A new way to donate organs—is it ethical? | Harrison Lee | TEDxUniversityofMississippi

Quick Overview

The ethical controversy surrounding Normothermic Regional Perfusion (NRP) stems from the objection that the procedure, which involves blocking blood flow to the brain while perfusing other organs, effectively kills the donor, an action that opponents argue violates the permanence criterion of death which requires irreversible loss of circulation; however, the speaker argues that this objection is misplaced because both NRP and standard machine perfusion (NMP) involve stopping circulation to the brain, and in both protocols, the donor is declared dead using the same circulatory criteria after a mandated waiting period, meaning neither procedure causes death, but rather utilizes organs from individuals already declared dead.

Key Points: There are currently about 105,000 people on the national transplant waitlist, with 17 people dying daily waiting for organs. The key ethical objection to Normothermic Regional Perfusion (NRP) is that it "kills the donor" by occluding arteries to the brain during organ retrieval. Both NRP and Normothermic Machine Perfusion (NMP) involve declaring death based on the same circulatory criteria (no circulation for five minutes after attempting resuscitation). The permanence criterion for death states a donor is dead if they have lost circulation and will never regain it, which is met before organ retrieval in both procedures. NRP allows procurement teams to assess organ function (heart, liver) while still inside the donor body, leading to more viable organs for transplantation compared to NMP. The speaker argues that the objection is flawed because the donor is already declared dead based on established circulatory criteria before either NRP or NMP procedures begin. NRP enables organs to be perfused with oxygenated blood immediately after declaration of death, preserving viability for transplantation, unlike standard NMP.

Context: The speaker, Harrison Lee, addresses the ethical controversy surrounding Normothermic Regional Perfusion (NRP), a procedure used in organ donation for individuals declared dead by circulatory criteria (DCD donors). The primary ethical concern raised by opponents is that the act of blocking blood flow to the brain during organ retrieval constitutes actively killing the donor, thereby violating the established permanence criterion for declaring death. The presentation contrasts NRP with the existing standard, Normothermic Machine Perfusion (NMP), to argue why NRP is ethically sound and medically advantageous.