Reconsidering the dead donor rule: is it important that organ donors be dead?

The "dead donor rule" is increasingly under attack for several reasons. First, there has long been disagreement about whether there is a correct or coherent definition of "death." Second, it has long been clear that the concept and ascertainment of "brain death" is medically flawed. Third, the requirement stands in the way of improving organ supply by prohibiting organ removal from patients who have little to lose--e.g., infants with anencephaly--and from patients who ardently want to donate while still alive--e.g., patients in a permanent vegetative state. One argument against abandoning the dead donor rule has been that the rule is important to the general public. There is now data suggesting that this assumption also may be flawed. These findings add additional weight to proposals to abandon the dead donor rule so that organ supply can be expanded in a way that is consistent with traditional notions of ethics, law, public policy, and public opinion.     

When are you dead enough to be a donor? Can any feasible protocol for the determination of death on circulatory criteria respect the dead donor rule?

The basic question concerning the compatibility of donation after circulatory death (DCD) protocols with the dead donor rule is whether such protocols can guarantee that the loss of relevant biological functions is truly irreversible. Which functions are the relevant ones? I argue that the answer to this question can be derived neither from a proper understanding of the meaning of the term “death” nor from a proper understanding of the nature of death as a biological phenomenon. The concept of death can be made fully determinate only by stipulation. I propose to focus on the irreversible loss of the capacity for consciousness and the capacity for spontaneous breathing. Having accepted that proposal, the meaning of “irreversibility” need not be twisted in order to claim that DCD protocols can guarantee that the loss of these functions is irreversible. And this guarantee does not mean that reversing that loss is either conceptually impossible or known to be impossible with absolute certainty.

     

Are the pathogens of out-groups really more dangerous?

We question the plausibility of Fincher & Thornhill's (F&T's) argument that localised pathogen-host coevolution leads to out-groups having pathogens more damaging than those infecting one's own family or religious group.     

Are rules and modules really necessary for explaining language?

Over the past few years Steven Pinker has argued that although some aspects of language may be more associational, and therefore properly modeled in connectionist networks, for the most part human language is still best characterized as a modularized set of rulesymbol systems. In support of his claim, Pinker garners a broad array of clinical, experimental, and observational data from neurology, psychology, and linguistics. Those data, unfortunately, are not compelling because they do not support his position uniquely. In this paper, I show how each of his arguments is compatible with alternative interpretations. I argue, moreover, that in focusing on certain details of connectionist models Pinker and his colleagues actually overlooked both the most serious deficiencies of the connectionist approach and its most significant theoretical contribution. I conclude by sketching briefly some emerging alternatives to connectionism which avoid those deficiencies while retaining its strengths over the rule-symbol systems of linguistic theory.This research was funded in part by University of Idaho Seed Grant 681-Y304.     

When do stereotypes become really consensual? Investigating the group-based dynamics of the consensualization process

Although it has long been recognized that stereotypes achieve much of their force from being shared by members of social groups, relatively little empirical work has examined the process by which such consensus is reached. This paper tests predictions derived from self-categorization theory that stereotype consensus will be enhanced (a) by factors which make the shared social identity of perceivers salient and (b) by group interaction that is premised upon that shared identity. In Experiment 1 (N=40) the consensus of ingroup stereotypes is enhanced where an ingroup is judged after (rather than before) an outgroup. In Experiment 2 (N=80) when only one group is judged, group interaction is shown to enhance the consensus of outgroup stereotypes more than those of the ingroup—an apparent ‘outgroup consensus effect’. In Experiment 3 (N=135) this asymmetry is extinguished and group interaction found to produce equally high consensus in both ingroup and outgroup stereotypes when the ingroup is explicitly contrasted from an outgroup. Implications for alternative models of consensus development are discussed. © 1998 John Wiley & Sons, Ltd.     

Clarifying the paradigm for the ethics of donation and transplantation: Was 'dead' really so clear before organ donation?

Recent commentaries by Verheijde et al, Evans and Potts suggesting that donation after cardiac death practices routinely violate the dead donor rule are based on flawed presumptions. Cell biology, cardiopulmonary resuscitation, critical care life support technologies, donation and transplantation continue to inform concepts of life and death. The impact of oxygen deprivation to cells, organs and the brain is discussed in relation to death as a biological transition. In the face of advancing organ support and replacement technologies, the reversibility of cardiac arrest is now purely related to the context in which it occurs, in association to the availability and application of support systems to maintain oxygenated circulation. The 'complete and irreversible' lexicon commonly used in death discussions and legal statutes are ambiguous, indefinable and should be replaced by accurate terms. Criticism of controlled DCD on the basis of violating the dead donor rule, where autoresuscitation has not been described beyond 2 minutes, in which life support is withdrawn and CPR is not provided, is not valid. However, any post mortem intervention that re-establishes brain blood flow should be prohibited. In comparison to traditional practice, organ donation has forced the clarification of the diagnostic criteria for death and improved the rigour of the determinations.     

