Politics of the New Pathway to Organ Donation

Abstract

Purpose – To examine the introduction of a practice known as Donation after Cardiac Death (DCD) into Australian hospitals notwithstanding that DCD constitutes a significant shift in medical practice. The shift is from holding off organ donation activities until after death has occurred (the Brain Death Scenario and Uncontrolled Cardiac Death Scenario) to progressing the injured patient to organ donor on the basis of an early prognostic call. The more precise term is ‘Controlled DCD’. What is controlled are the timing, location, mode and criteria of death.Findings – Controlled DCD first appears as an ‘inpatient trial’ in Pittsburgh, United States, in 1992, and has progressed, via various organisations and committees, to being used in a number of countries, including Australia and New Zealand, and being embodied in national, state and hospital protocols. Along the way, concerns that previously precluded such activity have been consistently raised and documented. Operational accounts reported in the medical literature do not acknowledge this history or the ethically problematic aspects of the practice. It is likely that these operational reports and related information sources, together with promotion of the positives of organ donation, have facilitated the practice’s progress through the relevant institutional committees.Social implications – Much is at stake when the quest for more organ donors starts changing what can be done to patients. How this practice has come to be tolerated in 2012, despite a number of irresolvable ethical issues, is a matter of vital community interest.Originality/value of chapter – This chapter is part of an ongoing study by the authors.

Citation

Kennedy, J. and Kennedy, M. (2013), "Politics of the New Pathway to Organ Donation", Schwartz, M. and Harris, H. (Ed.) Ethics, Values and Civil Society (Research in Ethical Issues in Organizations, Vol. 9), Emerald Group Publishing Limited, Leeds, pp. 81-92. https://doi.org/10.1108/S1529-2096(2013)0000009010