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31Correction to: Mapping trust relationships in organ donation and transplantation: a conceptual modelBMC Medical Ethics 25 (1): 1-2. 2024.
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37Mapping trust relationships in organ donation and transplantation: a conceptual modelBMC Medical Ethics 24 (1): 1-14. 2023.The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and …Read more
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157Defining Function in Medicine: Bridging the Gap between Biology and Clinical PracticeAmerican Journal of Bioethics Neuroscience 14 (3): 282-285. 2023.The classification of preserved hypothalamic activity in brain death and brainstem death as functional or non-functional has become a subject of debate. While proponents of the neurological criterion claim that these activities lack functional significance (Shemie et al. 2014), Nair-Collins and Joffe (2023) argue for their functional physiological role. However, the interpretation of the term "function" within the medico-legal framework, where death is characterized by the irreversible cessation…Read more
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58Death pluralism: a proposalPhilosophy, Ethics, and Humanities in Medicine 18 (1): 1-12. 2023.The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people’s beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. …Read more
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27Defining Consent: Autonomy and the Role of the FamilyIn Solveig Lena Hansen & Silke Schicktanz (eds.), Ethical Challenges of Organ Transplantation, Transcript Verlag. pp. 43-64. 2021.The ethics of deceased organ procurement (OP) is supposedly based on individual consent to donate, either explicit (opt-in) or presumed (opt-out). However, in many cases, individuals fail to express any preference regarding donation after death. When this happens, the decision to remove or not to remove their organs depends on the policy’s default option or on family preferences. Several studies show that in most countries the family plays a significant and often decisive role in the process of …Read more
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186Neuroethics, Consciousness and Death: Where Objective Knowledge Meets Subjective ExperienceAmerican Journal of Bioethics Neuroscience 13 (4): 259-261. 2022.Laura Specker Sullivan (2022) makes a fairly compelling case for the value of the perspectives of Buddhist practitioners in neuroethics. In this study, Tibetan Buddhist monks have been asked, among other things, whether consciousness, in brain-injured patients in a minimally conscious state, entails a duty to preserve life. In our view, some of the participants’ responses could be used to inform the bioethical debate on death determination.
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378Beyond the Altruistic Donor: Embedding Solidarity in Organ Procurement PoliciesPhilosophies 7 (5): 107. 2022.Altruism and solidarity are concepts that are closely related to organ donation for transplantation. On the one hand, they are typically used for encouraging people to donate. On the other hand, they also underpin the regulations in force in each country to different extents. They are often used indistinctly and equivocally, despite the different ethical implications of each concept. This paper aims to clarify to what extent we can speak of altruism and solidarity in the predominant models of or…Read more
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194Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the ro…Read more
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308Brain Death Debates: From Bioethics to Philosophy of ScienceF1000Research 11 195. 2022.50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was …Read more
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33Public Perception of Organ Donation and Transplantation Policies in Southern SpainTransplantation Proceedings 54 (3): 567-574. 2022.Background: This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among do…Read more
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292European and comparative law study regarding family’s legal role in deceased organ procurementRevista General de Derecho Público Comparado 29. 2021.Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family's decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives' decisional capacity over ind…Read more
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374Inconsistency between the Circulatory and the Brain Criteria of Death in the Uniform Determination of Death ActJournal of Medicine and Philosophy 48 (5): 422-433. 2023.The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless…Read more
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194La confiscación de órganos a la luz del derecho constitucional a la protección de la saludRevista Española de Derecho Constitucional 122 183-213. 2021.This paper analyses the arguments for and against what we have called automatic organ procurement model in relation to the organs of the deceased. For this purpose, this work provides empirical evidence to assess the potential impact of this model on donation rates and on public opinion. Specifically, we examine first the reasons supporting this model, with special reference to utilitarian and justice arguments. On the other hand, we analyse both the approaches based on the violation of pre mort…Read more
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229Governance quality indicators for organ procurement policiesPLoS ONE 16 (6). 2021.Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. Methods Between 2017–2019, we conducted a conv…Read more
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318Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-m…Read more
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38Why iBlastoids (Embryo-like Structures) Do Not Raise Significant Ethical IssuesAmerican Journal of Bioethics 22 (1): 59-61. 2022.Most technology is used properly for their intended purpose, but certain technological breakthroughs have a dual-use nature, pose risks or lead to unintended consequences when applied in some areas...
