Is brain death - death? New Canadian brain-death guidelines

ALEX SCHADENBERG: Is brain death - death? New Canadian brain-death guidelines.: There have been many concerns about whether organ donors are dead before their organs are removed, but the current Canadian guidelines appear to make it more likely that death occurs from the removal of organs rather than waiting for death to occur and then removing organs from a dead donor. National Post article; McGill Journal of Law and Health article

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Mom fights Texas hospital’s removal of food and water from 12-year-old son

Zach McDaniel suffered a severe head injury two weeks ago when he was caught in the crossfire of an alleged drug dispute in Abilene, Texas. He was placed on life support under heavy sedation at Cook Children’s Medical Center in Fort Worth. McDaniel has been heavily sedated and reportedly has yet to regain consciousness, but was able to breathe on his own when the ventilator was removed.

Texas Right to Life Legislative Director John Seago told LifeSiteNews.com that Cook doctors had begun pressuring McDaniel’s family to consider allowing the boy’s organs to be removed only hours after his brain surgery commenced. But it was when Zach’s family was told in a possible miscommunication that part of his brain was missing - a fact later contradicted by brain imagery - that they became suspicious, Seago said, and “started slowing down the organ donation conversation.”

Organ harvesting in light of questionable ‘brain death’ criterion

Vatican Radio tackles organ harvesting in light of questionable ‘brain death’ criterion | LifeSiteNews.com: The dubious criterion of ‘brain death,’ invented in 1968 to accommodate the need to acquire vital organs in their “freshest” state from a donor who some argue is still very much alive, made headlines two weeks ago when a young British man revealed to the media that he owed his life to his insistent father who would not allow his son’s organs to be removed from his body, despite assurances from four doctors that his son could not recover from the wounds he had suffered in a car accident.

Related:
Rebuttal and response
Making organ donations a thing of the past, British lab grows spare parts

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Critical organ donation warnings and guidance in new pamphlet: “Do not do an Apnea test!”

Critical organ donation warnings and guidance in new pamphlet: “Do not do an Apnea test!” | LifeSiteNews.com: Dr. Paul Byrne has been on a personal mission for many years to warn the public about the alarming facts and dangers of the $20 billion dollar-a-year organ transplant industry. Dr. Byrne has addressed serious concerns regarding so-called “brain death,” the apnea test, and organ transplantation. He also introduced a new 29-page booklet containing crucial information to assist the public in making informed decisions about organ donation.

Editor: He makes this interesting comment about ventilators --

“The ventilator can be effective only in someone living” emphasizes Byrne. “The ventilator pushes air into the lungs; the air goes out (exhaled) only when and because the living body pushes it out. This does not occur in a cadaver/corpse/dead body.”

Related: Rebuttal and response

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Woman says daughter denied transplant because of mental disability

South Jersey woman says daughter was denied transplant because of mental disability — NewsWorks: For doctors, transplant eligibility for those with mental disabilities is seen in shades of gray, not the same black and white. When determining eligibility for kidney transplants for mentally disabled adults, doctors would consider whether patients could take their post-transplant medication reliably, or have a support system to ensure they would. For kids, that kind of care is always the job of the parents. So the question becomes one of quality of life: how much better would life be for the child if he or she got the transplant rather than going on dialysis?

In her blog, the mother quotes this exchange with the doctor:

“So you mean to tell me that as a doctor, you are not recommending the transplant, and when her kidneys fail in six months to a year, you want me to let her die because she is mentally retarded? There is no other medical reason for her not to have this transplant other than she is MENTALLY RETARDED!”
“Yes, [said the doctor]. This is hard for me, you know.”

Related:
Is intellectual disability a reason to deny an organ transplant?
Wesley J. Smith commentary

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‘Dead-donor’ rule dangerously misleading, experts say

Doctors should abandon the “dangerously misleading” policy of having to declare donors dead before their organs can be extracted for transplant, and adopt a more honest policy that acknowledges some patients may still be technically alive, Canadian and Spanish experts suggest in a provocative new commentary.

