|"Huh? You're not dead?! Oops!"|
Wednesday, July 10, 2013
Dead People Can't Donate Vital Organs
Organ donation and brain death are in the news again, although the actual event being discussed took place in 2009. Here are the opening lines of the most detailed story I can find on the subject (H/T commenter fRED):
Doctors at St. Joseph’s Hospital Health Center [Syracuse, NY] were about to remove organs for transplant from a woman they thought was dead.
Then she opened her eyes. She was alive.
The state Health Department found St. Joe’s care of patient Colleen S. Burns in 2009 unacceptable and a federal agency criticized the hospital for not properly investigating the cause.
There’s a very good reason not to sign one of those organ donation cards: you might be alive when the doctors take those donated organs. That will kill you.
I have written about this issue of brain death and organ transplantation here, and I transcribed an excellent sermon on the subject which you can read by clicking the tab at the top of this page which says “May We Donate Organs?” The priest who gave that sermon repeatedly made the point that
Before the development of modern critical care, the diagnosis of death was relatively straightforward. Patients were dead when they were cold, blue, and stiff.
That definition of death has changed over time, primarily because:
Unfortunately, organs from these traditional cadavers cannot be used for transplantation.
Now, apparently, in the case that is currently in the news, hospital staff made many errors as the poor woman (who later committed suicide) was inexorably propelled toward her death-by-organ-donation. Here are a few of them, as related by the article (my emphases):
The day before her organs were to be removed, a nurse had performed a reflex test on Burns, scraping a finger on the bottom of her foot. The toes curled downward - not the expected reaction of someone who's supposed to be dead.
There were other indications that Burns had not suffered irreversible brain damage, as doctors had determined. Her nostrils flared in the prep area outside the OR. She seemed to be breathing independently from the respirator she was attached to. Her lips and tongue moved.
Twenty minutes after those observations were made, a nurse gave Burns an injection of the sedative Ativan, according to records.
If you think about it, it is quite odd to administer a sedative to a dead person. In fact, some of the doctors reviewing the case pointed this out. The article states:
"Dead people don't curl their toes," said Dr. Charles Wetli, a nationally known forensic pathologist out of New Jersey. "And they don't fight against the respirator and want to breathe on their own."
Once those signs of life appeared, the organ-harvesting process should've stopped, Wetli said.
Wetli wondered why, after seeing signs that Burns was alive, a nurse would give Burns a sedative.
Dr. David Mayer, general and vascular surgeon and an associate professor of clinical surgery at New York Medical College, also reviewed the records and found the use of a sedative perplexing.
"It would sedate her to the point that she would be non-reactive," Mayer said. "If you have to sedate them or give them pain medication, they're not brain dead and you shouldn't be harvesting their organs."
Duh! Because in harvesting the vital organs of living persons, you kill them!
On August 29, 2000, Pope John Paul II delivered an address to the XVIII International Congress of the Transplantation Society; apparently some medical professionals interpreted that address as unconditional approval for organ transplantation. But in a 2001 article, Bishop Fabian Bruskewitz, Bishop Robert F. Vasa, et al., disagreed with that interpretation, and sought to clarify and highlight the points actually made by Pope John Paul II. One of the points made by the Bruskewitz-Vasa team was this (all emphases mine throughout this post):
In response to the increasing number of protests from nurses and anesthesiologists, who sometimes react strongly to the movements of the supposed “corpse,” and because these movements sometimes make it impossible to continue the operation, transplant surgeons have come to rely on the use of paralyzing drugs. These drugs are used in the same manner and dosages as with living patients, but here they are used in order to suppress signs of life—and in order to dissipate the protests and objections of the medical, nursing, and pastoral personnel who are increasingly uncertain that the organ donor is truly dead.
And yet, if a person had died and the question was whether or not to begin embalming – with no intent to harvest organs – would not any signs of life be taken as an indication that death had not yet occurred? (This is the example given at the beginning of the sermon transcript.)
Bruskewitz and Vasa go on:
The donor is treated and prepared for surgery in a way similar to any other living patient going to the operating room. After the removal of healthy vital organs, what is left is an empty corpse. Such removal is ethically unacceptable. It is the removal of the organs that changes the living person to a dead one.
There are many justifications made for redefining death, for implementing the idea of “brain death”, and for making a rather hasty assessment of death in order to harvest organs that might save the life of another person. But Bruskewitz and Vasa refuse to start down that slippery slope:
Anyone familiar with the moment of death knows that once death has occurred, there is no more breathing, moving, grimacing, or squirming and that there is no longer a heartbeat or blood pressure. The argument of some physicians—that such movements in an organ donor are caused by “leftover energy” in the body—has no scientific validity. It is, therefore, unethical for transplantation surgeons to continue performing such procedures that mutilate a living human body. These procedures treat the donors as if they were artificially sustained biologic entities, rather than human persons worthy of dignity and respect. Later in the Pope’s address, he confirms this principle by stating that “the human body cannot be considered as a mere complex of tissues, organs, and functions. . . .”
The issue of organ transplantation is, in a lot of ways, very complex because of the competing claims of the medical community regarding brain function and other physiological indicators of life or death. But really, this is a false complexity. The issue is actually rather simple: vital organs can only be useful for transplantation if they come from a living donor. Dead donors’ vital organs are no longer functioning, and can’t be made to do so in a different body.
This leads to many questions, such as why death has been redefined, and how far medical professionals are willing to go to harvest organs.
It also raises questions for the “man on the street”. Should we sign “organ donation” cards? Should we agree to organ transplantation for ourselves and our loved ones? The answer to both is “no” when it comes to vital organs.