A little more than 40 years ago, a partially functioning brain would not have gotten in the way of organ donation; irreversible cardiopulmonary failure was still the only standard for determining death. But during the 1970s, that began to change, and by the early 1980s, the cessation of all brain activity — brain death — had become a widely accepted standard. In the transplant community, brain death was attractive for one particular reason: The bodies of such donors could remain on respirators to keep their organs healthy, even during much of the organ-removal surgery.
Today, the medical establishment, facing a huge shortage of organs, needs new sources for transplantation. One solution has been a return to procuring organs from patients who die of heart failure. Before dying, these patients are likely to have been in a coma, sustained by a ventilator, with very minimal brain function — a hopeless distance from what we mean by consciousness. Still, many people, including some physicians, consider this type of organ donation, known as “donation after cardiac death” or DCD, as akin to murder.