They advocate replacing the current “dead-donor rule” with a policy that educates the public about the true nature of patients used in transplant, obtains informed consent — and ensures the donor does not suffer during the organ harvesting.

The authors, including Dr. Neil Lazar, director of the medical-surgical intensive care unit at Toronto General Hospital, say 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.

. . . The suggestions, made at a major U.S. bioethics conference last week and in a recent paper in the American Journal of Bioethics, are coming under strenuous criticism by the transplant community, however. Some experts call the proposal a theoretical argument that has little foundation in reality, but that could seriously hurt the ongoing struggle to recruit potential organ donors.

“In the overwhelming majority of cases, the concept of death is easy, obvious and not really subject to any complex interpretation. It’s very clear,” said Dr. Andrew Baker, medical director of the Trillium Gift of Life Network, which oversees Ontario’s transplant system. “They’re dead, you can see it, there is no return of anything.”

. . . In questioning death declaration, the bioethics paper focuses largely on a recent trend in transplantation.
Most transplant organs are taken from patients declared brain dead. Those people account for only about 10% of hospital deaths, however, leaving a shortage of donors and hundreds of gravely ill Canadians languishing and dying on transplant waiting lists.

In response, the medical community has recently embraced a new protocol, where organs are removed after the heart has stopped — in Canada, five minutes after it has halted — but when the patient is not necessarily brain dead. 

. . . While the medical community generally supports “donation after cardiac death [DCD],” there has been some controversy. . . . [I]n most DCD cases, doctors have made a decision not to continue life-support measures that keep the patient breathing and their heart beating. That does not necessarily mean the heart could not be started again, artificially at least, they argue.

It is also possible that when cardiac death is declared, there may still be some brain activity, raising at least the possibility the donor could feel pain during the harvesting of organs, the paper argues. The process of inserting catheters that pump blood through the transplant organs before removal could also start blood circulation in the brain, triggering some limited activity there, the article says.

Dr. Baker said there is no evidence, however, that cardiac death is anything but the complete lack of life. When someone is removed from a ventilator, first they stop breathing, then their heart stops. That means that the brain stem, which regulates those activities and is considered the last part of the brain to die, would have lost all function. And perfusion is done here in a way that there is no blood flow through the brain, he said. National Post

Boycott China until they stop killing for body parts

Since there are not nearly enough organs to meet local needs, much less the demands of all these rich visitors, they are being procured from executed prisoners. The Chinese government has admitted that some executions may have even be timed for the convenience of a transplant recipient.

Without greater international pressure, killing for parts won’t stop. Killing prisoners for their parts is unethical on its own, but the practice is even more heinous given that prisoners in China can get death sentences for their religious or spiritual beliefs, political views or relatively minor crimes. MSNBC

Related: The Use of Prisoners as Sources of Organs–An Ethically Dubious Practice

Indian Girl Commits Suicide to Donate Organs to Family Members

Indian Girl Commits Suicide to Donate Organs to Family Members » Secondhand Smoke | A First Things Blog: "in India, a 12-year-old girl killed herself for that very purpose. From the Times of India story:

For days, Mumpy would listen quietly as the elders discussed how only an eye surgery could save her father’s vision and a kidney transplant her brother’s life. But both surgeries were beyond the family’s meagre means. So, Mumpy hit upon a plan, which to her 12-year-old mind seemed the answer to all troubles. She would kill herself, which would save the dowry, too, and her organs would give her loved ones back their lives. Mumpy did stick to her plan. But the suicide note in which she had scribbled down her wishes was found the day after she was cremated.

