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Killing for Organs Push in The Atlantic

March 27, 2015 — Leave a comment

Killing for Organs Push in The Atlantic.

This is an article by Wesley Smith, author of the book, Culture of Death,The Assault of Medical Ethics in America, in response to the Atlantic article which is advocating killing the profoundly disabled or imminently dying for their organs.

I’ve been saying this for the last three years here on this blog and everywhere I can that this is where we are headed.

Excerpts from Wesley’s post:

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. The assault on the “dead donor rule” has now filtered down to the popular media.

The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:”

Transplant-surgery programs in the United States are scrutinized by an alphabet soup of federal and nongovernmental entities. Centers with worse-than-expected transplant outcomes can be placed on probation or shut down.

Centers with worse-than-expected transplant outcomes can be placed on probation or shut down.

From the earliest days of transplantation, surgeons subscribed to an informal ethical norm known as the “dead-donor rule,” holding that organ procurement should NOT cause a donor’s death.

In practice, this meant waiting until patients were by all measures completely dead—no heartbeat, no blood pressure, no respiration—to remove any vital organs. (Sometimes 2 minutes, comment by me)

A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”

If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people. Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs. There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.

Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs.

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

As my friend, Carolyn said on her Facebook page, and I agree.

“Oh, this really makes me sick! Wake up everyone, the government is about to pass another law to enable the greedy the ability to dissect a living person for their organs. How many of you really want to die being dissected alive to satisfy the greed of a medical community and government gone mad? You think this could not happen to you, but it could.

The reason why so many fall in this cesspool of being a potential organ donor is because they are denied treatment.

Once this happens the doctor legally can demand the patient be denied anymore treatments. You can beg, I begged, You can cry, if you scream and act out, you will be arrested. Your loved is in harm’s way in a hospital in the World. You are at the mercy of a trained denial of medicine. Now they want to legally deny care to the almost, which is really what they have been doing all along.”

Read Caroly’s story about her daughter Melissa here.

I wrote on this and the dead-donor rule back in October, 2013 and the voices continue to get louder.

The “Dead Donor Rule”

The “dead-donor rule” refers to two accepted ‘ethical norms’ that govern the practice of organ harvesting before transplantation:

1) vital organs should be taken only from dead patients,

2) living patients should not be killed for or by organ procurement.

There is a movement now by several well-known transplant surgeons to get rid of the “dead donor rule,” and call it what it is a legal fiction. Tell people the truth about what is happening…that you are not dead…yes, critically injured…but you are NOT dead.

Transplant surgeons believe that with such consent, there is no harm or wrong done in retrieving vital organs before death, provided that anesthesia is administered. But, many doctor’s and OPO’s (Organ Procurement Organizations) are not so sure and are fearful that more people will NOT consent if the truth is exposed.

Beware of these words from doctors, “devastating neurological injury, no hope, and now “imminent death.”

Scary Stuff…Head Transplants

March 8, 2015 — Leave a comment

Head Transplants

Perhaps you saw this on the news. I think I caught a glimpse of it somewhere but when it came up on my Twitter feed from Journal of Medical Ethics, I went and did a little digging.

Fortunately New Scientist Magazine had carried an article on it. Sergio Canavero, Surgeon at the Turin Advanced Neuromodulation Group in Italy, first proposed the idea in 2013 and he now says it is completely possible by 2017.

Canavero plans to announce the project at the annual conference of the American Academy of Neurological and Orthopaedic Surgeons (AANOS) in Annapolis, Maryland, in June 2015.

I don’t even know what to say to this latest “Scientific research???

Furthermore, Dr. Canavero is calling his new surgical strategy the HEAVEN procedure, which preserves brain function through hypothermia during the transplantation procedure, which is performed at cervical level C5/6.

Basically doing a head transplant requires cooling the recipient’s head and the donor body to extend the time their cells can survive without oxygen. The tissue around the neck is dissected and the major blood vessels are linked using tiny tubes, before the spinal cords of each person are cut.

