Cardiac death

Besides the brain death criterion, some countries, including Great-Britain, Austria, Switzerland, the Netherlands, Spain, Belgium, and the USA, also apply so-called DCD criteria (Donation after Cardiac Death) (sometimes the older terminology NHBD for non heart-beating donor is still used). 

According to this procedure, it is permissible to remove organs before the determination of brain death, as soon as a ten minutes’ cardiovascular arrest at normal body temperature has been diagnosed. In Germany, the NHBD procedure may not be used as a criterion for the determination of death.

According to a communication of the German Medical Association Bundesärztekammer, a ten minutes’ cardiovascular arrest at normal body temperature does not represent a valid equivalent to brain death, as each successful reanimation (even if it is only temporary) demonstrates that cardiac arrest is not a safe criterion of death. On the other hand, proponents of the NHBD procedure argue that the cerebral functions are irreversibly lost after a ten minutes’ cardiovascular arrest. In the light of persistent organ shortage, they support early organ removal, as the organs cease their functions shortly after the onset of cardiovascular arrest.

Niederschlag, H. (Hg.) (2013): Wann ist der Mensch tot? Diskussion um Hirntod, Herztod und Ganztod. Ostfildern: Grünwald. (German)

Gutman, T. (2015): Donation after Circulatory Determination of Death: Regelungsoptionen. In: Preprints and Working Papers of the Centre for Advanced Study in Bioethics (78). WWU Münster, 1–16. Online Version (German)

Siegmund-Schultze, N. / Zylka-Menhorn, V. (2008): Non-Heart-Beating-Donors: "Herztote" Organspender. In: Deutsches Ärzteblatt 105 (16). Online Version (German)

Institutions and organisations on cardiac death:

Deutscher Ethikrat (2015): Stellungnahme "Hirntod und Entscheidung zur Organspende". Online Version (German)

Mitteilung der Bundesärztekammer zum NHBD-Verfahren Online Version (German)

Wissenschaftlicher Dienst des Deutschen Bundestages (2019): Zur Feststellung des Todes als Voraussetzung für die „postmortale“ Organspende in Deutschland, Österreich und der Schweiz. Online Version (German)

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