When Does Life Belong to the Living?

With thousands of people on the waiting lists for organs, doctors are bending the rules about when to declare that a donor is dead. Is it ethical to take one life and give it to another?
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Death used to be a simple affair: either a person’s heart was beating, or it was not. That clarity faded years ago when heroic medical technology started to keep hearts beating in­definitely. Although we have had decades to ponder the distinctions between various states of grave physiological failure, if anything our confusion has grown. When is it ethical to turn off a ventilator or remove a feeding tube? When does “life support” lose its meaning? And most critically, at what point is it acceptable to cut into a body and remove the heart that could save another life?

These issues are not academic. They raise questions about health care costs—is it worth using expensive machinery on a body that is for all intents and purposes dead?—as well as about dignity in end-of-life care. This year’s “death panel” subplot of the health care debate fed off the real fears people have about being taken advantage of when at their weakest.

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