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.

中文翻译：

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您什么时候死亡足以成为捐助者？用循环标准确定死亡的任何可行方案都可以遵守死者捐献者规则吗？

关于循环死亡后捐赠与死者捐赠规则的兼容性的基本问题是，这种协议是否可以保证相关生物学功能的丧失确实是不可逆的。相关的功能是什么？我认为，对这个问题的答案既不能源自对“死亡”一词含义的正确理解，也不能源自对死亡作为一种生物现象的本质的正确理解。只有通过规定，才能完全确定死亡的概念。我建议专注于意识能力和自发呼吸能力的不可逆转的丧失。接受了该提议，“不可逆性”的含义不必为了主张DCD协议可以保证这些功能的丧失是不可逆的而扭曲。而且，这种保证并不意味着在绝对概念上不可能完全弥补或从概念上不可能弥补这一损失。