The Dead Donor Rule Declare Death before Organ Harvesting

Before an organ can be harvest the patient must be declared dead.

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.

Prior to the publishing of the paper,”A Definition of Irreversible of Coma” from the Ad Hoc Committee at Harvard University in 1968  a person was truly dead “only” when their heart stopped beating and they stopped breathing.

After the publishing of the Harvard paper (which is the most cited paper on Brain Death), surgeons had an open door to transplant vital organs. However, the medical community had a legal and ethical dilemma: vital organs must be taken from a living body, but removing vital organs will cause death in the patient. 

Hummmm what to do, what to do?

What are vital organs?

You must remember that for the majority of your organs to be transplanted they must be vital. The word vital comes from Middle English, from Old French, from Latin vītālis (“of life, life-giving”), from vīta (“life”), from vīvō (“live”).

Vital means alive, dead organs can not be transplanted.

The vital organs are heart, liver, pancreas, lungs, and kidneys. Patients must be declared brain dead before the removal of any of these vital organs.

 The “dead donor rule” was enacted because it was believed (rightly so) that people would never morally accept a persons organs being harvested if a person was “almost dead.”

The dead-donor rule was instituted and accepted so that death could be pronounced  and the organs harvested. 

The “brain death theory” is essential to current practice of organ retrieval because it legitimizes organ removal from bodies that continue to have circulation and respiration, thereby avoiding ischemic injury to the organs. Ischemic injury occurs when the blood supply to an organ is either partially or totally cut off.

If you injured in an accident and die before you can be resuscitated then your organs CAN NOT be transplanted. They are dead, useless. However, if you are declared “brain dead”, and are in the hospital and on a ventilator you are not truly dead, and your organs can be harvested.

The Controversy

In a shocking statement, Dr. Neil Lazar, Director of the Medical-Surgical Intensive Care unit at Toronto General Hospital, says the focus should be on the well-being of donors rather than whether they are legally dead. That could mean giving anesthetics during organ harvesting.

He and his co-authors, Dr. Maxwell J. Smith of the University of Toronto, and David Rodriguez-Arias of Universidad del Pais Vasco in Spain, advocate replacing the current “dead-donor rule” with a policy that educates the public about the true nature of patients used in transplants, obtain informed consent from everyone — and ensure the donor does not suffer during the organ harvesting. The study was published in the American Journal of Bioethics.

The authors state frankly that under current practices donors may be technically still alive when organs are harvested – a necessary condition to produce healthy, living organs. Because of this, they say that protocol requiring a donor’s death is “dangerously misleading,” and could overlook the well-being of the donor who may still be able to suffer during the harvesting procedure.

 “Because there is a general assumption that dead individuals cannot be harmed, veneration of the dead-donor rule is dangerously misleading,” they write. “Ultimately, what is important for the protection and respect of potential donors is not to have a death certificate signed, but rather to be certain they are beyond suffering and to guarantee that their autonomy is respected.”

The transplant community was NOT in favor of removing “the dead-donor rule” believing it would decrease organ transplants, upset families and stress health care workers.

Ya think?

How would you feel if the truth were told?

Doctors: “We are ready to take your loved one down now and harvest their organs.”

Family Member Crying: “So they really are dead?”

Doctor: “No, not really, but… we’ll give them anesthesia so they won’t feel a thing?”

At least Lazar, Smith and Rodriguez-Arias are telling the truth that you are not dead like most people have been deceived into believing.  

The transplant agencies want to keep the “dead donor rule” standard,the lie alive, and continue to allow you to believe you are dead to harvest your organs.