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Although access to technology varies from country to country, and even hospital to hospital, medicine has advanced to the point that it is possible to support all vital organs (heart, lung, liver, kidney) using machines, or replace them through transplantation.
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The irreversibility of cardiac arrest is related to the context in which it occurs. For example, ability to restore the circulation depends on the location of the arrest.
From a conceptual standpoint, it is important to note that one accepted standard for brain death is the absence of brain blood flow. Absence of whole body circulation invariably is accompanied by absent brain blood flow, thus conceptually fulfilling criteria for brain death.
A major criticism of donation after circulatory death (DCD) protocols has been the concern regarding the time of observation to determine death and the possibility that death is irreversible within the time limits proposed.
Concerns are expressed about violating the dead donor rule, ethical compromise, and the theoretical medico-legal risks for practitioners of being accused of causing the death of a potential donor.
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