Details will be presented at the conference in June however you IF you ARE interested in this you can read some of the details here.

Ethics

Transplanting living human heads onto new bodies raises extraordinary ethical questions. But so did a non-beating heart donor a few years ago. Canavero intends to use brain-dead organ donors to test the fusing of the spinal cord with Polyethylene glycol.

Polyethylene glycol (PEG) is a polyether compound with many applications from industrial manufacturing to medicine.

Dr. Scripkoa neurologist and bioethicist with an interest in headache, traumatic brain injuries and concussions at Salinas Valley Hospital in California said that “many of the ethical implications related to the surgery depend on how you define human life. “I believe that what is specifically human is held within the higher cortex. If you modify that, then you are not the same human and you should question whether it is ethical. In this case, you’re not altering the cortex.” However, she adds that many cultures would not approve of the surgery because of their belief in a human soul that is not confined to the brain.”

So it all boils down to yes maybe it CAN be done, But SHOULD it be done?

When does human life begin?
Who should determine’s when someone is dead?

You know my belief, life begins at conception and ends when true death occurs? It is not our choice but God’s. He is the author and finisher of life. The beginning and the end. True death occurs WHEN the soul leaves the body.

Your eyes saw my unformed body; ALL the days ordained for me were written in your book before one of them came to be. Psalm 139:16

Vital organs need to be fresh and undamaged for transplantation. Vital organs (from the Latin vita, meaning life) include the heart, liver, lungs, kidneys and pancreas. In order to be suitable for transplant, they need to be removed from the donor before respiration and circulation cease.

We know that brain death is not true death. We know that without blood and oxygen the brain it starts to die within a few minutes. So I think we can conclude that in a head transplant the brain would need to alive with blood and oxygen flowing into both the donor and the recipient. As Dr. Canavero said doing a head transplant would require cooling the bodies of both donor and recipient to slow down cell death.

My question is WHY is this cooling NOT being done in hospitals to prohibit the brain swelling after a traumatic brain injury?

I posted on guidelines for treating trauma here and asked why hospitals aren’t doing it as a standard protocol?

As I quoted from the Nova interview between Dr. Jamshid Ghajar:

It’s a lot easier just to put the patient on the ventilator and then turn up the rate and then give them some drugs and come back next week and see how they’re doing. They’re lying there in a coma. They’re not screaming out for help. They’re not saying, “I’m in pain.” And so it would be quite easy to say, “Well, they have half a foot in the grave, why do anything else?”

“That’s the real issue. I think if these patients were awake and saying, “Listen do something for me,” we’d be doing a lot more for them. But because they’re in a coma and they cannot speak for themselves, we’re treating them the way they are now.”

I find in unconscionable that we are on the verge of head transplants as a scientific reality and doctors can’t immediately use hypothermia to cool down the body and the brain of an injured person upon first entering the hospital.

Dr. Jamshid Ghajar continued, “here are a lot of young people, children, especially, who are dying unnecessarily. These kids could live and have a very good quality of life, and they’re dying.

Flickr Photo Credit

In Organ donation brain death, head transplants, organ donation

Organ Donor Found Not Quite Dead

January 17, 2015 — Leave a comment

Organ Donor Found Not Quite Dead

The phrase “not completely brain dead”, like “not completely pregnant”, has a Monty Python-esque ring to it. But it is the way the Daily Mail described an alarming organ transplant incident in the German city of Bremen.

Doctors in a hospital in Bremen had already made an incision in the abdomen of a man who was presumed to be dead when they discovered that the deceased donor was still alive according to organ transplant protocols.

The operation was immediately terminated – and the brain-damaged patient died. The incident is being investigated by the German Medical Association.

The Süddeutsche Zeitung (the source for the Daily Mail) was told that “it is quite possible that the man’s brain was so damaged that he would not have been able to return to a normal life, but as long as he was not properly diagnosed as brain dead, nobody knows.”

