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The agitation to increase the pool of potential organ donors by allowing people who are unquestionably not dead, but who have profound cognitive disabilities, to be killed for their organs continues. An article in the American Medical News, primarily concerned with organ procurement after “heart death,” is the latest example. From the story:

Other critics said the concept of transplanting a heart after cardiac death isn’t logical. “If someone is pronounced dead on the basis of irreversible loss of heart function, after all, it would not be possible for heart function to be restored in another body,” wrote Robert M. Veatch, PhD, a Georgetown University medical ethics professor, in an Aug. 14, 2008, NEJM essay. “One cannot say a heart is irreversibly stopped if, in fact, it will be
restarted.”
This is to sow intentional confusion. The heart can beat outside the body because it has its own nerve clusters, and no one would say that the body from which it came was not dead. The issue is whether the heart could spontaneously restart beating, not whether the heart itself is so degraded it can no longer function.

Here’s the advocacy part:
Veatch said the dead-donor rule should be changed to allow patients or their families to opt for a standard that takes a loss of functioning consciousness (short of brain death) as another kind of death. Physicians could then procure hearts “in the absence of irreversible heart stoppage.”

Robert D. Truog, MD, said the Denver cases illustrate the underlying problem in how death is defined to facilitate organ donation and transplantation. He said it is time to reconsider the dead-donor rule. “The existing paradigm, built around the dead-donor rule, has increasingly pushed us into more and more implausible definitions of death, until eventually we end up with such a tortured definition that nobody’s going to believe it,” said Dr. Truog, professor of medical ethics and anesthesia at Harvard Medical School in Massachusetts.
This is known in the trade as “redefining death,” and if it ever comes to pass—people like Terri Schiavo could be called dead instead of unconscious and harvested to death. Moreover, we are not being “pushed” into this. Some want to choose it. It is our job to make sure it doesn’t happen.

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