restores the heart after death, but ethical concerns persist among some surgeons and bioethicists.

Critics of this new organ retrieval method raise ethical concerns, particularly related to the traditional definition of death involving irreversible cessation of the heart and blood circulation. Restarting blood flow in the new procedure challenges this definition, leading some to question the validity of the initial death declaration. 

Another controversial aspect is using metal clamps to cut blood flow to the donor's head after heart revival, aiming to prevent any potential restoration of brain activity. This precaution implies a recognition that the donor may not be legally dead. The legal determination of death involves two criteria: circulatory death and brain death. The new potential donors, not declared brain dead, exhibit some signs of life, such as blinking or gasping when the breathing tube is removed.

For more information see Joseph Goldstein “When Does Life Stop? A New Way of Harvesting Organs Divides Doctors”, The New York Times, November 22, 2023.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.