The article above is published by and BioEdge.org under a Creative Commons licence.

Here are excerpts from the original article in the Süddeutsche Zeitung German Paper If you go read it there, just translate it to English at the top of your browser.

My takeaway’s from the German article which unfortunately happen’s here in the US but goes unreported.

Critics warn some time: The brain death diagnosis is uncertain

The case proves once again what critics have long admitted: The diagnosis of brain death is not secure enough in Germany. Doctors are not sufficiently trained in how they determine the loss of brain function in a patient correctly. So it always comes back to errors.

Especially terrible was the idea that a patient whose brain still shows residual activity may suffer the pain of surgery and organ removal as opposed to a brain dead.

Did he know he was going to have his organs harvested but couldn’t show anything to stop the doctors? Did he feel pain when the doctors sliced into his abdomen? You do know by now from reading my blog that anesthesia is NOT used.

Perhaps the man in Germany felt the way Christina Nichole Thornsberry, did when she was paralyzed in a hospital in Spokane,WA where she stated on her blog,

“Don’t cut me open — don’t hurt me! Let me wake up!.” While doctors hovered over her bed… discussing organ donation, Christina Nichole could hear every word they said – and their conversation terrified her.

In Brain Death brain death, organ donation

Doctors Who Want to Change the Conversation on Brain Death

July 26, 2014 — Leave a comment

Doctors who want to change the conversation about brain death.

Dr. Robert Truog, Harvard Medical School and Boston Children’s Hospital and Dr. Frank Miller, National Institute of Health

We seek to change the conversation about brain death by highlighting the distinction between brain death as a biological concept versus brain death as a legal status. The fact that brain death does not cohere with any biologically plausible definition of death has been known for decades. Nevertheless, this fact has not threatened the acceptance of brain death as a legal status that permits individuals to be treated as if they are dead. The similarities between “legally dead” and “legally blind” demonstrate how we may legitimately choose bright-line legal definitions that do not cohere with biological reality. Not only does this distinction bring conceptual coherence to the conversation about brain death, but it has practical implications as well. Once brain death is recognized as a social construction not grounded in biological reality, we create the possibility of changing the social construction in ways that may better serve both organ donors and recipients alike.

American Journal of Bioethics, 14(8):9-14,2014

Both doctors have written extensively about brain death and ethics in organ donation. I have quoted them many times here as they became famous for their term brain death as a legal fiction and brain death is as good as dead.

“Although it is clear that brain death is not the same as death, moreover, brain death does correspond to the loss of an ability to interact with others and the world in meaningful ways. With consent for withdrawing therapy and a separate consent for organ donation, it is reasonable for brain-dead patients to serve as organ donors, and it may even serve to leave behind a valuable legacy of having saved the lives of others.

It makes sense ethically to employ a status legal fiction to ensure that brain-dead donors can be treated as dead for the purposes of vital organ donation and withdrawal of therapy.”I radically disagree with them on their theory of being able to withdraw life support to donate organs.”

Although they have argued for exposing this legal fiction they have also said brain death and true death should be treated the same for harvesting organs.

I applaud them in understanding that brain death is NOT true death and wanting to expose the legal, medical fiction of brain death.

Dr.Alan Shewmon, UCLA, and former advocate for brain death who has changed his mind, compiled 150 documented cases of brain-dead patients whose hearts continued to beat, and whose bodies did not disintegrate, past one week’s time.

In one remarkable case, the patient survived 20 years after brain death before succumbing to cardiac arrest. Dr. Shewmon has successfully documented and published on somatic integration of the human body and all its functions.

LIFE processes after pronouncing brain death

Cellular wastes continue to be eliminated, detoxified, and recycled.
Body temperature is maintained, though at a lower than normal temperature and with the help of blankets.
Wounds heal.
Infections are fought by the body.
Infections produce fever.
Organs and tissues continue to function.
Brain-dead pregnant women can deliver a baby.
Brain-dead children mature sexually and grow proportionately.

