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Rev."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thoracoabdominal normothermic regional perfusion (TA-NRP), a new method of controlled donation after circulatory death, seems to provide more and better organs for patients on organ transplant waiting lists compared to standard controlled donation after circulatory death. Despite its benefits, the ethical permissibility of TA-NRP is currently a highly debated issue. The recent statement published by the American College of Physicians (ACP) highlights the reasons for these debates. Critics\u2019 main concern is that TA-NRP violates the Dead Donor Rule. This paper presents an ethical analysis of the objections raised by the ACP against TA-NRP and argues that TA-NRP is not only morally permissible but also morally required where it is financially and technically feasible. To support this conclusion, the concepts of \u2018resuscitation,\u2019 \u2018intention,\u2019 \u2018irreversibility,\u2019 \u2018permanence,\u2019 \u2018impossibility,\u2019 and \u2018respect\u2019 in the context of TA-NRP are explored. Additionally, the ethical permissibility of this procedure is evaluated through the lenses of Utilitarianism, Kantianism, the core principles of bioethics, and the Doctrine of Double Effect. This ethical analysis demonstrates why the ACP\u2019s objection lacks a solid moral foundation and conflates moral and legal considerations. This paper also argues that extra measures are needed to ensure the moral permissibility of TA-NRP, emphasizing the importance of informed consent, additional brain blood flow and activity monitoring, and a contingency plan to abort the organ procurement process if a sign of morally relevant brain activity is detected.<\/jats:p>","DOI":"10.1007\/s40592-025-00229-2","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:11:28Z","timestamp":1738109488000},"page":"166-189","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Thoracoabdominal normothermic regional perfusion: Is it ethical?"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-8578","authenticated-orcid":false,"given":"Caner","family":"Turan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"10","key":"229_CR1","doi-asserted-by":"publisher","first-page":"2302","DOI":"10.1111\/ajt.17083","volume":"22","author":"BL Adams","year":"2022","unstructured":"Adams, B.L., L. Brenner, M. Levan, and B. Parent. 2022. CDCDD-NRP is consistent with US legal standards for determining death. American Journal of Transplantation 22 (10): 2302\u20132305. https:\/\/doi.org\/10.1111\/ajt.17083.","journal-title":"American Journal of Transplantation"},{"key":"229_CR2","unstructured":"American College of Physicians. 2021. Ethics, determination of death, and organ transplantation in normothermic regional perfusion (NRP) with controlled donation after circulatory determination of death (CDCD): American College of Physicians statement of concern. https:\/\/www.acponline.org\/sites\/default\/files\/documents\/clinical_information\/resources\/end_of_life_care\/ethics_determination_of_death_and_organ_transplantation_in_nrp_2021.pdf. Accessed 17 May 2024."},{"issue":"4","key":"229_CR3","doi-asserted-by":"publisher","first-page":"427","DOI":"10.2307\/2183752","volume":"80","author":"DM Armstrong","year":"1971","unstructured":"Armstrong, D.M. 1971. Meaning and communication. 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The work presented is a theoretical and ethical analysis, adhering to the standard academic norms of the field.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable, as the research did not involve animals.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Animal welfare"}},{"value":"Not applicable, as the research did not involve human participants.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}