Karen has authored Redefining Death, Yale University Press (1986), co-edited Ethical Challenge in Managed Care: A Casebook, Georgetown University Press (1999), and published articles in such journals as the Hastings Center Report, Medical Humanities Review, Journal of Clinical Ethics, Journal of Participatory Medicine, American Journal of Bioethics, Vaccine, Neurology, and Minnesota Medicine.
She is currently director of the Minnesota Center for Health Care Ethics. Karen was one of 14 Europeans and 6 Americans invited to participate in an international workshop convened by the Center for Interdisciplinary Research of the University of Bielefeld and the Centre for Advanced Study in Bioethics of the University of Munster (Germany) from September 12-14, 2013. The title of the workshop was, “The Importance of Being Dead: The Dead Donor Rule and the Ethics of Transplantation Medicine.” In Gervais’ presentation, she recommended changes to current organ donation-related policy and practices that increasingly adjust the terms under which donors are considered dead.
She recommended a coherent concept and criteria for determining death, a conscience clause allowing for diverse belief systems, general adherence to the Dead Donor Rule (DDR), but an exception to the DDR in the case of patients who wish to be donors following the removal of life-sustaining treatment. Current and evolving practices in organ donation (called “controlled donation after cardiac death” and “uncontrolled donation after cardiac death”) involve declaring patients dead following the removal of life-sustaining interventions (e.g., a ventilator) whose heart stoppage is reversible and whose level of consciousness/awareness is not tested for and therefore unknown when organ procurement is initiated. Gervais will recommend that these patients or their surrogates be offered the option of being living donors following fully informed consent to the deviations from end-of-life best practices this will require, agreement to general anesthesia, and acknowledgment that donation itself will be the proximate cause of death. The basis of her argument is the informed decision, by the patient or surrogate, that death is a non-harm under the patient’s circumstances.