The article "Restoring the Organism as a Whole: Does NRP Resurrect the Dead?" by Emil J. N. Busch addresses the ethical concerns surrounding normothermic regional perfusion (NRP) in controlled donation after circulatory determination of death (cDADD) protocols. The American College of Physicians (ACP) has raised concerns about NRP-cDADD, arguing that it violates the dead donor rule (DDR) and potentially resuscitates donors. Busch argues that these concerns are misplaced. Busch begins by explaining the circulatory criterion for determining death, which is based on the concept of the organism as a whole. According to this criterion, death is determined when the organism has lost its ability to function as a whole, rather than just the loss of specific functions like circulation or respiration. In cDADD protocols, the circulatory criterion is used to determine if the donor is dead, and the no-touch period after cardiac arrest is crucial in confirming this. The article then discusses the use of NRP in cDADD, where blood flow is reestablished to preserve organs for transplantation. Busch argues that while NRP may restore circulation in some parts of the body, it excludes circulation to the brain, which is essential for the organism to function as a whole. Therefore, the circulation restored by NRP does not support the organism's fundamental vital work and does not violate the circulatory criterion for death. Busch concludes that the ACP's claim that NRP-cDADD violates the DDR and resuscitates donors is incorrect. The circulatory criterion is fulfilled in cDADD donors, and the exclusion of brain circulation in NRP ensures that the donor remains dead. Thus, NRP does not negate the determination of death or resuscitate the donor.The article "Restoring the Organism as a Whole: Does NRP Resurrect the Dead?" by Emil J. N. Busch addresses the ethical concerns surrounding normothermic regional perfusion (NRP) in controlled donation after circulatory determination of death (cDADD) protocols. The American College of Physicians (ACP) has raised concerns about NRP-cDADD, arguing that it violates the dead donor rule (DDR) and potentially resuscitates donors. Busch argues that these concerns are misplaced. Busch begins by explaining the circulatory criterion for determining death, which is based on the concept of the organism as a whole. According to this criterion, death is determined when the organism has lost its ability to function as a whole, rather than just the loss of specific functions like circulation or respiration. In cDADD protocols, the circulatory criterion is used to determine if the donor is dead, and the no-touch period after cardiac arrest is crucial in confirming this. The article then discusses the use of NRP in cDADD, where blood flow is reestablished to preserve organs for transplantation. Busch argues that while NRP may restore circulation in some parts of the body, it excludes circulation to the brain, which is essential for the organism to function as a whole. Therefore, the circulation restored by NRP does not support the organism's fundamental vital work and does not violate the circulatory criterion for death. Busch concludes that the ACP's claim that NRP-cDADD violates the DDR and resuscitates donors is incorrect. The circulatory criterion is fulfilled in cDADD donors, and the exclusion of brain circulation in NRP ensures that the donor remains dead. Thus, NRP does not negate the determination of death or resuscitate the donor.