Should the Criterion for Brain Death Require Irreversible or Permanent Cessation of Function? Irreversible The UDDA Revision Series

Article Ethics

Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision

D. Alan Shewmon

Summary: Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) have led to proposals for revising the UDDA. The proposed revision called RUDDA has attracted attention, but 107 experts agree that it is not the right approach. They highlight the risks of false-positive errors in the guidelines, the importance of hypothalamic function, and the unnecessary and potentially harmful nature of the apnea test. They also stress the need to respect individuals' judgments and beliefs regarding the concept of death.

JOURNAL OF MEDICINE AND PHILOSOPHY (2023)

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Article Multidisciplinary Sciences

Emergency preservation and resuscitation for cardiac arrest from trauma

Samuel A. Tisherman

Summary: Emergency preservation and resuscitation (EPR) is being tested as a method to improve survival for trauma patients experiencing cardiac arrest from exsanguination. The EPR-CAT trial is evaluating the feasibility and safety of initiating EPR in patients with penetrating trauma. The primary outcome is to assess survival to hospital discharge without significant neurologic deficits.

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES (2022)

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Article Multidisciplinary Sciences

Cellular recovery after prolonged warm ischaemia of the whole body

David Andrijevic et al.

Summary: Researchers have developed a technology called OrganEx that can maintain tissue integrity, reduce cell death, and restore molecular and cellular processes in multiple vital organs in a pig's whole body. Single-nucleus transcriptomic analysis revealed gene expression patterns specific to organ and cell type, reflecting specific molecular and cellular repair processes. This study reveals the underappreciated potential for cellular recovery after prolonged whole-body warm ischemia in large mammals.

NATURE (2022)

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Review Ethics

The intractable problems with brain death and possible solutions

Ari R. Joffe et al.

Summary: Brain death is accepted as the biological state of death, but persistent problems exist in its acceptance. The metaphysical problem questions the reason behind considering brain death as biological death, while the epistemic problem arises from the inability to diagnose brain death using current tests. The proposed solution involves abandoning the dead donor rule for organ donation from patients diagnosed as brain dead.

PHILOSOPHY ETHICS AND HUMANITIES IN MEDICINE (2021)

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Review Medicine, General & Internal