All Your Organ Are Belong to Us

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All Your Organ Are Belong to Us

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The Bioethics Of Mandatory Organ Donation

"One is faced with a choice of saying that the notion of brain death doesn’t work, and since you’re not supposed
to take organs from a donor until they’re dead, we have to stop doing a lot of transplantation —
or you can find a better explanation for why total brain failure constitutes the
death of an organism," said Gilbert Meilaender, a Valparaiso University bioethicist and Council member.
"We offer a better philosophical explanation."¹

“If the heart still beats and the body still breathes (even with a ventilator)
and the body is warm and organs are maintained (somewhat) then it is a fiction to say the body is dead.
Death is not a hidden thing: it is manifest, and such a body is manifestly still alive”.²

The definition of death is being manipulated to provide hospitals with unconscious, unwilling donors; free organs and obscene profits.

The Organ Donation Dictionary


Opt-out Organ Donation (presumed consent)
There are two main systems for voluntary systems: "opt in" (anyone who has not given consent is not a donor) and "opt out" (anyone who has not refused is a donor). In some systems like in Australia (13.8 donors per million, 309 donors in 2010), family members are required to give consent or refusal, or may veto a potential recovery even if the donor has consented.

Opt-out legislative systems dramatically increase effective rates of consent for donation. However, because of cultural and infrastructural factors, public policies and other factors, this does not translate directly into increased rates of donation.

Some countries with an opt-out system like Spain (34 donors per million inhabitants) or Austria (21 donors/million) have high donor rates and some countries with opt-in systems like Germany (16 donors/million) or Greece (six donors/million) have lower rates. However Sweden, which has an opt-out system, has a low rate as well (15 donors/million). The president of the Spanish National Transplant Organisation, has acknowledged Spain's legislative approach is likely not the primary reason for the country's success in increasing the donor rates, starting in the 1990s.³

Glasgow Coma Scale or GCS
A neurological scale that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (the more widely used modified or revised scale).



Irreversible Cessation of the Circulation of Blood
One of the two possible criteria for death in several countries including Australia.

Irreversible Cessation of all Function of the Brain
One of the two possible criteria for death in several countries including Australia.




ref.

0. http://www.wired.com/wiredscience/2007/10/opt-out-organ-d/#previouspost
1. http://www.wired.com/wiredscience/2009/01/braindeath/
2. Davis Albert Jones, "Nagging Doubts about Brain Death”, Catholic Medical Quarterly (February 1985), http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e32.pdf
3. http://en.wikipedia.org/wiki/Organ_donation
4. http://www.legislation.sa.gov.au/LZ/C/A/DEATH%20%28DEFINITION%29%20ACT%201983/CURRENT/1983.12.UN.PDF

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The non-compliance of clinical guidelines for organ donation with Australian statute law.
by James Tibballs

Journal of Law and Medicine (2008)
Volume: 16, Issue: 2, Pages: 335-355


Abstract
Organ procurement is possible under statutes defining death as either irreversible cessation of all functions of the brain or irreversible cessation of the circulation, thus fulfilling the "dead donor rule". However, present practice does not conform strictly to these conditions.

Clinical guidelines for the diagnosis of whole-brain death are equated, with coma, to absence of brain-stem reflexes which essentially means the absence of spontaneous respiration which is clinically interpreted as "dead enough" or "as good as dead" for the purpose. Moreover, Krommydas v Sydney West Area Health Service 2006 NSWSC 901 suggests public distrust of brain-stem reflexes as tests to diagnose whole-brain death. Mandatory adoption of a test of brain blood circulation, at present optional, would strengthen reliability of the diagnosis.

Organ procurement is performed after cessation of the circulation following orchestrated withdrawal of futile life-support and is commenced when the heart fails to "auto-resuscitate" two minutes after it stops, rather than proven irreversible cessation. Ante-mortem procedures are performed on the donor to increase organ availability and viability but may contribute to or cause death. State and national ethical guidelines on this practice conflict and it appears proscribed under State guardianship legislation which requires actions in the best interests of the donor, not the recipient.