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45Addressing organ shortage: An automatic organ procurement model as a proposalClinical Ethics 16 (4): 278-290. 2021.Organ shortage constitutes an unsolved problem for every country that offers transplantation as a therapeutic option. Besides the largely implemented donation model and the eventually implemented market model, a theorized automatic organ procurement model has raised a rich debate in the legal, medical and bioethical community, since it could show a higher potential to solve organ shortage. In this paper, we study the main arguments for and against this model. We show how, in the light of empiric…Read more
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65Do Automated Vehicles Face Moral Dilemmas? A Plea for a Political ApproachPhilosophy and Technology 34 811-832. 2021.How should automated vehicles react in emergency circumstances? Most research projects and scientific literature deal with this question from a moral perspective. In particular, it is customary to treat emergencies involving AVs as instances of moral dilemmas and to use the trolley problem as a framework to address such alleged dilemmas. Some critics have pointed out some shortcomings of this strategy and have urged to focus on mundane traffic situations instead of trolley cases involving AVs. B…Read more
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577Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic reviewTransplantation Reviews 33 (1): 1-8. 2019.Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection,…Read more
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234Objetividad versus inteligibilidad de las funciones biológicas: La paradoja normativa y el autismo epistemológico de las ciencias modernasLudus Vitalis 14 (26): 39-67. 2006.Finality, design and purpose have started to be excluded from the language of the natural sciences since the XVIIth century. Darwin succeeded in excluding them from his theory of evolution appealing to a blind and mechanical natural selection. Today, the most usual definitions for the concept of biological function take for granted that functions: 1) are not dependent on a goal; 2) are not dependent on observers, but only on nature; 3) are explicable in causal terms, either with reference to the…Read more
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595The role of the family in deceased organ procurement: A guide for Clinitians and PolicymakersTransplantation 103 (5). 2019.Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals abo…Read more
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61Death Determination and Clinicians’ Epistemic AuthorityAmerican Journal of Bioethics 20 (6): 44-47. 2020.Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own …Read more
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1521Téléologie et fonctions en biologie. Une approche non causale des explications téléofonctionnellesDissertation, Universidad Autónoma de Madrid. 2017.This dissertation focuses on teleology and functions in biology. More precisely, it focuses on the scientific legitimacy of teleofunctional attributions and explanations in biology. It belongs to a multi-faceted debate that can be traced back to at least the 1970s. One aspect of the debate concerns the naturalization of functions. Most authors try to reduce, translate or explain functions and teleology in terms of efficient causes so that they find their place in the framework of the natural sci…Read more
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385Should individuals choose their definition of death?Journal of Medical Ethics 34 (9): 688-689. 2008.Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than…Read more
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313A comparative analysis of biomedical research ethics regulation systems in Europe and Latin America with regard to the protection of human subjectsJournal of Medical Ethics 36 (12): 750-753. 2010.The European project European and Latin American Systems of Ethics Regulation of Biomedical Research Project (EULABOR) has carried out the first comparative analysis of ethics regulation systems for biomedical research in seven countries in Europe and Latin America, evaluating their roles in the protection of human subjects. We developed a conceptual and methodological framework defining ‘ethics regulation system for biomedical research’ as a set of actors, institutions, codes and laws involved …Read more
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388Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --a…Read more
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302¿Normal o patológico? El enfermo imaginario en tierra de nadieArbor 189 (763). 2013.Is the boundary between the normal and the pathological real or fiction? Are health and disease just a matter of fact or are they value-laden? Here we present some examples of how alleged diseases can be invented and propagated by the industry (disease mongering) or by the methodology of medical science itself. We show that the boundary between health and disease is blurred and depends on individual and social representations, culture relative ways of categorising things and people, and by the s…Read more
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275Techniques et concepts du vivant en biologie synthétiqueLudus Vitalis 17 (31): 237-240. 2009.[ENGLISH] This article discusses the potential of synthetic biology to address fundamental questions in the philosophy of biology regarding the nature of life and biological functions. Synthetic biology aims to reduce living organisms to their simplest forms by identifying the minimal components of a cell and also to create novel life forms through genetic reprogramming, biobrick assembly, or novel proteins. However, the technical success of these endeavors does not guarantee their conceptual su…Read more
Alberto Molina-Pérez
Instituto de Estudios Sociales Avanzados (IESA-CSIC)
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Instituto de Estudios Sociales Avanzados (IESA-CSIC)Post-doctoral Fellow
Areas of Interest
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