Is the brain an organ for free energy minimisation?

Philosophical Studies - Two striking claims are advanced on behalf of the free energy principle (FEP) in cognitive science and philosophy: (i) that it identifies a condition of the possibility of...     

Are microsaccades responsible for the gap effect?

Extinguishing a fixation point shortly before, or concurrently with, the onset of a peripheral visual target reduces the latency of saccades to that target. Saslow (1967) hypothesized that thisgap effect might occur because fixation point offsets reduce the incidence of corrective microsaccades with an associated saccadic refractory period. In the present study, a robust gap effect was obtained. However, using a Purkinje image eyetracker with 1 arcmin of resolution, we found that fixation point offsets had no effect on the occurrence of microsaccades and that the occurrence of microsaccades had no impact on the magnitude of the gap effect. Microsaccades therefore do not appear to play any part in the production of the gap effect.     

How honest are the signals? A protocol for validating wearable sensors

There is growing interest among organizational researchers in tapping into alternative sources of data beyond self-reports to provide a new avenue for measuring behavioral constructs. Use of alternative data sources such as wearable sensors is necessary for developing theory and enhancing organizational practice. Although wearable sensors are now commercially available, the veracity of the data they capture is largely unknown and mostly based on manufacturers’ claims. The goal of this research is to test the validity and reliability of data captured by one such wearable badge (by Humanyze) in the context of structured meetings where all individuals wear a badge for the duration of the encounter. We developed a series of studies, each targeting a specific sensor of this badge that is relevant for structured meetings, and we make specific recommendations for badge data usage based on our validation results. We have incorporated the insights from our studies on a website that researchers can use to conduct validation tests for their badges, upload their data, and assess the validity of the data. We discuss this website in the corresponding studies.     

Harvesting the living?: separating "brain death" and organ transplantation

The chronic shortage of transplantable organs has reached critical proportions. In the wake of this crisis, some bioethicists have argued that there is sufficient public support to expand organ recovery through use of neocortical criteria of death or even pre-mortem organ retrieval. I present a typology of ways in which data gathered from the public can be misread or selectively used by bioethicists in service of an ideological or policy agenda, resulting in bad policy and bad ethics. Such risks should lead us to look at alternatives for increasing organ supplies short of expanding or abandoning the dead donor rule. The chronic problem of organ scarcity should prompt bioethicists to engage in constructive dialogue about the relation of the social sciences and bioethics, to examine the social malleability of the definition of death, and to revisit the question of the priority of organ transplants in the overall package of healthcare benefits provided to most, but not all, citizens.     

Sex differences among partner preferences: Are the sexes really very similar?

The question as to what type of individual we prefer in a “romantic” partner has stimulated a long history of research, with much of the present debate centering around the issue of the sex differences in partner preferences. In the studies described in this paper, two groups of participants completed a variety of different questionnaire schedules indicating their preferences for a partner. In study 1, 216 single students demonstrated a prevailing desire for a kind, considerate, and honest partner who displayed a keen sense of humor. Consistent with the hypothesis, there were no clear sex differences evident in these results. In study 2, 76 dating agency members completed a similar schedule examining partner preferences. Here again, preferences were similar across the sexes, although men preferred the submissive and introverted partner and stressed the importance of physical appearance in a mate. The general discussion considers the implications of these findings in the light of previous research on partner preferences.     

Big Five personality traits: Are they really important for the subjective well‐being of Indians?

This study empirically examined the relationship between the Big Five personality traits and subjective well‐being (SWB) in India. SWB variables used were life satisfaction, positive affect and negative affect. A total of 183 participants in the age range 30–40 years from Pune, India, completed the personality and SWB measures. Backward stepwise regression analysis showed that the Big Five traits accounted for 17% of the variance in life satisfaction, 35% variance in positive affect and 28% variance in negative affect. Conscientiousness emerged as the strongest predictor of life satisfaction. In line with the earlier research findings, neuroticism and extraversion were found to predict negative affect and positive affect, respectively. Neither openness to experience nor agreeableness contributed to SWB. The research emphasises the need to revisit the association between personality and SWB across different cultures, especially non‐western cultures.     

Are retailers fully prepared for the holiday shopping season?

Secret shoppers anonymously observed and rated 114 Chicagoland retailers during the 1991 end-of-year holiday shopping season. The raters assessed if the stores were clean, safe, and organized, and whether or not the employees and management provided a high-caliber of customer service. Statistical analyses showed that there were multiple opportunities for improvement in the areas of store organization, service management, employee productivity, and customers' overall feelings about the holiday shopping experience. It was also discovered that stores that were supervised by highly involved and enthused managers were better prepared for shoppers than were stores with no managers on the floor or else the managers were present yet they seem uninterested and uninvolved. Finally, stores that used multi-purpose employment tests appeared to be more prepared for shoppers than non-testing stores.