Organ Donation and Organ Transplantation

Also see: Death and Brain Death

“Variability of brain death determination guidelines in leading US neurologic institutions”
(Neurology)
Major differences exist in brain death guidelines among the leading neurologic hospitals in the United States. Adherence to the American Academy of Neurology guidelines is variable. If the guidelines reflect actual practice at each institution, there are substantial differences in practice which may have consequences for the determination of death and initiation of transplant procedures.

Articles

“Can you legally consent to a head transplant?”
(Washington Post — August 25, 2016)
Transplanting a human head onto a different body sounds like the plot of a science fiction story….A head transplant requires two decapitations and then a grafting of the patient’s head onto the body of another person….

“‘Remove organs from euthanasia patients while they’re still ALIVE'”
(Daily Mail — March 31, 2016)
Those who want to be killed should be sedated in hospital then allowed to die after the removal of their vital organs, according to the proposal published by a British-based medical ethics journal. Using organs for transplant surgery from patients who have been helped to die is allowed in Belgium and Holland….[A]n article in the Journal of Medical Ethics yesterday advocated “heart-beating organ donation euthanasia.”  This would involve an operation in which organs would be taken from still-living patients who have given permission.

“Teen Survived Kalamazoo Shooting after Being Pronounced Brain Dead”
(ABC7 — February 23, 2016)
The hospital was in the process of preparing her organs for donation when the girl squeezed her mother’s hand.

“When are you dead? It may depend on which hospital makes the call”
(Washington Post — December 29, 2015)
But there, under the bright lights of the prep room in the OR, Burns opened her eyes.  The 41-year-old wasn’t brain dead.  She wasn’t even unconscious anymore.  And doctors had been minutes away from cutting into her to remove her organs.

“Exclusive: Islamic State sanctioned organ harvesting in document taken in U.S. raid”
(Reuters — December 25, 2015)
Islamic State has sanctioned the harvesting of human organs in a previously undisclosed ruling by the group’s Islamic scholars, raising concerns that the violent extremist group may be trafficking in body parts.
The ruling, contained in a January 31, 2015 document reviewed by Reuters, says taking organs from a living captive to save a Muslim’s life, even if it is fatal for the captive, is permissible.

“The ethics of new organ donation methods”
(Swiss Info — December 14, 2014)
Is it ethical to use organs from people who have died with assisted suicide?  Biomedical ethicist David Shaw [of the Institute for Biomedical Ethics at the University of Basil] believes it’s one of the ways to try and counter organ donor shortages.
More on Switzerland

“An eloquent defense of euthanasia by organ removal”
(BioEdge — December 6, 2014)
In an article in this month’s edition of Bioethics, Oxford bioethicists Julian Savulescu and Dominic Wilkinson present a rational defense of what they label “organ donation euthanasia.” The practice, as they describe in the article, involves the steady removal of a patients’ organs after they have been put under anaesthetic.  “Death.” the authors write, “follows the removal of the heart.”

“‘Miracle’ Woman Ruby Graupera-Cassimiro Survives After 45 Minutes Without Pulse”
(ABC News — November 10, 2014)
Doctors glanced up at the monitors to call the time of death for a patient whose heart hadn’t beat in 45 minutes and who hadn’t breathed in three hours.
Then, they saw it:  a blip on the screen.

“Mother in Coma Heard Everything: Was Petrified They’d Turn Off Life Support”
(Mix102.3 — October 14, 2014)
Kate Allat is a mother who suffered a stroke at 39.  The Daily Mail reports Kate’s mind was functioning perfectly, but everyone around her, including medics, thought she was brain dead.

“Death determination debate rages on in science, medicine”
(CBC New: Technology and Science — October 13, 2014)
Uncertainty influences disconnecting life support, organ donation.

“Arizona College Student Bounces Back From The Dead After Nearly Giving Organs”
(ABC News — May 16, 2014)
Two years ago, Sam Schmid’s close encounter with death was called a “Christmas miracle.” As he lay in a coma after sustaining massive brain injuries in a car crash, doctors were discussing organ donation with his parents and ready to take him off life support.  Schmid astounded those at his hospital bedside who thought he was brain dead…

“Stroke Patient Hears Doctors Discuss Organ Donation”
(ABC News — April 5, 2014)
A Swedish man who was paralyzed by a massive stroke has filed a complaint against the hospital that cared for him because he claimed he could hear doctors discussing whether to donate his organs just before they gave him a sedative that put him under. According to Fritze, they told his then-girlfriend to get his family and say their goodbyes.

“Mexican authorities accuse Knights Templar of organ harvesting racket”
(Bioedge — April 4, 2014)
Last Tuesday, Mexican police arrested a senior member of the Knights Templar crime syndicate, alleged to have kidnapped children to harvest their organs.

“Police nab cartel member in organ trafficking case”
(USA Today — March 17, 2014)
Ring would kidnap children, take them to homes to have organs removed, official said.

“Bioethics and the Dogma of ‘Brain Death'”
(Hastings Center Bioethics Forum — February 2014)
While brain death is legally recognized as death in all 50 states, we are not alone in arguing that the “brain dead” remain alive in view of the biological conception of death established within medicine….We submit that no bioethics commentary on cases involving “brain death” is intellectually acceptable in the absence of acknowledging that there is vigorous controversy in the field over the determination of death and the status of those diagnosed as “brain dead”.

