Harvesting The "almost Dead" Organs

[cmotherofpirl]

Organ Harvesting Before "Brain-Death" Increasingly Common, Concerned Doctors Warn
Warning that changing definition of death will eventually lead to organ harvesting from disabled

By Gudrun Schultz

WASHINGTON, D.C., March 21, 2007 (LifeSiteNews.com) - Organ harvesting from patients before brain-death has been declared is a rapidly increasing trend in U. S. hospitals, the Washington Post reported March 18, alarming doctors and ethicists about the dubious ethics behind the practice.

Instead of waiting until brain function ceases and the patient is declared "brain-dead" by medical officials (itself a questionable practice since there is no universally-accepted definition of brain-death) surgeons have begun following an approach known as "donation after cardiac death." Organs are harvested once the heart has stopped beating and several minutes have passed without the heart spontaneously re-starting.

"The person is not dead yet," said Jerry A. Menikoff, an associate professor
of law, ethics and medicine at the University of Kansas. "They are going to
be dead, but we should be honest and say that we're starting to remove the
organs a few minutes before they meet the legal definition of death."

"Non-beating heart" organ donations have more than doubled since 2003, from 268 to more than 605 in 2006, and the numbers are continuing to rise. The United Network for Organ Sharing and the Joint Commission on Accreditation of Healthcare Organizations now require all hospitals to evaluate the practice and decide whether or not to adopt it.

The Alliance for Human Research Protection issued an alert Sunday warning that the policy is under consideration by hospitals without allowing for public input.

"The race to catch-up to China's policy of live vivisection organ removal from prisoners is underway right here in the US where, the Post reports, the trend is expected to accelerate this year," the AHRP stated.

"So far as we know, our right to informed consent--which means the right to
say, NO--has been abrogated without so much as a public hearing!"

While doctors normally wait five minutes after the heart has stopped before pronouncing death, more and more doctors are shortening the wait period to maximize the quality of the organs. Surgeons at the Children's Hospital in Denver, Colorado wait only 75 seconds after infants' hearts stop beating before removing the heart for transplant, according to the Post. The demand for usable organs is a powerful incentive to push back the ethical boundaries of harvesting policies, say alarmed physicians.

"A lot of us are not particularly happy about cutting that line particularly
close," said Gail A. Van Norman, an anesthesiologist and bioethicist at the
University of Washington in Seattle.

"It's worrisome when you stop thinking of the person who is dying as a patient but rather as a set of organs, and start thinking more about what's best for the patient in the next room waiting for the organs."

While the National Academy of Sciences' Institute of Medicine approved the practice as ethical so long as strict guidelines are followed, opponents say it is difficult to ensure patients are not being killed by over-eager harvesting, particularly in pediatric situations. Van Norman and others said the practice could put pressure on families to stop care prematurely, especially when doctors and nurses are caring for both the potential donor and potential recipient.

David Crippen, a University of Pittsburgh critical-care specialist, told the Post he is concerned the changing definition of death will eventually lead to organ harvesting from the disabled.

"Now that we've established that we're going to take organs from patients
who have a prognosis of death but who do not meet the strict definition of
death, might we become more interested in taking organs from patients who
are not dead at all but who are incapacitated or disabled?"

See coverage from the Washington Post:
[url="http://www.washingtonpost.com/wp-dyn/content/article/2007/03.."]http://www.washingtonpost.com/wp-dyn/conte...ticle/2007/03..[/url].

See related LifeSiteNews coverage:

Organ "Harvesting" Policy in Canada to Allow Terminal Patients to be Killed for Parts?
[url="http://www.lifesite.net/ldn/2005/sep/05091604.html"]http://www.lifesite.net/ldn/2005/sep/05091604.html[/url]

Organ Harvesting from Chinese Prisoners Confirmed
[url="http://www.lifesite.net/ldn/2006/apr/06042805.html"]http://www.lifesite.net/ldn/2006/apr/06042805.html[/url]

Russian Surgeons Removing Organs Saying Patients Almost Dead Anyways
[url="http://www.lifesite.net/ldn/2003/sep/03090906.html"]http://www.lifesite.net/ldn/2003/sep/03090906.html[/url]

[Thy Geekdom Come]

That's just sick.

