organ donor

The “dead donor rule” is the cement that binds the public’s trust in organ transplant medicine. Under the DDR (other than in living donations, such as of one kidney) organs cannot be procured unless donors, in the words of the Munchkins, are not merely dead but really most sincerely dead.

There are two means of declaring death. Let’s call the first “heart death,” that is an irreversible cessation of all cardio/pulmonary function. The other is popularly known as “brain death,” (death declared by neurological criteria) in which function in the whole brain and each of its constituent parts have irreversibly ceased. The key word in both means of declaring death is “irreversible.”

But something appears to have gone badly off the rails in the field of procuring organs after heart death. A long New York Times expose found cases of patients who were clearly alive when organ procurement began. At the same time, a very disturbing report by the Department of Health and Human Services contained similar findings.

First, the NYT. From “A Push for More Organ Transplants Is Putting Donors at Risk”:

Last spring at a small Alabama hospital, a team of transplant surgeons prepared to cut into Misty Hawkins.…Days earlier, she had been a vibrant 42-year-old with a playful sense of humor and a love for the Thunder Beach Motorcycle Rally. But after Ms. Hawkins choked while eating and fell into a coma, her mother decided to take her off life support and donate her organs. She was removed from a ventilator and, after 103 minutes, declared dead.

A surgeon made an incision in her chest and sawed through her breastbone. That’s when the doctors discovered her heart was beating. She appeared to be breathing. They were slicing into Ms. Hawkins while she was alive.

The horror! Why are such awful things happening?

In the Netherlands, Belgium, Spain, and Canada, people who want euthanasia can become organ donors. (A recent report in Spain showed that 13 percent of those euthanized donated organs.) Let’s call it “kill and harvest,” a policy heartily approved by our ever more crassly utilitarian medical establishment. Indeed, a recent study in JAMA Surgery applauds procuring the kidneys of the euthanized because, after five years, the organs of those killed by doctors and then transplanted have worked well — even better than kidneys donated by people after brain death. From the conclusion of the study, which discusses donation after circulatory death from euthanasia (DCD-V): This study found that DCD-V kidney transplantation yielded a lower incidence of DGF [delayed graft function] compared with DCD-III kidney transplantation Read More ›