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699The Death Debates: A Call for Public DeliberationHastings Center Report 43 (5): 34-35. 2013.In this issue of the Report, James L. Bernat proposes an innovative and sophisticated distinction to justify the introduction of permanent cessation as a valid substitute standard for irreversible cessation in death determination. He differentiates two approaches to conceptualizing and determining death: the biological concept and the prevailing medical practice standard. While irreversibility is required by the biological concept, the weaker criterion of permanence, he claims, has always suffic…Read more
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543The 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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527Public 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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361Since 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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344Should 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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284“Just” accuracy? Procedural fairness demands explainability in AI‑based medical resource allocationAI and Society 1-12. 2022.The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowled…Read more
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243Goal: 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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205Governance 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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174La 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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162Objectives 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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120Development of a Knockout Competition in Basketball: A Study of the Spanish Copa del ReyFrontiers in Psychology 10. 2019.
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89Donation After Circulatory Death: Burying the Dead Donor RuleAmerican Journal of Bioethics 11 (8): 36-43. 2011.Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reas…Read more
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69One or two types of death? Attitudes of health professionals towards brain death and donation after circulatory death in three countriesMedicine, Health Care and Philosophy 16 (3): 457-467. 2013.This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual…Read more
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63Do Publics Share Experts’ Concerns about Brain–Computer Interfaces? A Trinational Survey on the Ethics of Neural TechnologyScience, Technology, and Human Values 2019 (6): 1242-1270. 2019.Since the 1960s, scientists, engineers, and healthcare professionals have developed brain–computer interface (BCI) technologies, connecting the user’s brain activity to communication or motor devices. This new technology has also captured the imagination of publics, industry, and ethicists. Academic ethics has highlighted the ethical challenges of BCIs, although these conclusions often rely on speculative or conceptual methods rather than empirical evidence or public engagement. From a social sc…Read more
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54Response to Open Peer Commentaries on “Donation After Circulatory Death: Burying the Dead Donor Rule”American Journal of Bioethics 11 (8). 2011.The American Journal of Bioethics, Volume 11, Issue 8, Page W4-W6, August 2011
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53Testing the Motivational Strength of Positive and Negative Duty Arguments Regarding Global PovertyReview of Philosophy and Psychology 13 (3): 699-717. 2022.Two main types of philosophical arguments have been given in support of the claim that the citizens of affluent societies have stringent moral duties to aid the global poor: “positive duty” arguments based on the notion of beneficence and “negative duty” arguments based on noninterference. Peter Singer’s positive duty argument (Singer 1972) and Thomas Pogge’s negative duty argument (Pogge 2002) are among the most prominent examples. Philosophers have made speculative claims about the relative ef…Read more
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48Death 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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46“Nudging” Deceased Donation Through an Opt-Out System: A Libertarian Approach or Manipulation?American Journal of Bioethics 16 (11): 25-28. 2016.Nudges involve designing social “choice contexts” to promote what “experts” regard as beneficial for individuals and the society, by making the “right” choices easier. The most common form of nudge...
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46Advance directives and the family: French and American perspectivesClinical Ethics 2 (3): 139-145. 2007.Several studies have explored differences between North American and European doctor patient relationships. They have focused primarily on differences in philosophical traditions and historic and socioeconomic factors between these two regions that might lead to differences in behaviour, as well as divergent concepts in and justifications of medical practice. However, few empirical intercultural studies have been carried out to identify in practice these cultural differences. This lack of standa…Read more
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46How do people use ‘killing’, ‘letting die’ and related bioethical concepts? Contrasting descriptive and normative hypothesesBioethics 34 (5): 509-518. 2020.Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality. In the present report, we extend this line of research by examining how medical students and professionals (N = 184) and laypeople (N = 1…Read more
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44Bioética, reanimación cardiopulmonar y donación de órganos en asistoliaDilemata 13 283-296. 2013.The so-called uncontrolled donation after circulatory determination of death (uDCDD) have been implemented in several countries, including Spain and France, to increase the availability of organs for transplantation. These protocols allow obtaining kidneys, livers and lungs of patients who do not survive cardio-pulmonary resuscitation performed in out-of-hospital settings. Simultaneously with the development and recent proliferation of these protocols, some emergency teams have begun to employ u…Read more
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38Absolutely Right and Relatively Good: Consequentialists See Bioethical Disagreement in a Relativist LightAJOB Empirical Bioethics 12 (3): 190-205. 2021.Background Contemporary societies are rife with moral disagreement, resulting in recalcitrant disputes on matters of public policy. In the context of ongoing bioethical controversies, are uncompromising attitudes rooted in beliefs about the nature of moral truth?Methods To answer this question, we conducted both exploratory and confirmatory studies, with both a convenience and a nationally representative sample (total N = 1501), investigating the link between people’s beliefs about moral truth (…Read more
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38Avoiding Violation of the Dead Donor Rule: The Costs to PatientsAmerican Journal of Bioethics 12 (6): 15-17. 2012.The American Journal of Bioethics, Volume 12, Issue 6, Page 15-17, June 2012
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37A Review of: “Timothy F. Murphy. 2004. Case Studies in Biomedical Research Ethics”: Cambridge, MA: The MIT Press. 368 pp. $29.00, paperback (review)American Journal of Bioethics 5 (2): 64-66. 2005.
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34Addressing 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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33How Can You Be Transparent About Labeling the Living as Dead?American Journal of Bioethics 17 (5): 24-25. 2017.
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29ALESSO, Marta . Hermenéutica de los géneros literarios: de la Antigüedad al cristianismo Buenos Aires, Facultad de Filosofía y Letras, Universidad de Buenos Aires, 2013, XXX + 430 págs. ISBN 978-987-1785-97-1 (review)Circe de Clásicos y Modernos 19 (1): 95-100. 2015.
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28Ni vivo ni muerto, sino todo lo contrario. Reflexiones sobre la muerte cerebralArbor 189 (763). 2013.