Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life - Hardcover

Miller, Franklin G.; Truog, Robert D.

Hardcover

ISBN 10: 019973917X ISBN 13: 9780199739172

Publisher: Oxford University Press, 2011

Synopsis

In Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, Miller and Truog challenge fundamental doctrines of established medical ethics. They argue that the routine practice of stopping life support technology in hospitals causes the death of patients and that donors of vital organs (hearts, lungs, liver, and both kidneys) are not really dead at the time that their organs are removed for life-saving transplantation. These practices are ethically legitimate but are not compatible with traditional rules of medical ethics that doctors must not intentionally cause the death of their patients and that vital organs can be obtained for transplantation only from dead donors.
In this book Miller and Truog undertake an ethical examination that aims to honestly face the reality of medical practices at the end of life. They expose the misconception that stopping life support merely allows patients to die from their medical conditions, and they dispute the accuracy of determining death of hospitalized patients on the basis of a diagnosis of "brain death" prior to vital organ donation. After detailing the factual and conceptual errors surrounding current practices of determining death for the purpose of organ donation, the authors develop a novel ethical account of procuring vital organs. In the context of reasonable plans to withdraw life support, still-living patients are not harmed or wronged by organ donation prior to their death, provided that valid consent has been obtained for stopping treatment and for organ donation.
Recognizing practical difficulties in facing the truth regarding organ donation, the authors also develop a pragmatic alternative account based on the concept of transparent legal fictions. In sum, Miller and Truog argue that in order to preserve the legitimacy of end-of-life practices, we need to reconstruct medical ethics.

About this title

About the Author:

Franklin G. Miller, Ph.D. is retired from the senior faculty in the Department of Bioethics, National Institutes of Health and currently Professor of Medical Ethics in Medicine at Weill Cornell Medical College. Dr. Miller has published a book of his selected essays, The Ethical Challenges of Human Research, edited six books, and published numerous articles in medical and bioethics journals on the ethics of clinical research, death and dying, professional integrity, pragmatism and bioethics, and the placebo effect. Dr. Miller is a fellow of the Hastings Center and Associate Editor of Perspectives in Biology and Medicine.

Robert D. Truog, MD. is the Frances Glessner Lee Professor of Medical Ethics, Anaesthesia, & Pediatrics and Director of the Center for Bioethics, both at Harvard Medical School. He has practiced pediatric intensive care medicine at Boston Children's Hospital for more than 25 years.

Review:

Although the authors draw extensively from their argumentation in published articles, this is their first full-length presentation... Their argument should be taken seriously by academic bioethicists." -- DOODY'S

"This slender, 174-page book is engaging and will have broad interest to all professionals and academicians whose work touches on issues surrounding the withdrawal of lifesustaining treatment, vital organ transplantation, or both. I highly recommend Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life and consider it one of the best bioethics texts I have read in the last year." -- Andrew R. Barnosky, DO, MPH, JAMA

The core metaphysical conclusion of the book is that "the human being dies when the body ceases to function as an organism, which is marked by the irreversible cessation of circulation and respiration" (p. 78). In support of this claim, the authors draw on a rich acquaintance with clinical practice, the relevant neuroscience, and the scientific and political history of the notion of brain death, offering a highly informed case for the view that the elimination of brain function does not destroy the ability of the rest of the organism to function in an integrated fashion." -- The Hastings Center Report

"This book is amodel of quality scholarship in bioethics. The central arguments are detailed, carefully constructed, empirically well grounded, and are presented in cogent, clear prose with an economy of style, all of which are helpful to the reader in readily identifying loci of agreement and disagreement." -- Benjamin E. Hippen, Metrolina Nephrology Associates, The American Journal of Bioethics

"An extensive, relevant bibliography supports the text. Summing up: Recommended. Upper-division undergraduates and above." - J.N. Muzio, emeritus, CUNY Kingsborough Community College, CHOICE

"This book is very well developed in the challenges posed to the current way of thinking about clinical death and how these challenges relate to the current organ... Students and clinicians who work with patients in intensive care unit settings will benefit in many ways from the content in this book. Expanding one's mind beyond the status quo always results in meaningful knowledge and personal growth, whether one accepts the precepts or not." -- Lisa Anderson, DrPH, MA, MSN, Clinical Ethics Consult Service, University of Illinois Medical Center

"Whether one agrees with Miller and Truog's viewpoints and proposals, there is no denying that this is a stimulating and thoroughly engaging book...although the book's focus is on issues at the end of life, it also carries implications for other areas over which the discourse of medical ethics casts a critical eye. For that reason, it is likely to appeal to practitioners,
teachers and students of medicine and medical ethics." -- Kartina A. Choong, University of Central Lancashire, Medical Law Review

About this edition

• Publisher: Oxford University Press
• Publication date: 2011
• ISBN 10: 019973917X
• ISBN 13: 9780199739172
• Binding: Hardcover
• Edition number: 1
• Number of pages: 208