‘Brain dead’ Quebec woman wakes up after family refuses organ donation

‘Brain dead’ Quebec woman wakes up after family refuses organ donation | LifeSiteNews.com: 76 year old Madeleine Gauron was hospitalized for an inflammation of the gums, which required a brief operation. During her recovery, hospital staff gave the elderly woman solid food, which she had been unable to consume in her family home for some time, and left her unattended. Choking on the food, she fell into a coma, after unsuccessful resuscitation.

Medical staff contacted her family, explaining to them that their mother was “brain dead,” with no hope of recovery. Citing Gauron’s eyes as particularly viable, the doctors asked if the family would agree to organ donation. While supporting the possibility of donation, her shocked family first demanded further medical tests to prove Gauron was really dead.

The next day, the family was astonished to learn that Gauron had awakened. Shortly afterwards, she sat up in bed and ate yogurt. “If we had decided to donate her organs, they would have killed her,” said her son.

Belgian transplant surgeons use lungs from euthanased patients

BioEdge: Belgian transplant surgeons use lungs from euthanased patients: A press release from a team at a hospital in Leuven announced yesterday that it had successfully transplanted lungs from four euthanased patients between 2007 and 2009. In an article in the journal Applied Cardiopulmonary Pathophysiology, the authors observe that the quality of the lungs from euthanased patients seems superior to those obtained from brain dead donors and donations after cardiac death.

“In contrast to these donors, euthanasia donors do not experience an agonal phase before circulatory arrest as seen in donors dying from hypoxemia or from cardiogenic or hypovolemic shock.” Apparently a number of patients who request euthanasia want to donate their organs. However, since many of them have cancer, the organs are not suitable.

Related: Organs harvested from euthanized patients make better transplants

Vital organ donation

Vital organ donation: If you were to compare a dead body with someone declared 'brain dead,' you would find that the dead body is pale, cold, stiff, and unresponsive. There is no heartbeat, no body functions, no breathing, and no movement. Someone declared 'brain dead' is warm and flexible. There is a beating heart, normal color, temperature, and blood pressure. Most functions continue, including digestion, excretion, and maintenance of fluid balance with normal urine output. There will often be response to surgical incisions. In a long enough period of observation, someone declared 'brain dead' will show healing and growth, and will go through puberty if they are a child.

Ignore wishes of dead if their organs are needed

One of Britain's leading bioethicists has endorsed compulsory deceased organ donation. Writing in the Journal of Medical Ethics, John Harris, of the University of Manchester, and Antonia Cronin, of Kings College London, argue that today's organ shortage is so severe that it trumps autonomy over the posthumous use of one's body.

Belgian Doctors Euthanized Disabled Patient and Harvested Her Organs

Secondhand Smoke references an article in which Belgian doctors took organs from a disabled patient. The woman in question was not terminally ill, but in a “locked-in” state, that is, fully conscious and completely paralyzed. She wanted to die–a desire accommodated by her doctors. Just prior to being killed, she decided to donate her organs.

Article proposes Organ Donation Euthanasia

"It is permissible to withdraw life support from a patient with extremely poor prognosis, in the knowledge that this will certainly lead to their death, even if it would be possible to keep them alive for some time. It is permissible to remove their organs after they have died. But why should surgeons have to wait until the patient has died as a result of withdrawal of advanced life support or even simple life prolonging medical treatment? An alternative would be to anaesthetize the patient and remove organs, including the heart and lungs. Brain death would follow removal of the heart (call this Organ Donation Euthanasia (ODE)). The process of death would be less likely to be associated with suffering for the patient than death following withdrawal of life-sustaining treatment (which is not usually accompanied by full anaesthetic doses of drugs). If there were a careful and appropriate process for selection, no patient would die who would not otherwise have died." Bioethics

Editor: Dr. Jack would be proud.

Chinese accused of vast trade in organs harvested from religious dissidents

China's hidden policy of executing prisoners of the forbidden quasi-Buddhist group Falun Gong and harvesting their organs for worldwide sale has been expanded to include Tibetans, "house church" Christians and Muslim Uighurs. Washington Times