Full text of Truog and Miller recent paper

Flickr photo credit

In Brain Death brain death, change the conversation, legal fiction, organ donation

This Happens Everyday When People Sign The Organ Donor Card

May 9, 2014 — 1 Comment

This Happens Everyday When People Sign The Organ Donor Card

This is the story of Barbara Radcliffe from Vermont, who recently lost her son, Robert Strain. He most recently was employed as an instructor with the McKinney High School Color Guard as a choreographer. Barbara posted her story on a Facebook group I belong to called Organ Donation Exposed.

I have only corrected a few misspelled words.

“My son moved to McKinney Texas for a job teaching color guard at the high school there. He was 35 years old. He left Vermont at the end of May 2013 and drove to Texas with his new girlfriend of three months, they never lived together before they went to Texas.He was in Texas eight days when an ambulance was called to his residence and he was transported of the medical center of McKinney. His girlfriend told the EMS that it was an asthma attack.

I am not sure if his heart stopped in the ambulance or the E.R. from lack of oxygen but I was told they took forty minutes to resuscitate him.

As i write this I begin to feel my heart race, my throat close, my hands shake. It is so hard to explain what happened yet i live it everyday.

I will begin with some facts. My son was transported to the hospital on a Wednesday.I was not notified until Friday night around 6 p.m. I flew to Texas as soon as i could on Saturday.

When I arrived at the hospital I was met at the elevator by a chaplain who’s first words to me were my son’s girlfriend (now being called his fiancée) did everything she could by calling the ambulance… O.K. I want to see my son. I knew nothing of his status.

Then I walked to his room following the Chaplain, my son’s girlfriend, and the girlfriends brother.The four of us enter my son’s hospital room in ICU. As I see my son for the first time hooked up to machines the chaplain again tells me what a good job Marisa (the girlfriend) did by calling 911.

She says nothing. nothing at all.

Then I begin to ask a lot of questions and it dawns on me that they have already decided to take my son off life support. The brother whom I have never met before and did not know my son says “He will always be with us”.

I am in total shock.

I tell them no this will not happen and the Chaplain tells me i might not have a choice. I beg to speak to a doctor or a nurse and I ask the chaplain to leave.

I sit and hold my son’s hand.

I do not get to speak to a doctor until Monday.The prognosis is brain death.

I also speak to the hospital administrator who almost immediately starts asking me to take my son off life support. It seems i have ruined all their plans. the hospital administrator is worried about the bill and she mentions it frequently. And she wants me to give a exact time and day to remove my son from life support and asap.

I have to fight to declare myself my sons directive….As his live in girlfriend of eight days has assumed that role including giving her income to make my son not eligible for Texas Medicaid . The hospital does not even have my sons ss number. I inform them my son has Vermont Medicaid and they tell me no they do not accept that…and my son is considered indigent.

So before I arrived at the hospital the girlfriend and the hospital administrator have decided to end my son’s life. Because they decided he had no usable insurance. This in two days time. And she is already planning to leave Texas with my sons belongings. When I mention this to the hospital administrator she is surprised and tells me now she considers them “broke up”.

Now I know this story is getting a little long and I am trying to make it as comprehensible as possible but it is so crazy and the horror keeps growing. (even now) I am very confused and I reach out to the Brain Injury Association of America to try to educate myself on brain injury procedures, and my sons rights.

Every few hours the hospital administrator is asking me to set a time and date to remove the ventilator. This is torture. This is excruciating to keep asking me for a time a day to remove my son from life support.

To me my son is showing signs of life; he is reacting to pain. He has a gag reflexes. He is over breathing the ventilator. His heart goes faster when I speak. I am told the hearing is the last to go. And I wonder if he has heard everyone. Is he in pain? I want to bring him home to Vermont.