Considerations should be given to organ procurement in situations where the donor is dying or in which survival is impossible. Simple abandonment of the "dead donor rule", however, is not feasible since organ procurement would be the direct cause of death.

http://www.mendeley.com/research/the-noncompliance-of-clinical-guidelines-for-organ-donation-with-australian-statute-law/

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Pediatric Organ Donation and Transplantation Policy Statement: More Questions, not Answers

Joseph L. Verheijde, PhD, MBA, PT
Departments of Biomedical Ethics and Physical Medicine and Rehabilitation Mayo Clinic College of Medicine Mayo Clinic Phoenix, Arizona Center for Biology and Society School of Life Sciences Arizona State University Tempe, Arizona

Mohamed Y. Rady, MD, PhD, FCCM
Department of Medicine Mayo Clinic College of Medicine Mayo Clinic Phoenix, Arizona Department of Critical Care Medicine Mayo Clinic Hospital Phoenix, Arizona Center for Biology and Society School of Life Sciences Arizona State University Tempe, Arizona

The American Academy of Pediatrics (AAP) released a policy statement regarding pediatric organ donation and transplantation¹ in which several strategies to increase the supply of transplantable organs from pediatric donors were endorsed. A significant increase in the supply of transplantable organs from pediatric donors is also necessary to meet the demands of adults awaiting organ transplant.² Although the AAP opted to not address unresolved problems in pediatric organ donation, the policy statement generated additional questions by positing that (1) an accurate and timely declaration of neurologic death in heart-beating donation (HBD) or circulatory-respiratory death in non–HBD (NHBD) (also known as donation after cardiac death or donation after circulatory death) is essential, (2) organ donation is an integral part of end-of-life care, (3) timely referral to organ-procurement organizations (OPOs) is critical, and (4) consent should be handled by procurement professionals.

In the policy statement, HBD and NHBD were identified as appropriate venues of pediatric organ procurement, but the statement was explicitly silent on recent scientific controversies about both types of procurement practices. Both the validity of the criteria and the accuracy of the clinical standards of determining neurologic or circulatory-respiratory death in donors have been challenged.3,–,10 In the absence of scientific evidence that donors are truly dead, new philosophical, teleologic justifications have been proposed to defend redefinitions of human death for the purpose of organ procurement.

more: http://pediatrics.aappublications.org/content/126/2/e489.short

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Man Pronounced Dead,Comes To Life.
Nov. 21: An Oklahoma man declared brain dead shocks everyone when he suddenly reaches for the nurse who was prepping him for organ donation.
http://www.liveleak.com/view?i=f71_1195672709

Woman’s Waking After Brain Death Raises Many Questions About Organ Donation
CHARLESTON, West Virginia, May 27, 2008 (LifeSiteNews.com) - A Virginia family was shocked but relieved when their mother, Val Thomas, woke up after doctors said she was dead.
http://www.lifesitenews.com/news/archive/ldn/2008/may/08052709
http://www.dailymail.co.uk/news/article-1021818/The-mother-came-dead--minutes-life-support-machine-turned-OFF.html

Illinois man believed to be brain dead wakes up
WEST BURLINGTON, Iowa — An Illinois man who was believed brain dead after he had an aortic aneurysm woke up and began talking, his daughter said.
Read more: http://www.dailyherald.com/article/20101126/news/101129682/#ixzz1WeD2Y94M

Husband Celebrates Miracle as 'Brain Dead' Wife Wakes Up in Hospital
Gloria Cruz, 56, underwent brain surgery after a tumor was discovered when she suffered a stroke on March 7 and was rushed to the Royal Darwin Hospital in Darwin, Northern Territory. Doctors told her husband Tani Cruz, 51, the case was “hopeless” and she would probably die within 48 hours following the surgery. After two weeks, a breathing tube was inserted in Mrs Cruz's mouth and the ventilator was turned off. Hospital staff were stunned when she woke from her coma three days later.
http://www.freerepublic.com/focus/f-news/2718183/posts

Woman Diagnosed as “Brain Dead” Walks and Talks after Awakening
LAKE ELMO, Minnesota, February 15, 2008 (LifeSiteNews.com) - 65-year-old Raleane "Rae" Kupferschmidt’s relatives were told by doctors that she was "brain dead" after she had suffered a massive cerebral haemorrhage in mid-January, according to an Associated Press Report. Her family had taken her home to die and were in the process of grieving and planning her funeral when she awoke and was rushed back to hospital.
http://www.lifesitenews.com/news/archive/ldn/2008/feb/08021508

