Discussion Of Donation Of Cardiac Death

In recent years, the WHO and relevant international organizations had the meetings to solve the organ shortage frequently. At last they were calling for the countries to engage in not only donation after brain death (DBD) but also donation after cardiac death (DCD) in order to reduce the quantity of living donations. As the hope of organ sources’ expansion, DCD emerged to the stage of history once again. Following the world footsteps, China also carried out the national death donations experimental work mainly in DCD. Whether DCD was suitable for China, which could extend the source of organs, it had to be practice.Before brain death standard established, DCD had been the mainly source of body organ donation. Because brain death organs could not satisfy the more and more organ demands, DCD was raised again. With the development of science and policy theory propulsion, DCD gradually became two types, controllable DCD and uncontrollable DCD. Because uncontrollable DCD need higher medical level and higher staff’s technical demands, uncontrollable DCD had been the mainly type in many countries who practice DCD today. Because DCD led to warm ischemia time delay, comparing with DBD, DCD provided more limited kinds of organs. Kidneys and livers were the most major organs resources that DCD offered. In recent years many countries and international organizations carried out many meetings and made many decisions and plans in order to promote DCD development in practice all over the world.During the DCD practice processes many scholars also had many questions to development and promotion of DCD. These questions included:the technical level should face, the heart death standard question, the boundary of every stage of controllable DCD dispute, all kinds of derivative technology ethics problems; operation platform should face, the conflicts between donors and recipients, donors and their family members’ right of informed consent attack, the question of free donation; Local practice in China, the traditional view of death stopped from DCD, family standard of ethics hided independent donation, family emotional needs weakened DCD contributions will, etc. Although these misgivings existed, DCD ethically could get defense in fact, whether in the argument of death standard or in DCD’s micro and macro ethical values or existence rationality above local views. Facing these questions of technical, operational and practice, some could be discussed and refuted by ethics, some others need ethics restriction, legal regulation and policy direction to avoid and solve. It was suggested that we should establish brain death standard to pave for organ donation sustainable development. Take the principles of informed consent, non-malficence, dead donor rule; donation on brain death priority; maximal utility and appropriate compensation. Focus on prospective of culture during the promotion; strengthen the construction of legislation, legal implementation, in order to create a fair and transparent way of organ donation and create a good atmosphere of DCD practice in China.