The Use of Anencephalic Infants as Organ Sources
A Critique
- D. Alan Shewmon, MD;
- Alexander M. Capron, LLB;
- Warwick J. Peacock, MD;
- Barbara L. Schulman, RN
- From the Departments of Pediatrics and Neurology (Dr Shewmon), Neurosurgery (Dr Peacock), and Surgery (Ms Schulman), UCLA Medical Center, Los Angeles, Calif; and The Law Center, University of Southern California, Los Angeles (Mr Capron). Ms Schulman is Transplant Coordinator, Regional Organ Procurement Agency of Southern California.
Abstract
The recent abandonment of the only active US protocol for harvesting organs from anencephalic "donors" indicates both the practical and the ethical problems inherent in such an effort. Various data suggest that surprisingly few such organs would actually end up benefiting other children. Attempts to revise either the Uniform Anatomical Gift Act or the Uniform Determination of Death Act to allow organ removal from spontaneously breathing anencephalic infants face major ethical objections. Even if this posed no ethical problem in theory, the ultimate harm to society would not be offset by the good of the few surviving recipients of these organs. Furthermore, providing anencephalic infants with intensive care would tend to preserve the brain stem as effectively as the other organs, predictably rendering the occurrence of brain death unlikely. Thus, despite the great need for newborn organs, anencephalic infants are not as attractive a source as some had hoped.
(JAMA. 1989;261:1773-1781)
Footnotes
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Reprint requests to UCLA Medical Center, MDCC 22-464,10833 LeConte Ave, Los Angeles, CA 90024-1752 (Dr Shewmon).
