Knowing what we know now, doesn’t this speech make more sense?
Knowing what we know now, doesn’t this speech make more sense?
50 years ago, an ad hoc Harvard Medical School committee declared that patients in an “irreversible coma” were dead from a legal and ethical point of view. By irreversible coma, the committee had in mind “comatose individuals who have no discernible central nervous system activity”. In making this pronouncement, the committee was seeking to resolve a series of ethical and legal questions that had arisen since the advent of positive pressure ventilation and research into vital organ procurement.
The criterion was rapidly enshrined in law around the US and, indeed, the globe, and it became the most common standard by which vital organ procurement and the withdrawal of treatment were regulated.
Yet 50 years on, the brain death criterion for death is under intense criticism, with several high profile legal cases in the US calling into question the claim that brain dead patients are really dead.
In two recent JAMA articles (one co-authored with lawyer Thaddeus Pope and psychiatrist David S. Jones), Harvard Medical School’s Robert Truog evaluates the brain death criterion, arguing that, while the rationale behind the brain death criterion is defensible, it nevertheless lacks philosophical justification.
Truog states that the brain death criterion was intended to provide a clear biological criterion in which we could ground our legal definition death. The law needs black and white distinctions, and brain death provides one such distinction:
The law necessarily depends on bright-line determinations to standardize many important societal distinctions, such as when a person becomes an adult, when a person is blind, and when a person is dead…By drawing a bright line at the level of permanent unconsciousness and ventilator dependence, the [Uniform Determination of Death Act]* has defined when a person should be considered dead, making it permissible for the person to be an organ donor if they wish and making it permissible for the health care system to refuse to continue to provide the patient with life support.
Yet Truog also observes that “attempts to find a conceptual justification for linking this diagnosis (i.e., brain death) to the death of the patient remain incomplete”. He recounts how neurologist Alan Shewmon has shown that virtually every function undertaken by a healthy living body can be carried by a brain dead person on a ventilator. He also questions the 2008 attempt by the President’s Council for Bioethics to define death in terms of the absence of the “fundamental vital work of a living organism”. While xenotransplantation and 3D printing may one day provide a solution to organ shortages, the brain death criterion will remain for some time a source of spirited debate.
*The Uniform Determination of Death Act is a 1981 act adopted by most US states according to which “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead”.
On a personal note: The brain scan above was what caught my attention because Jamie’s had blood flow and the radiologist said, “there is blood flow”. Vanderbilt said, “oh, we expected to find some blood flow”.
Then why didn’t they give him more time? Will I ever get over this?
May 29, 2018 The Wall Street Journal article “Doctors Face Scrutiny About Defining Death- As families challenge the determination of brain death, physicians are changing their approach.”, the assumptions about brain death are now being challenged because of cases like Jahi McMath, a 13 year old girl who suffered complications after a 2013 tonsillectomy in California and was declared “brain dead” but who is still alive in New Jersey after her parents refused to allow the ventilator to be removed.
February 5, 2018 New Yorker magazine article titled “What Does It Mean to Die?” about the McMath case, the public is now becoming aware of the ethical, legal and medical controversies surrounding “brain death” and questions are being asked.
In the WSJ article, the author Rachel Aviv says,
The commission’s staff philosopher, Daniel Wikler, a professor at Harvard and the first staff ethicist for the World Health Organization, told me that he didn’t think the commission’s theory of death was supported by the scientific facts it cited. “I thought it was demonstrably untrue, but so what?” he said. “I didn’t see a downside at the time.” Wikler told the commission that it would be more logical to say that death occurred when the cerebrum—the center for consciousness, thoughts, and feelings, the properties essential to having a personal identity—was destroyed. His formulation would have rendered a much broader population of patients, including those who could breathe on their own, dead.
Despite Wikler’s reservations, he drafted the third chapter of the report, “Understanding the ‘Meaning’ of Death.” “I was put in a tight spot, and I fudged,” he told me. “I knew that there was an air of bad faith about it. I made it seem like there are a lot of profound unknowns and went in the direction of fuzziness, so that no one could say, ‘Hey, your philosopher says this is nonsense.’ That’s what I thought, but you’d never know from what I wrote.”
Doyen Nguyen, M.D., S.T.L., is a physician specialized in hematopathology and a moral theologian. She is currently pursuing her doctorate in theology at the Pontifical University of St. Thomas Aquinas (Angelicum) in Rome. Her research is quite extensive and it is featured on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102188/
This is what has taken place since the introduction of the Harvard criteria. Spaemann thus wrote:
The new definition of death as “brain death” makes it possible to declare people dead while they are still breathing and to bypass the dying process in order to quarry spare parts for the living from the dying. Death no longer comes at the end of the dying process, but—by the fiat of a Harvard commission—at its beginning. (Spaemann 2006, 299)
In other words, even a noble act such as organ donation can be manipulated to serve utilitarian, materialistic, and dehumanizing motives, whereby the most vulnerable members of society are conveniently excluded from the human moral community (Veatch 2004, 267–8).42 As mentioned in the introduction, pragmatic-utilitarian motives were evident in the workings of the Harvard Committee to bring about the birth of “brain death.” Such motives have remained well hidden behind both the veil “of the powerful metaphor of the ‘gift of life’ associated with the transplant world” (Lock 2002, 114), and the loud appeal to altruism and noble charity. With respect to brain-dead donors, however, we must ask ourselves, “Is such a vigorous appeal to altruism and charity grounded in truth?”43
There are physicians and bioethicists that do not agree with the legal fiction of “brain death”. There are injured people who have woken up prior to having their organs harvested. We have been manipulated for many years now by a lie that you are dead before your organs are harvested.
