Robert D Truog
Biographic Data
| ID | 5557787 |
|---|---|
| NAME | Robert D Truog |
| GIVEN NAMES | Robert D |
| FAMILY NAME | Truog |
| SIGNATURE | TRUOG R D |
| AFFILIATIONS | Boston Children's Hospital |
| ORCID | 0000-0001-5384-8281 |
| VERIFIED | Yes |
| TOTAL WORKS | 26 |
| TOTAL CITATIONS | 0 |
| WORKS AS AUTHOR | 26 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1992 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Robert D. Truog replies
This letter responds to the letter “Reexamining the UDDA: Are We Ready for Significant Change?,” by Paul T. Menzel, in the same, July‐August 2026, issue of the Hastings Center Report .
The Enigma of Brain Death
This is a commentary on an historical analysis by Anne E. Clinton in the Hastings Center Report's November‐December 2025 issue on the creation of the Uniform Determination of Death Act in 1980, focusing on the attempt by the Uniform Law Commission to revise the act in 2020. The original UDDA was based on scientific evidence that the brain is responsible for maintaining the integrated functioning of the body, such that brain death quickly leads to…
Research involving the recently deceased
Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gain…
In Defense of Normothermic Regional Perfusion
Normothermic regional perfusion (NRP) is a relatively new approach to procuring organs for transplantation. After circulatory death is declared, perfusion is restored to either the thoracoabdominal organs (in TA‐NRP) or abdominal organs alone (in A‐NRP) using extracorporeal membrane oxygenation. Simultaneously, surgeons clamp the cerebral arteries, causing a fatal brain injury. Critics claim that clamping the arteries is the proximate cause of de…
Ethical climate in contemporary paediatric intensive care
Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric inten…
Ventilator Allocation Protocols
I was a member of the Massachusetts advisory working group that wrote the Commonwealth's crisis standards of care guidance for the Covid‐19 pandemic, and I was proud of the work we did, thinking carefully about whether age should matter and whether priority should be given to essential workers if there was a scarcity of medical resources, about whether protocols should address issues of structural racism, and so forth. But as a critical care phys…
It Is Time to Abandon the Dogma That Brain Death Is Biological Death
Drawing on a recent case report of a pregnant, brain‐dead woman who gave birth to a healthy child after over seven months of intensive care treatment, this essay rejects the established doctrine in medicine that brain death constitutes the biological death of the human being. The essay describes three policy options with respect to determination of death and vital organ transplantation in the case of patients who are irreversibly comatose but rem…
The Toughest Triage — Allocating Ventilators in a Pandemic
The Toughest Triage Of all the medical care that will have to be rationed during the Covid-19 pandemic, the most problematic will be mechanical ventilation. One strategy for avoiding debilitating d...
Trustworthiness before Trust — Covid-19 Vaccine Trials and the Black Community
Trustworthiness before Trust If Black communities are to participate in Covid-19 trials, clinicians, investigators, and pharmaceutical companies must provide convincing evidence — sufficient to ove...
Use of Nazi torture device image in digital scholarship article
"Use of Nazi torture device image in digital scholarship article*." Medical Teacher, 42(6), pp. 717–718
What Should We Do When Families Refuse Testing for Brain Death
Two commentaries respond to a case about apnea testing to confirm death by neurologic criteria
Of Slide Rules and Stethoscopes
Historically, the practice of medicine has been a physically intimate endeavor. Physicians have used their hands to palpate and reveal the secrets hidden within the body. Smelling the breath for the ketosis of diabetes or tasting the skin for the saltiness of cystic fibrosis were among the physician's essential practices. Today, perhaps the most defining characteristic of a brilliant clinician is the ability to synthesize many images—from electro…
Lessons from the Case of Jahi McMath
Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been…
Brain Death at Fifty
This special report is published in commemoration of the fiftieth anniversary of the “Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,” a landmark document that proposed a new way to define death, with implications that advanced the field of organ transplantation. This remarkable success notwithstanding, the concept has raised lasting questions about what it means to be dead. Is death defined …
Expanding the Horizon of Our Obligations in the Clinician‐Patient Relationship
Johan Brännmark's article “Patients as Rights Holders,” in this issue of the Hastings Center Report, squarely identifies some important problems with the way we in clinical practice conceive of our obligations to our patients. As a solution, he helpfully suggests augmenting our focus on autonomy and informed consent with a broader menu of considerations drawn from the literature on human rights. Respect for autonomy is, of course, one of the hall…
