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 They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs.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.”

Is it cruel to question organ donation?

Steve Salerno wrote a piece for Playboy Magazine called, “The Heart Stopping Truth about Organ Donation”, in October 2002. No, I don’t read Playboy I’ve just read the article online. I’m glad there was an article in Playboy, because wherever the TRUTH can be exposed about the lie of brain death being true death the better.

Mr. Salerno states that, “According to the Centers for Disease Control, the mortality rate due to injury among men 18 to 35 years old is about twice that of the national average.” In other words, organ-procurement organizations (OPOs) are “waiting for you to do something stupid. In fact, they’re counting on it.”

The stats are on their side.

If you fall within that age range, you’re about four times more likely to meet a sudden end than your wife or girlfriend of an equivalent age is. Bottom line: If you’re the typical reader of Playboy magazine, you’re a prize candidate for organ donation. (Yes, glad Steve Salerno said it)

One popular belief peddled by the transplantation community is that brain death is as much a bedrock medical concept as conventional cardiac death. By those terms, a brain-dead patient is dead. Period.

In fact, brain death is an expedient “medical fiction,” to use Stuart Youngner’s phrase, invented to enable physicians to declare patients dead in a timely fashion and in a controlled environment.

“Anesthesiologist Philip Keep told the BBC that ‘nurses get really upset. You stick the knife in [into a patient whose organs are being removed], and the pulse and blood pressure shoot up.’ In an effort to squelch such disturbing manifestations, many British hospitals administer anesthesia prior to harvest. As Dr. Keep noted (without apparent irony), ‘If you don’t give anything at all, the patient will start moving and wriggling around and it’s impossible to do the operation.”

The Rules Have Been Written

The Dead Donor Rule

The Uniform Definition of Death Act

The Uniform Anatomical Gift Act

All of these laws are written to harvest your organs when you are pronounced brain dead. Though it’s not the kind of thing the medical establishment is eager to publicize, there has long been an arbitrariness to policies governing clinical determinations of death. “

Years ago one hospital, The Cleveland Clinic, wanted to implement a new standard that would declare a person dead with a five or seven-minute absence of a pulse,” says Carmen Marino, a former prosecutor for Ohio’s Cuyahoga County and one of a number of law-enforcement officials who have challenged the medical community’s willingness to alter current definitions of death.

“The organs that are most susceptible to blood deprivation after death are the heart and the liver. The liver transplant doctors said, “That’s too long. If we wait five or seven minutes, we’re not going to have a useful organ anymore. Let’s make it two minutes. And that was that.”

As a result, concludes Marino, “You go without a pulse for two minutes in some hospitals, you’re dead. They take your organs. In other places, at two minutes, they’re still trying to revive you.”

The reason for hushing up such facts is simple, says Stuart Youngner, director of the Center for Biomedical Ethics at Case Western Reserve University. “The OPOs are afraid that if we have these discussions publicly, it will slow down donations dramatically.”

Cynics look back on the Harvard milestone as a case in which a far-reaching medical judgment was made largely, if not purely, for non medical reasons.

Stuart Youngner is blunt: “The thrust of the Harvard decision was, ‘Let’s call them dead so we can’t be accused of killing them when we take their organs.”

Well regardless of Marino’s ability to stop the Cleveland temporarily eventually every hospital adopted a 2 minute rule, and now there are even shorter guidelines.

During transfer the patient is supported on a ventilator, the ventilator is turned off, the patients heart stops, death is pronounced, then the heart is started again, then your organs are harvested.

The heart is the last to go and at that point you are dead like most people think of death.

The legitimacy of “brain death,” “cardiac death,” and even “circulatory death” – which can be declared only 75 seconds after circulatory arrest – as actual death has been an ongoing debate in public commentary on organ donation.

Many experts assert that doctors familiar with organ donation are aware that the terms, intended to delineate a threshold of probable death, is different from actual bodily death, rendering highly uncertain the moral status of organ donation.

Is it cruel to question organ donation?

Archives For the dead donor rule