The recent abandonment of the only active US protocol for harvesting organs from anencephalic "donors" indicates both the practical and the ethical problems inherent in such an effort. Various data suggest that surprisingly few such organs would actually end up benefiting other children. Attempts to revise either the Uniform Anatomical Gift Act or the Uniform Determination of Death Act to allow organ removal from spontaneously breathing anencephalic infants face major ethical objections. Even if this posed no ethical problem in theory, the ultimate harm to society would not be offset by the good of the few surviving recipients of these organs. Furthermore, providing anencephalic infants with intensive care would tend to preserve the brain stem as effectively as the other organs, predictably rendering the occurrence of brain death unlikely. Thus, despite the great need for newborn organs, anencephalic infants are not as attractive a source as some had hoped.
KIE: The recent abandonment of the only active U.S. protocol for harvesting organs from anencephalic donors by Loma Linda University Medical Center in California indicates the unresolved issues inherent in such an effort. An historical review of transplants using anencephalic donors is given. Issues discussed include the medical utility of such practice, the legal definition of anencephalics as nonpersons, provision of intensive care while awaiting brain death, and revision of the Uniform Anatomical Gift Act to include live anencephalics as acceptable donors and of the Uniform Determination of Death Act to define anencephalics as dead. Ethical objections and data suggesting that few such organs would actually benefit other children lead the authors to conclude that the ultimate harm to society would not be offset by the good of the surviving recipients of such organs and that anencephalic infants are not as attractive a source of newborn organs as some had hoped.