{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:19:53Z","timestamp":1777940393691,"version":"3.51.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Policy, Politics, &amp; Nursing Practice"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule\u2014as may be already occurring\u2014or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.<\/jats:p>","DOI":"10.1177\/1527154419864717","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T11:10:17Z","timestamp":1565694617000},"page":"163-173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1641-7623","authenticated-orcid":false,"given":"Lila","family":"de Tantillo","sequence":"first","affiliation":[{"name":"University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan M.","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johis","family":"Ortega","sequence":"additional","affiliation":[{"name":"University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"issue":"3","key":"bibr1-1527154419864717","first-page":"573","volume":"7","author":"Abel B.","year":"2012","journal-title":"Journal of Health & Biomedical Law"},{"key":"bibr2-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000179"},{"key":"bibr3-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2016-103460"},{"key":"bibr4-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1001\/virtualmentor.2012.14.3.coet1-1203"},{"key":"bibr5-1527154419864717","volume-title":"Code of ethics for nurses with interpretive statements","author":"American Nurses Association","year":"2015"},{"key":"bibr6-1527154419864717","volume-title":"The nurse's role in ethics and human rights: Protecting and promoting individual worth, dignity, and human rights in practice settings","author":"American Nurses Association","year":"2016"},{"key":"bibr7-1527154419864717","volume-title":"State determination of death laws","author":"Association of Organ Procurement Organizations","year":"2011"},{"key":"bibr8-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-196903000-00007"},{"key":"bibr9-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1308078"},{"key":"bibr10-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-315560"},{"key":"bibr11-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1017\/S0953820804001396"},{"key":"bibr12-1527154419864717","volume-title":"Non-heart-beating organ transplantation: Practice and protocols. A report of the Committee on Non-Heart-Beating Transplantation II, Institute of Medicine","author":"Cassel C.","year":"2000"},{"key":"bibr13-1527154419864717","doi-asserted-by":"publisher","DOI":"10.2307\/3527640"},{"issue":"104","key":"bibr14-1527154419864717","first-page":"30981","volume":"71","author":"Centers for Medicare and Medicaid Services","year":"2006","journal-title":"Federal Register"},{"key":"bibr15-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/01.NEP.0000000000000134"},{"key":"bibr16-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2018.04.012"},{"key":"bibr17-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2013-101333"},{"key":"bibr18-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8519.2009.01767.x"},{"key":"bibr19-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13792"},{"issue":"0","key":"bibr20-1527154419864717","first-page":"1","volume":"0","author":"de Tantillo L.","year":"2019","journal-title":"Advances in Nursing Science"},{"key":"bibr21-1527154419864717","volume-title":"Promoting organ donation through public education campaigns: A random-effects meta-analysis","author":"Feeley T. H.","year":"2011"},{"key":"bibr22-1527154419864717","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.53108"},{"issue":"1","key":"bibr23-1527154419864717","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1164\/rccm.201304-0714ST","volume":"188","author":"Gries C. J.","year":"2013","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"key":"bibr24-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-005-0104-7"},{"key":"bibr25-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0b013e31819b01ff"},{"key":"bibr26-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13051"},{"key":"bibr27-1527154419864717","doi-asserted-by":"publisher","DOI":"10.7182\/pit2012157"},{"key":"bibr28-1527154419864717","volume-title":"Non-heart-beating organ transplantation: Medical and ethical issues in procurement","author":"Institute of Medicine","year":"1997"},{"key":"bibr29-1527154419864717","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2010396"},{"key":"bibr30-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2013.10.012"},{"key":"bibr31-1527154419864717","first-page":"1","volume":"55","author":"Lizza J. P.","year":"2018","journal-title":"Diametros"},{"key":"bibr32-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000224"},{"key":"bibr33-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer357"},{"issue":"11","key":"bibr34-1527154419864717","first-page":"1476","volume":"67","author":"McCabe J. M.","year":"1981","journal-title":"American Bar Association Journal"},{"key":"bibr35-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.01.007"},{"key":"bibr36-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.01.007"},{"key":"bibr37-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000437178.48174.db"},{"key":"bibr38-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12712"},{"key":"bibr39-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2014-102229"},{"key":"bibr40-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-791"},{"key":"bibr41-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhw002"},{"key":"bibr42-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2015.1047999"},{"key":"bibr43-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.05.007"},{"key":"bibr44-1527154419864717","doi-asserted-by":"publisher","DOI":"10.2307\/3527865"},{"key":"bibr45-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer399"},{"key":"bibr46-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2014.925169"},{"key":"bibr47-1527154419864717","unstructured":"Sanghavi, D. (2009, December 20). When does death start?\n                      The New York Times Magazine\n                      , p. 16. Retrieved from https:\/\/www.nytimes.com\/2009\/12\/20\/magazine\/20organ-t.html."},{"key":"bibr48-1527154419864717","doi-asserted-by":"publisher","DOI":"10.2307\/2709175"},{"key":"bibr49-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1177\/1751143717731230"},{"issue":"2","key":"bibr50-1527154419864717","doi-asserted-by":"crossref","DOI":"10.1097\/TXD.0000000000000513","volume":"1","author":"Siminoff L. A.","year":"2015","journal-title":"Transplantation Direct"},{"key":"bibr51-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp078066"},{"key":"bibr52-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1307220"},{"key":"bibr53-1527154419864717","author":"United Network for Organ Sharing","year":"2017","journal-title":"History of UNOS"},{"key":"bibr54-1527154419864717","author":"United Network for Organ Sharing","year":"2018","journal-title":"Deceased organ donors in United States exceeded 10,000 for first time in 2017"},{"key":"bibr55-1527154419864717","unstructured":"U.S. Department of Health and Human Services. (1979).\n                      The Belmont report: Ethical principles and guidelines for the protection of human subjects of research\n                      . Retrieved from http:\/\/www.hhs.gov\/ohrp\/regulations-and-policy\/belmont-report\/."},{"key":"bibr56-1527154419864717","author":"U.S. Department of Health and Human Services","year":"2019","journal-title":"Organ donation statistics"},{"key":"bibr57-1527154419864717","unstructured":"U.S. Department of Health and Human Services. (n.d.).\n                      Timeline of historical events and significant milestones\n                      . Retrieved from https:\/\/organdonor.gov\/about\/facts-terms\/history.html."},{"key":"bibr58-1527154419864717","author":"U.S. President's Commission for the Study of Ethical Problems in Medicine, Biomedical, and Behavioral Research","year":"1981","journal-title":"Defining death: A report on the medical, legal and ethical issues in the determination of death"},{"issue":"2","key":"bibr59-1527154419864717","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1353\/ken.0.0181","volume":"3","author":"University of Pittsburgh Medical Center","year":"1993","journal-title":"Kennedy Institute of Ethics Journal"},{"key":"bibr60-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-009-9204-0"},{"key":"bibr61-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31822d4e2f"},{"key":"bibr62-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer384"},{"key":"bibr63-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e242a8"},{"key":"bibr64-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ec29f0"},{"key":"bibr65-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2010.01201.x"},{"key":"bibr66-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1992.00530290162028"},{"key":"bibr67-1527154419864717","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500210069034"}],"container-title":["Policy, Politics, &amp; Nursing Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1527154419864717","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1527154419864717","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1527154419864717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:48:21Z","timestamp":1777700901000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1527154419864717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":67,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1177\/1527154419864717"],"URL":"https:\/\/doi.org\/10.1177\/1527154419864717","relation":{},"ISSN":["1527-1544","1552-7468"],"issn-type":[{"value":"1527-1544","type":"print"},{"value":"1552-7468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}