[Maggyie]

The idea of over-zealous doctors harvesting organs from not-quite-dead-yet patients has sadly always given me the willies about checking that box for organ donation...

I believe there was a Robin Cook novel that had the harvesting scenario in it. Life imitating art

[prose]

Wow. 75 seconds

[track2004]

If my heart ever stopped beating for a few minutes I'd let 'em take my organs. 75 seconds seems a bit short but I'm guessing the docs have a bit more knowledge on the subject that we do. The whole point of organ donation is that the person doing the donating is only like 75% dead anyway, and most people who sign up to be organ donors know what they're getting into (or I hope they do). Anyone who says yes when the DMV asks if you want to be an organ donor needs to know this, and let their families know because, at least for me, if I wasn't coming back I'd want to at least help some other people. I've made that point very clear to my parents because if something bad did happen I don't want the situation to be any worse for them.

[cmotherofpirl]

I want to be actually dead before anyone gets near me thank you very much.

[Birgitta Noel]

But in this instance the patients are dead. When your heart stops beating you're dead. The patients from whom these organs are removed are not patients who either a) can be resuscitated, or b) wish to be resuscitated. They are dead. When the heart stops beating it takes about 15 seconds for the brain to begin to shut down. With no heart beat there is no circulation. With no circulation there is no life.

Before there was an understanding of brain death cardiac death was the only definition of death. Using this criteria is nothing new.

Edited March 24, 2007 by The Little Way

[RezaMikhaeil]

You know its a known fact that alot of people that are "declared dead" are not really dead and therefore barried alive. Some people may show no vitals but just out of nowhere come alive after a certain amount of time. That's why I told my wife, if I'm declared dead, still put a cell phone in the coffin and don't remove none of my organs or nothing like that, just bury me naturally.

Reza

[Guest T-Bone]

I don't want my guts touching sick people--Bart Simpson

[Archaeology cat]

[quote name='RezaLemmyng' post='1218089' date='Mar 24 2007, 06:43 AM']You know its a known fact that alot of people that are "declared dead" are not really dead and therefore barried alive. Some people may show no vitals but just out of nowhere come alive after a certain amount of time. That's why I told my wife, if I'm declared dead, still put a cell phone in the coffin and don't remove none of my organs or nothing like that, just bury me naturally.

Reza[/quote]

My grandfather was declared dead a couple of times, actually, with his first heart attack. He lived 20 more years.

I have a lot of thinking to do about organ donation. On the one hand, it sounds good being able to help people, but I want to make sure there's absolutely no chance of me being resuscitated first.

[SJRod55]

[quote]You know its a known fact that alot of people that are "declared dead" are not really dead and therefore barried alive. Some people may show no vitals but just out of nowhere come alive after a certain amount of time.[/quote]

This is very true. I also heard that if the figures were really known we would all be quite horrified! (And more than a little scared)

[cmotherofpirl]

[quote name='The Little Way' post='1218053' date='Mar 24 2007, 01:56 AM']But in this instance the patients are dead. When your heart stops beating you're dead. The patients from whom these organs are removed are not patients who either a) can be resuscitated, or b) wish to be resuscitated. They are dead. When the heart stops beating it takes about 15 seconds for the brain to begin to shut down. With no heart beat there is no circulation. With no circulation there is no life.

Before there was an understanding of brain death cardiac death was the only definition of death. Using this criteria is nothing new.[/quote]
You are not dead if your heart stops beating. Too many people who were revived after drowning or heart attacks or many other things would dispute that . You ARE dead if your heart stops beating and no one resusitates you. You are dead if your heart stops beating and all other bodily functions cease and irreversible cell death has occurred. None of that occurrs in a "75 second window" as mentioned in this story. "Brain death" is an excuse to make money from harvesting living tissue.
How dead is someone when you have to anesthetize a body before you can harvest the organs??

