The anencephalic organ donor: A challenge to existing moral and statutory laws

J. H. Diaz, A. Steinberg, E. Katz, C. L. Sprung

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objectives: To inform physicians of the critical shortage of neonatal heart donors and to provide arguments for and against selecting brain-absent anencephalics as heart donors for brain-normal infants who are dying of hypoplastic left heart syndrome. Data Sources: International scientific journals of medicine, genetics, epidemiology, bioethics, and public health; adjudicated U.S. civil court cases; and state regulations and statutes. Study Selection: Worldwide experience with anencephalics as homologous organ donors. Data Extraction: Demographic and epidemiologic data on anencephalic births and natural histories; U.S. civil, district, and appellate court case decisions directing or prohibiting organ donation; state determination-of- death acts; state uniform-anatomical-gift acts. Data Synthesis: Organization of all data into either moral challenges or legal challenges to anencephalic organ donation. Conclusions: Statutory laws pose a greater challenge to anencephalic organ donation than moral laws. Case law reviews eliminate substituted judgment rulings in directing anencephalic organ donation. A redefinition of brain death applying only to human beings born without a brain would make more donor hearts available to brain-normal infants dying of hypoplastic left heart syndrome.

Original languageEnglish
Pages (from-to)1781-1790
Number of pages10
JournalCritical Care Medicine
Issue number11
StatePublished - Nov 1993
Externally publishedYes


  • abortion, legal
  • anencephaly
  • brain death
  • congenital heart disease
  • critical illness
  • ethics, medical
  • euthanasia
  • organ donation
  • organ transplantation
  • pediatrics


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