“Let’s Have a REAL Discussion: Bioethicists Preach, Fail to Teach on Brain Death”
(Not Dead Yet — January 7, 2014)
What most people are unaware of is that, under the Uniform Determination of Death Act (UDDA), hospitals get to set their own standards and specific protocols to use in making the determination of death.

“Disability Rights Victory in Organ Procurement Protocols…”
(Not Dead Yet — November 14, 2013)
This week the Board of Directors of the Organ Procurement and Transplantation Network (OPTN) adopted a policy that removed two major threats to people with disabilities posed by previous proposals.
More on Disability Perspectives

“Girl smuggled into Britain to have her ‘organs harvested'”
(Telegraph — October 18, 2013)
The unnamed girl was brought to the UK from Somalia with the intention of removing her organs and selling them on to those desperate for a transplant.

“Death of the Brain Is Not the Death of a Human Being”
(Medscape — September 23, 2013)
In order to be considered living, a human organism must be able to integrate and coordinate the physical and mental functions of her body. She must process nutrition, eliminate waste, and exhibit growth. She must have homeostasis. If she can integrate these functions as a coherent organism with homeostasis, then she is alive — but if she cannot, then she is dead.

“Brain activity found after ‘brain death'”
(Los Angeles Times — September 18, 2014)
The findings could revive debate over the criteria for declaring a person “brain dead.” In the U.S. two such flat-line readings 24 hours apart are necessary, along with other tests of brain function.

“Euthanased patients a new source of organ donations in Belgium”
(BioEdge — September 7, 2013)
With a shortage of organ donors in Europe, Belgium doctors have a novel solution: patients with unbearable suffering donate their organs after voluntary euthanasia…Euthanasia donors accounted for 12.8% of lung donors — one half had severe muscular disease and one half were mentally ill.
Abstract of “Lung Transplantation with Grafts Recovered from Euthanasia Donors” from Report of 21st Conference for Thoractic Surgery — describes organ donation after euthanasia.

“Woman brought back to life after being dead 40 minutes”
(ABC News — August 19, 2013)
In Melbourne, doctors are crediting a unique and rare piece of equipment with saving the life of a 41 year old woman who was declared clinically dead for 40 minutes following a serious heart attack.  Today that woman, Vanessa Tanasio, is walking and talking about the Lucas 2 device.

“A Plea For Assisted Suicide: Terminally Ill Woman Wants To Donate Organs”
(Fox17 — Michigan– August 7, 2013)
As she nears her death, Sherri Muzher is asking for help to end her live so she can donate her organs.

“Family loses fight to keep son’s organs from donation”
(Columbus Dispatch — July 19, 2013)
Elijah Smith, 21, said he wanted to be an organ and tissue donor when he applied for a driver’s license in September….Ohio law bars anyone other than the donor from amending or revoking an organ donation.

“Patient Wakes Up as Doctors Get Ready to Remove Organs”
(ABC News — July 9, 2013)
It was exactly midnight when Colleen Burns eerily opened her eyes and looked at the operating lights above her, shocking doctors who believed she was dead and were about to remove her organs and donate them to patients on the transplant waiting list.

“St. Joe’s ‘dead’ patient awoke as docs prepared to remove organs”
(Syracuse, NY — July 7, 2013)
Doctors at St. Joseph’s Hospital Health Center were about to remove organs for transplant from a woman they thought was dead.  Then she opened her eyes.  She was alive…Doctors had ignored a nurse’s observations indicating Burns was not dead and her condition was improving.

“Organ donation: Drakeford hails ‘historic day’ for Wales”
(BBC — July 3, 2013)
A vote in favour of a system where people are presumed to have consented for their organs to be donated after death has been hailed as a “historic day” by Wales’ health minister.  It means Wales will be the first UK nation to introduce a system where people are presumed to have consented to become organ donors unless they opt out.

“AMs to vote on ‘presumed consent’ organ donation plans”
(BBC — July 2, 2013)
The Welsh government wants to introduce a system where individuals will be presumed to have consented for their organs to be donated after death unless they have specifically objected.

“Q & A: Organ donation planned changes in Wales”
(BBC — July 1, 2013)
Questions and answers regarding proposed changes to organ donation.

“Proposed Changes In Organ Donation Stir Debate”
(NPR — June 24, 2013)
So there’s always been one clear rule: No one should even raise the possibility of a patient becoming an organ donor until either they’re clearly dead or there’s no hope and either the patient or their family has decided to discontinue care.

“Proposed Changes to Organ Donation Blur the Line on End of Life Care”
(Palli Med — June 24, 2013)
At the heart of the effort is an attempt to increase the number of organ donors, of course, but the ethical question is how to achieve that noble goal.

“Not Dead Yet Urges Secretary Sibelius and Organ Procurement and Transplantation Network to Prohibit Organ Procurers from Pressuring Sick or Injured to Give Up on Living”
(Not Dead Yet press release — June 20, 2013)

“Severe Brain Injury and Organ Solicitation: A Call for Temperance”
(Virtual Mentor: AMA Journal of Ethics — March 2012)
My problem as an OPO (organ procurement organization) board member was that, too often, patients like these were viewed as if they were destined or compelled to die.

“Should We Allow Organ Donation Euthanasia? Alternatives for Maximizing the Number and Quality of Organs for Transplantation”
(Bioethics — Volume 26, No. 1, 2012)
Dominic Wilkinson and Julian Savulescu argue that Organ Donation Euthanasia would be a rational improvement over current practice regarding withdrawal of life support.