How Should Clinicians Weigh the Benefits and Harms of Discussing Politicized Topics that Influence Their Individual Patients’ Health
Health implications of politically charged phenomena are particularly difficult for physicians to discuss with their patients and communities. Addressing climate change and its associated health effects involves trade-offs between health and economic prosperity, necessitating that physicians weigh the potential benefits and risks of discussing climate change health effects. We argue that the potential benefits of physician communication and advoc…
What to Do When There Aren't Enough Beds in the Picu
The concepts of medical futility and rationing are often misunderstood and lead to significant consternation when resources are stretched and pediatric intensive care unit (PICU) beds are unavailable. While the two concepts overlap, each has its own distinct application and moral justification. Most importantly, we should avoid using one to justify the other. Bioethics professionals should assist critical care clinicians in clarifying when each r…
Microethics
Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethi…
The Question of Clinical Equipoise and Patients' Best Interests
0 B.92 .4 2 FB012 ;03= 2 ; 9= 034 9; 2 @ JKL5034 L.= B -;34 = N F>2 B 0BM 2 3G0 O 1.1L>/3= = L90= = = F1G 931904 D E;0 I 04P0B >F4 P Q 804 9012 31B 2 ;0 9F4 4 012 >2 31B34 B .I 934 0 9;0/.2 ;04 385D E;0 R..B 31B A4 FG SB/ 2 4 32 N F>2 3884 .P0B 3 84 ./ D
Ethical Controversies in Pediatric Critical Care
Brain Death
a recent article on the subject of brain death by noting that "If one subject in health law and bioethics can be said to be at once well settled and persistently unresolved, it is how to determine that death has occurred" [1]. The "well settled" aspect is easy to understand-thousands of deaths are diagnosed daily on the basis of cessation of pulse and respiration. A much smaller number are diagnosed on the basis of neurological criteria-so-called…
Death
Case Study
On Brain Death
Is It Time to Abandon Brain Death
Despite its familiarity and widespread acceptance, the concept of\n"brain death" remains incoherent in theory and confused in practice. Moreover,\nthe only purpose served by the concept is to facilitate the procurement of\ntransplantable organs. By abandoning the concept of brain death and adopting\ndifferent criteria for organ procurement, we may be able to increase both the\nsupply of transplantable organs and clarity in our understanding of\nd…
No prominent works on this page.
Triage in the ICU
Some patients in intensive care units are too sick to derive much benefit from being there, while others are too well to require the technology and skills offered. When ICU resources are scarce, they may ethically be withdrawn from either sort of patient in favor of one more likely to benefit from the care
Case Study
On Brain Death
Is It Time to Abandon Brain Death
Despite its familiarity and widespread acceptance, the concept of\n"brain death" remains incoherent in theory and confused in practice. Moreover,\nthe only purpose served by the concept is to facilitate the procurement of\ntransplantable organs. By abandoning the concept of brain death and adopting\ndifferent criteria for organ procurement, we may be able to increase both the\nsupply of transplantable organs and clarity in our understanding of\nd…
Death
Brain Death
a recent article on the subject of brain death by noting that "If one subject in health law and bioethics can be said to be at once well settled and persistently unresolved, it is how to determine that death has occurred" [1]. The "well settled" aspect is easy to understand-thousands of deaths are diagnosed daily on the basis of cessation of pulse and respiration. A much smaller number are diagnosed on the basis of neurological criteria-so-called…
Ethical Controversies in Pediatric Critical Care
Microethics
Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethi…
The Question of Clinical Equipoise and Patients' Best Interests
0 B.92 .4 2 FB012 ;03= 2 ; 9= 034 9; 2 @ JKL5034 L.= B -;34 = N F>2 B 0BM 2 3G0 O 1.1L>/3= = L90= = = F1G 931904 D E;0 I 04P0B >F4 P Q 804 9012 31B 2 ;0 9F4 4 012 >2 31B34 B .I 934 0 9;0/.2 ;04 385D E;0 R..B 31B A4 FG SB/ 2 4 32 N F>2 3884 .P0B 3 84 ./ D
Expanding the Horizon of Our Obligations in the Clinician‐Patient Relationship
Johan Brännmark's article “Patients as Rights Holders,” in this issue of the Hastings Center Report, squarely identifies some important problems with the way we in clinical practice conceive of our obligations to our patients. As a solution, he helpfully suggests augmenting our focus on autonomy and informed consent with a broader menu of considerations drawn from the literature on human rights. Respect for autonomy is, of course, one of the hall…
How Should Clinicians Weigh the Benefits and Harms of Discussing Politicized Topics that Influence Their Individual Patients’ Health