I am told this is not even a remote possibility

I ask for more tests. I need more information. they say they will do a blood flow test and a apnea test.

I ask the hospital administrator to walk me through the steps to take my son off life support while i am waiting for the blood flow test to come back. She does. We do this several times.

Now the blood flow test comes back and they tell me my son is brain dead. Devastation beyond what I ever thought possible.

I am in a daze when I mention to someone my son wanted to be an organ donor. Or did someone ask me? I’m not sure. but next thing that happens is I am told to wait for the Southwest Transplant Alliance to show up.

Stupid me.

I thought what was going to happen is what I was told over and over… about the hospital administrator saying over and over about the ventilator being removed and she said my son would take guppy breaths and then pass on. This did not happen.

Now i am informed by Southwest Transplant Alliance that it takes 20 to 30 hours of testing for matches and when they were done that’s when my son’s life would end. WOW. I do not want this for my son but I am trying to honor his wishes and I am promised that Southwest Transplant Alliance would get me all my son medical records.

So after all the painful hours of being forced to decide the time and day of death ..they never mentioned procedures for organ donors …..it’s not even my choice to decide. After all the tormented hours of being forced to decide valuable time taken from me and my son for NOTHING.

I would like to sue the hospital administrator for not really knowing what she was talking about and forcing me to make a decision that is ultimately out of my control for not going through all the procedures when I asked over and over again.

So now here I am watching my poor son being worked on…not to help him but to harvest his organs. Hours go by each minute HELL.

I wonder if he feels pain. They say no but who knows really????

I am asked to leave the room a few times and i cringe at the thought of what invasive thing are they doing to him.

I feel so bad for my son he is like a rag doll at their disposal. It’s not dignified at all. I want them to stop. I leave the hospital throwing up.

I am giving updates by phone. I am told they have a heart recipient.

I can’t do this. but I feel it’s too late to stop… like a run-way train.

The next call I get I expect to be told what was going happen, I expected them to say “we are on our way to the operating room and I expected to get to see my son and tell him how proud I am of him and how brave he is.

Oh my god I never learn. This is not what happens.

I am whisked into a room with three Southwest Transplant Alliance workers (I notice there not smiling as much as before)and a doctor from the hospital and a nurse from the hospital. I am horrified .

This is the 11th day.

The doctor starts by telling me my sons prognosis has not changed he is almost defensive.

What is it?

“We have to tell you that we did the apnea test and your son breathed on his own for some time and we had to put the ventilator back in and we need you to sign another paper as there will be no heart transplant just his liver and kidneys.”

Oh Jeez please what is going on?

Don’t get me wrong I did not want any of this. NONE OF IT so what I am thinking is that my son was not brain dead not dead when they were testing him for organ donation.

Someone please give him pain medicine please stop touching him. The complete horror I feel makes me sick even today what did we put him through????? He did not deserve this he is a good person a giving, loving person and I failed him.

I sign the papers just to let my son have peace and now I will always have second thought on all my decisions.

I would like to sue Southwest Transplant Alliance and medical center of McKinney Tx for not following procedure by not doing a apnea test before declaration of brain death ……also Southwest Transplant Alliance lied to me ………they never produced the medical records they promised or any paper work at all including the paperwork I signed.

I never received copies even though I have requested them over and over I just get the form letters they send everyone with wishes of peace.”

This is what happens when your child signs the organ donor card.

According to Chief of Trauma at Temple University Hospital and Residency Director of that schools General Surgery Dr. Amy Goldberg, “Families are never sorry that they donated. They are at times sorry they missed that opportunity.”

I don’t think so, ask Bernice about Brandon or Carolyn about her daughter Melissa.

I am so sorry for your loss Barbara. Thank you for allowing me to print your story.

In Brain Death, Organ donation Barbara Radcliffe Story, brain death, organ donation

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