Organ donation is a profitable scheme based on an altruistic motives when people say, “I don’t care if they take my organs when I am dead, I have no use for them.”
Problem is this is not true death.
H/T to Nancy Volko, registered nurse since 1969 and currently I am a spokesperson for the National Association of Prolife Nurses (www.nursesforlife.org). I have also been a past President of Missouri Nurses for Life and past co-chair of the St. Louis Archdiocesan Respect Life Committee for inspiring this article.
via Alfie Evans
In case you have not been following this story:
Alfie Evans has a brain disorder. He has been at Alder Hey Hospital in Liverpool since December 2016. Doctors have not been able to diagnose him and therefore have not treated him, except for providing ventilator support. Alfie has been on and off of the ventilator since being admitted to Alder Hey.
Last December, the hospital sued Alfie’s parents to have Alfie’s ventilator removed, saying it was in the toddler’s “best interest” to die. The judge agreed.
Alfie’s father appealed to the Vatican for help. Bambino Gesu Hospital in Rome agreed to take Alfie as a transfer patient.
The judge issued a travel ban prohibiting Alfie from leaving England. Alder Hey removed Alfie’s ventilator on April 23, 2018.
Alfie did not die. He continues to breathe on his own. But the hospital insists that Alfie be made dead. Now they are starving him–all in the name of “dignity” of course.
But this is not dignity. This is not health care. This is not about Alfie’s “best interest.” This is MURDER.
Taquisha McKitty was admitted into the Brampton Civic Hospital, Ontario, Canada on September 14, 2017 having suffered a drug overdose. While although Taquisha was breathing on her own and moving in response to her family, Taquisha was recognized as a registered organ donor and medical treatment to protect and preserve her life were circumvented.
Two apnea tests were performed, she was declared “brain dead” by two physicians in accordance to Ontario law and to this effect, a death certificate was issued September 20, 2017. Her family hopes to have Taquisha’s death certificate canceled in pursuit of medical therapy her wellbeing, to protect and preserve her life, not that of another(s) as an organ donor.
A Brampton judge issued a two-week injunction to keep a woman declared brain dead on September 20 on life support.
Ontario Superior Court Justice Lucille Shaw ruled that Dr. Andrew Baker, chief of critical care at St. Michael’s Hospital would run further tests.
“If you are there with her and you touch her and you grab her feet, she will pull her feet from you. If you tickle her she will move her feet. In one instance one of her cousins was squeezing her hand and asked her to show her thumb and she moved her thumb,” McKitty’s father Stanley Stewart told CP24 on Thursday night. “We know for a fact that she is alive because if she was dead and her brain was dead there is no way that a week-and-a-half later she would still be moving. If you are brain dead then no parts should be moving.”
“What’s going on here is the young lady is living,” Dr. Paul A. Byrne, a retired neonatologist, past president of the Catholic Medical Association is retained by the family to speak on their behalf, told CP24 on Thursday.
“A declaration by a doctor does not make someone dead. There is clearly a difference between being alive and being dead and she is alive. Her heart beats, she has circulation, she moves her legs and she responds to the family.”
Byrne told CP24 that he believes doctors are rushing to declare Taquisha McKitty brain dead so that her organs can be donated. If he is granted expert status, he will be able to advise a physician licensed in Ontario to provide McKitty with treatment.
Dr. Byrne said that all the family wants is for their loved one to be given “proper treatment.” he said it is his belief that Taquisha McKitty could still recover.
“Patients like this, if they treat them with thyroid hormones and other things, they have a chance to continue to live,” he said.
*** Please if you’re ever in this situation don’t do the Apnea test, I have written on it so much and it only makes things worse, even in the doctors call it the “gold standard.”
Brain death is NOT true death. It is a legal term created by doctors to get your organs. When organs are removed from a “brain dead” donor, all the vital signs of the “donors” are still present prior to the harvesting of organs, such as normal body temperature and blood pressure; the heart is beating; vital organs, like the liver and kidneys, are functioning; and the donor is breathing with the help of a ventilator.
In medicine, we protect, preserve, and prolong life and postpone death. Our goal is to keep body and soul united. When a vital organ ceases to function, death can result. On the other hand, medical intervention can sometimes restore the function of the damaged organ, or medical devices (such as pacemakers and heart-lung machines) can preserve life. The observation of a cessation of functioning of the brain or some other organ of the body does not in itself indicate destruction of even that organ, much less death of the person. Dr. Paul Byrne
All of us who know the truth of the fallacy of brain death must pray and be there to help her. Watch the short video with Dr. Byrne and her dad and pastor.