organ transplant

Euthanasia conjoined with organ harvesting just took a particularly disturbing turn in Spain, where a woman was euthanized and then had part of her face transplanted. From the Catalan News story: Vall d’Hebron University Hospital in Barcelona has performed the world’s first face transplant with a donor who passed away from euthanasia. Around 100 medical professionals took part in the partial face transplant, a highly complex operation using neurovascular microsurgery techniques that lasted about 24 hours. In presenting the milestone procedure, the healthcare director, Maria José Abadías, highlighted the “extraordinary generosity of the donor,” the “collective effort” behind the operation and the “pride” of all workers who took part in it. Don’t get me wrong. There is no inherent moral Read More ›

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?

With so many people on the organ transplant waiting list, the ethics of organ donation have begun to buckle. These proposals are not only unethical, in my opinion; in some cases they also treat donors as objects rather than subjects. Each and any of them could undermine the public’s already thin trust in the organ transplant system, which would be a catastrophe. But an ethical way forward has also been researched assiduously, and it is beginning to bear fruit: xenotransplantation, that is, the use of pigs’ organs, genetically altered to be more compatible with humans. Early experiments offer cause for optimism. Recently, a woman who was dying of kidney failure received a pig kidney, and she seems to be doing well. Read More ›