Oh, oh: Here they come.
Nature is one of the top science journals in the world. What is published within its pages matter. And now, it has editorialized to loosen standards of declaring brain death so that more organs can be harvested. From the editorial:
The law seems admirably straightforward: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” In practice, unfortunately, physicians know that when they declare that someone on life support is dead, they are usually obeying the spirit, but not the letter, of this law. And many are feeling increasingly uncomfortable about it.
Then, they should stop doing it! Cutting corners is a profound betrayal of the living patient falsely declared dead, of the organ transplant system because it destroys public trust, and of medicine as a whole because it turns doctors from healers into death causers.
Alas, Nature’s answer–in keeping with the spirit of the age–isn’t to rein in abuse, but expand and liberalize death declarations so that some living patients will be falsely declared dead:
Ideally, the law should be changed to describe more accurately and honestly the way that death is determined in clinical practice. Most doctors have hesitated to say so too loudly, lest they be caricatured in public as greedy harvesters eager to strip living patients of their organs. But their public silence was broken on 24 September at an international meeting that included physicians, transplant surgeons and bioethicists at the Italian Festival of Health in Viareggio. The meeting concluded that lawmakers in the United States and elsewhere should reconsider rigid definitions of death, and called for a wider public debate.
I am sorry, but dead “for all intents and purposes,” isn’t dead: The people won’t stand for it no matter what “the experts” say. And get this relativism:
Few things are as sensitive as death. But concerns about the legal details of declaring death in someone who will never again be the person he or she was should be weighed against the value of giving a full and healthy life to someone who will die without a transplant.
That is the classical road of good intentions that leads to very dark places. Organ transplant medicine is too important to allow relativism and utilitarianism in the door. I mean, there aren’t even unified standards or training required in the US today, and they want to change the standards?! This agenda must be resisted at all resolve–most of all because it is right to resist–but if that isn’t enough, because loosen the definitions and no one will want to be donors.
September 30th, 2009 | 3:21 pm
[...] that is true, the answer to this is to rein in bad practices, not loosen the definitions! More over at Secondhand Smoke. Comments [...]
September 30th, 2009 | 4:27 pm
Wow, this bit is frighteningly honest:
“Physicians and others involved in the issue would be wise to investigate just how incendiary the theme might be, perhaps in contained focus groups, and design their strategy accordingly.”
So we have to focus-group this so we know how to pitch the ball without discouraging organ donation. And they have the gall to worry about pushing people toward deceit! I guess they hope hoi polloi don’t read _Nature_ where they are here openly scheming about how to do propaganda.
September 30th, 2009 | 8:58 pm
Once upon a time I thought that, when the revolution came, all the lawyers should be fed into the thresher first, but I’m quickly coming to the conclusion that the bioethicists should move to the front of that particular line.
(Note: the preceding is sarcastic, so please don’t play the game of calling me a bloodthirsty lunatic…and, yes, for the rest of you I thin kit’s sad and not a little pathetic that I have to add this disclaimer lest some clown seize on it as ‘proof’ that everyone that doesn’t share their views is a maniac.)
September 30th, 2009 | 9:06 pm
ECM: Gulp. I’m a lawyer, and some people call me a bioethicist!
September 30th, 2009 | 9:23 pm
Organ Donation requires the permission and help of individuals and families. If an organ donor card turns into a, “kill me,” card then organ donation will become much rarer.
Popular support must be maintained.
September 30th, 2009 | 9:25 pm
AB: Add in that many of these same advocates want “presumed consent,” meaning you are an organ donor unless you opt out, and the danger becomes clear.
September 30th, 2009 | 11:12 pm
[...] This post was mentioned on Twitter by Dan Kennedy and Wesley J. Smith. Wesley J. Smith said: “The Scientists” Want To Loosen Definition of “Brain Death” » Secondhand Smoke | A First Things Blog – http://shar.es/15Ln0 [...]
October 1st, 2009 | 8:43 am
Yeah, ol’ Cass Sunstein advocates presumed consent, I believe. I guess we’d better not say that, though, or we’ll be called “bad for conservatism.”
October 1st, 2009 | 8:56 am
I understand the idea of, “presumed consent.” This impacts that as well. First, people will opt-out wholesale. Second, more to my point, if popular support collapses, or just declines significantly, the laws for “presumed consent,” will either not be passed or will be repealed.
Without popular support turned into political support, there will be neither the money for organ transplants nor the laws to support it.
October 1st, 2009 | 9:52 am
Organ transplant has become yet another form of entitlement. A rather gruesome form. Is it possible for us to return to the idea that when our organs are exhausted, it is time for prayer, not for rifling someone else’s body for spare parts?
October 1st, 2009 | 10:35 am
I believe in organ transplant medicine, but this effort to cut corners is very damaging to that sector and to the people’s trust.
October 3rd, 2009 | 4:17 pm
[...] I reported the other day that Nature editorialized in favor of loosening the rules to allow living patients to be killed for their organs (more about which, soon). And now, we see more advocacy for lethal medicine in The Journal of Medical Ethics, an international publication. From the article by (No link, here’s the abstract): Revisiting the still-provocative essays of Jonas on brain death and organ donation helps in mapping present and future ethical and policy options. Four options seem most salient. First, we can follow the lead of Jonas by adopting a stance of deontological rectitude that abandons vital organ procurement from brain-dead, but still-living patients. This position is logically tidy and unassailable if its major premise is endorsed: (1) doctors must not kill patients; (2) brain-dead patients are alive; (3) procuring vital organs from brain-dead patients would cause their death; therefore, (4) this practice is wrong and must cease. However, the validity of the first premise is debatable; and if applied consistently, it would have drastic consequences. For not only would it put a stop to the life-saving practice of vital organ transplantation using the organs of brain-dead individuals; it also arguably would rule out the routine practice of deliberately stopping life-sustaining treatment, assuming the reasonable, but unorthodox, view that this practice involves causing death. [...]
October 3rd, 2009 | 4:31 pm
[...] urging that the dead donor rule be discarded to allow doctors to kill for organs are proliferating. I reported on a Nature editorial so advocating just a few days ago. Now a similar piece has been published in the Journal of Medical Ethics, [...]
October 6th, 2009 | 11:48 am
[...] Oh, Oh: Scientists Want To Loosen Definition of “Brain Death” [...]
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