Health implications of politically charged phenomena are particularly difficult for physicians to discuss with their patients and communities. Addressing climate change and its associated health effects involves trade-offs between health and economic prosperity, necessitating that physicians weigh the potential benefits and risks of discussing climate change health effects. We argue that the potential benefits of physician communication and advoc…
What to Do When There Aren't Enough Beds in the Picu
The concepts of medical futility and rationing are often misunderstood and lead to significant consternation when resources are stretched and pediatric intensive care unit (PICU) beds are unavailable. While the two concepts overlap, each has its own distinct application and moral justification. Most importantly, we should avoid using one to justify the other. Bioethics professionals should assist critical care clinicians in clarifying when each r…
Lessons from the Case of Jahi McMath
Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been…
Brain Death at Fifty
This special report is published in commemoration of the fiftieth anniversary of the “Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,” a landmark document that proposed a new way to define death, with implications that advanced the field of organ transplantation. This remarkable success notwithstanding, the concept has raised lasting questions about what it means to be dead. Is death defined …
Of Slide Rules and Stethoscopes
Historically, the practice of medicine has been a physically intimate endeavor. Physicians have used their hands to palpate and reveal the secrets hidden within the body. Smelling the breath for the ketosis of diabetes or tasting the skin for the saltiness of cystic fibrosis were among the physician's essential practices. Today, perhaps the most defining characteristic of a brilliant clinician is the ability to synthesize many images—from electro…
The Toughest Triage — Allocating Ventilators in a Pandemic
The Toughest Triage Of all the medical care that will have to be rationed during the Covid-19 pandemic, the most problematic will be mechanical ventilation. One strategy for avoiding debilitating d...
Trustworthiness before Trust — Covid-19 Vaccine Trials and the Black Community
Trustworthiness before Trust If Black communities are to participate in Covid-19 trials, clinicians, investigators, and pharmaceutical companies must provide convincing evidence — sufficient to ove...
Use of Nazi torture device image in digital scholarship article
"Use of Nazi torture device image in digital scholarship article*." Medical Teacher, 42(6), pp. 717–718
What Should We Do When Families Refuse Testing for Brain Death
Two commentaries respond to a case about apnea testing to confirm death by neurologic criteria
Ethical climate in contemporary paediatric intensive care
Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric inten…
Ventilator Allocation Protocols
I was a member of the Massachusetts advisory working group that wrote the Commonwealth's crisis standards of care guidance for the Covid‐19 pandemic, and I was proud of the work we did, thinking carefully about whether age should matter and whether priority should be given to essential workers if there was a scarcity of medical resources, about whether protocols should address issues of structural racism, and so forth. But as a critical care phys…
It Is Time to Abandon the Dogma That Brain Death Is Biological Death
Drawing on a recent case report of a pregnant, brain‐dead woman who gave birth to a healthy child after over seven months of intensive care treatment, this essay rejects the established doctrine in medicine that brain death constitutes the biological death of the human being. The essay describes three policy options with respect to determination of death and vital organ transplantation in the case of patients who are irreversibly comatose but rem…
Research involving the recently deceased
Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gain…
In Defense of Normothermic Regional Perfusion
Normothermic regional perfusion (NRP) is a relatively new approach to procuring organs for transplantation. After circulatory death is declared, perfusion is restored to either the thoracoabdominal organs (in TA‐NRP) or abdominal organs alone (in A‐NRP) using extracorporeal membrane oxygenation. Simultaneously, surgeons clamp the cerebral arteries, causing a fatal brain injury. Critics claim that clamping the arteries is the proximate cause of de…
The Enigma of Brain Death
This is a commentary on an historical analysis by Anne E. Clinton in the Hastings Center Report's November‐December 2025 issue on the creation of the Uniform Determination of Death Act in 1980, focusing on the attempt by the Uniform Law Commission to revise the act in 2020. The original UDDA was based on scientific evidence that the brain is responsible for maintaining the integrated functioning of the body, such that brain death quickly leads to…
Medicine (16 works) · Psychology (16 works) · Political science (12 works) · Law (9 works) · Organ Donation and Transplantation (9 works) · Palliative Care and End-of-Life Issues (9 works) · Engineering ethics (5 works) · Ethics and Legal Issues in Pediatric Healthcare (5 works) · Grief, Bereavement, and Mental Health (5 works) · Sociology (5 works)