[Birgitta Noel]

[quote name='cmotherofpirl' post='1218194' date='Mar 24 2007, 09:11 AM']You are not dead if your heart stops beating. Too many people who were revived after drowning or heart attacks or many other things would dispute that . You ARE dead if your heart stops beating and no one resusitates you. You are dead if your heart stops beating and all other bodily functions cease and irreversible cell death has occurred. None of that occurrs in a "75 second window" as mentioned in this story. "Brain death" is an excuse to make money from harvesting living tissue.
How dead is someone when you have to anesthetize a body before you can harvest the organs??[/quote]

Those who are non-heart beating donors are dead dead. There was an excellent blog post by Wesley J. Smith who keeps close watch on the Culture of Death titled [url="http://bioethicsnews.com/2007/03/23/organ-hysteria/"]Organ Hysteria[/url]. He blogs about cardiac death and transplantation again [url="http://www.wesleyjsmith.com/blog/2007/02/irresponsible-headline-organ-harvesting.html"]HERE[/url]. It's also important to note that there is no moral obligation to resuscitate someone. If one's heart stops beating and they do not want to be resuscitated to do so would be assault. Thus there is no problem with this person becoming an organ donor. The Church does not hold a vitalist position that we have to do everything available to extend a person's life.

Those who are DCD organ donors are a limited group. Potential DCD donors are facing imminent death. They are patients who have a terminal disease for which further intervention is viewed as a futile prolongation of death or as overly burdensome; patients (or their surrogates) who determine the withdrawal or withholding of life sustaining care is in their best interest. In no other medical scenarios when the patient has refused life sustaining intervention do we question whether death has actually occurred simply because the physician may have the physical capacity to attempt to reverse it. It is counterintuitive to do so in the case of DCD. The capacity of the patient to autoresuscitate, coupled with their wishes to not pursue life sustaining intervention is the understanding of irreversibility embraced by those involved with DCD. Key to this understanding of irreversibility is the informed consent of the patient. Death simpliciter may be a necessary condition for DCD, but it is not a “sufficient condition to take someone’s organs” if apart from the need for donors one may have wished that an attempt be made to reverse the death.

Those who are considered as candidates for DCD are not “fresh, cold water drowning victims or patients that have taken an overdose of barbiturates who can give the superficial appearance of death.” In fact, “the majority of these patients will have sustained a severe brain injury by diverse mechanisms—traumatic, vascular, hypoxic, metabolic or infective—but not be brainstem dead.” Others will have “end-stage musculoskeletal disease and high spinal cord injury.” Most have “functioning organs” but are “being supported by such life-sustaining interventions as mechanical ventilators, heart-lung bypass machines, cardiopulmonary resuscitation, and inotropic and pressor medications.” They are patients who have been “aggressively evaluated for any survival potential and failed long before they were assigned to potential donor status.” These are patients who themselves, or more likely their surrogates, have requested the withdrawal or withholding of life sustaining care. Only once this request has been made is any discussion of becoming DCD donors initiated – often by the patient or family.

One further difficulty regarding “irreversibility” arises from the public perception of the potential for CPR to revive and “save” the patient. Because of the high rate of use and success portrayed on television and in film the public not only expects that resuscitation occur when cardiac arrest happens, but expects it to be effective to the extent that a patient recovers and even returns home. While this is true in some cases those who are candidates for DCD are not those who are in reality candidates for CPR. As DuBois points out, even if death were reversible in some way, though undesired by the patient and thus unethical and illegal to pursue a resurrection of sorts, the fact that the patient is currently dead means that the procurement of organs cannot kill the patient again: “If death has occurred, it can no longer be caused”!

Finally, the reason bodies are anesthetized is to prevent the spinal reflex from occurring. This is a nerve reflex, not a reflex of an integrated functioning system. I have spoken to a nurse transplant coordinator who confirmed this for me.

Edited March 24, 2007 by The Little Way

[SJRod55]

[quote name='The Little Way' post='1218768' date='Mar 24 2007, 09:46 PM']The reason bodies are anesthetized is to prevent the spinal reflex from occurring. This is a nerve reflex, not a reflex of an integrated functioning system. I have spoken to a nurse transplant coordinator who confirmed this for me.[/quote]

I have never heard of this before and it sounds really horrid.

[Birgitta Noel]

It's not really horrid though, the patient is dead. Dead patients have all sorts of reflexes, but because their hearts have stopped beating and about 15 seconds later their brains have shut down there is no pain being experienced because the patient is dead. There is no more consciousness.

The anesthesia is to prevent spinal cord reflexes. Not conscious responses.