To the Editor: The donation after cardiac death (DCD) procedure used by Coulson and colleagues1 is ethically problematic and is not, as claimed, re-implementation of the practice followed before brain-death organ donation protocols were introduced. First reported in 1992, the more precise term is controlled donation after cardiac death or controlled non-heart-beating organ donation.2 What is controlled is the timing, mode and criteria of death, and its location (operating theatres). The threshold medical decision is to remove life-support and allow the patient to die. The aim of the procedure is to seize the opportunity to procure a particular kind of death within a particular time frame for organ transplant purposes. The procedure fails if the patient survives past the point for organ viability (usually 60 minutes).
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