(PHILADELPHIA) – The babies were dying – without life support, they might live just another few minutes. Their families had said goodbye, and wanted their newborns to become organ donors, in hopes of saving another tiny life. But the babies' conditions couldn't meet the normal standards for organ donor eligibility. What to do?

The August 14 issue of the New England Journal of Medicine explores the issue of organ donation after cardiac death through the lens of emotionally charged cases like these, which occurred at the Denver Children's Hospital. In the journal's Perspective Roundtable, Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania School of Medicine, weighs in on the ethical considerations of the changing assumptions about when death occurs, the importance of respecting "the dead donor rule" and how to decide which patients are suitable organ donors.