The Day Donny Herbert Woke Up
It's a story that made headlines around the world when on April 30, 2005, Donny Herbert, a 43-year old Buffalo firefighter, stunned his doctors, family and friends when he suddenly emerged from a vegetative stupor after nearly 10 years.
http://abcnews.go.com/GMA/Books/story?id=3916331&page=1

Man who awoke from coma raises new questions about death of Terri Schiavo
Little Rock, Ark., Jul 7, 2006 / 12:00 am (CNA).- The case of Terry Wallis, an Arkansas man who suddenly woke up from a 19-year long coma, has raised new questions about the death of Terri Schiavo, who died last year after a court ordered her feeding tube to be disconnected.  Wallis fell into his coma in 1984 after a serious car accident.  At the time he was 19.
http://www.catholicnewsagency.com/news/man_who_awoke_from_coma_raises_new_questions_about_death_of_terri_schiavo/

Prof James Tibballs says organs are taken before donors are dead
A DOCTOR claims most organ donors are not dead when their organs are removed. In an article in the Journal of Law and Medicine, Melbourne specialist Associate Professor James Tibballs argues it is "impossible to be certain" that the brain and circulation have ceased "irreversibly" before organs are taken. "It may be better to concede that, although organ donation is presently conducted under the guise of total brain death, it is in reality conducted under a point of 'neurological no return' or 'as good as dead'," he said.
Read more: http://www.news.com.au/national/organs-are-taken-before-donors-are-dead/story-e6frfkw9-1111117804707#ixzz1WeHTEAVO

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Melbourne Doctor: Most Donors Still Alive when Organs are Removed

by LifeSiteNews.com

    Tue Oct 21, 2008 11:15 EST

By Kathleen Gilbert

MELBOURNE, Australia, October 21, 2008 (LifeSiteNews.com) - A prominent Melbourne doctor has written that, contrary to popular belief, most organ donations take place before the donor is actually dead.  He argues that the vague criterion of "brain death" has blinded potential donors to the fact that their organs are often harvested while they are still alive.

Pediatric intensive care specialist Dr. James Tibballs published his controversial views in the Journal of Law and Medicine earlier this month, calling upon medical institutions to review their organ harvesting guidelines to ensure that donors know that they may be volunteering to surrender their life on the operating table.

Tibballs points out that current medical practices usually contravene the law, which state that a donor must display irreversible cessation of all functions of their brain or of blood circulation in order to be eligible for the surgery. Australian doctors, however, usually wait only two minutes after a heart has stopped beating before giving the green light for harvesting, said the pediatric specialist.

But Tibballs says two minutes is inadequate time to determine whether the loss of circulation is "irreversible." The two minutes criterion was established purely for utilitarian reasons, he says - because waiting longer could threaten the viability of donated organs.

"It could be troubling for the public to realise that doctors looking out for organ donors are also the ones formulating guidelines on how to declare death for organ transplantation," observed Tibballs.

"For this reason, there should be members of the community and people with legal backgrounds on the committee that create these clinical guidelines used to declare someone dead."

Organ donor groups have criticized Tibballs’ article, expressing concern that it may cause donors or potential donors to reconsider their commitment.

"This could be very damaging to public confidence of brain death diagnosis, because a lot of people might say, ‘we don’t believe in this any more,’ and as a consequence, people might die on waiting lists," said Bill Silvester, the medical director of LifeGift.

Dr Gerry O’Callaghan also dismissed Tibballs’ ideas, claiming that donors should be confident that a brain death diagnosis always means true death. "There is no possibility that they would be conscious, that they would have the capacity to feel pain, that they have the capacity for independent life," he said.

However, although Tibballs’ opponents stress that his opinions are in the minority, there has been growing concern about aggressive organ harvesting policies that fail to ensure that the patient is actually dead.  

more: http://www.lifesitenews.com/news/archive/ldn/2008/oct/08102105

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