Tuesday, January 15, 2008

A Closer Look at Brain Death and Compulsory Organ Donation

Stuart Cunliffe sent over this tip about Melanie Phillips's latest column for the Daily Mail (U.K.):

This is the first time to my knowledge that any British newspaperman or newspaperwoman has decided to blow the gaffe on brain stem death and organ removal for transplantation. I was absolutely delighted to see it.

So am I.

Phillips has written an enlightening (and scary) piece. I'll cite several excerpts below but I do encourage you to read it in its entirety.

...Undoubtedly, the impulse to give people the gift of life after one's own death is a noble one. But if Mr Brown really imagines that he will win popular acclaim by saying that the state will whip out people's hearts or kidneys without their consent, his advisers undoubtedly need a brain transplant. For the implications are truly terrifying...

If the medical profession alone were to suggest this - as its leadership most lamentably is doing - it would be alarmingly coercive.
For the Government to be backing it, however, deepens coercion into something even more threatening. Volunteering to donate your organs is one thing. Making it compulsory unless you opt out transforms an act of altruism into state oppression...

Chillingly, hospitals are to be rated according to the number of dead patients they "convert" into donors.
It is hard to imagine a more sinister incentive for the wholesale abuse of vulnerable patients.

There is, however, a yet more fundamental objection to the opt-out proposal. This is the serious doubt whether people whose organs are harvested are indeed dead.


All the evidence suggests that organs are harvested not from the dead but from the dying. In other words, at the time the organs are removed the patients are still alive.
This is because, in these cases, the criterion doctors use to decide that someone has died is the death of the brain stem. This is said to be "brain death", and thus death itself.

However, it does not follow at all that the rest of the brain has also ceased to function. Yet no tests are carried out on other parts of the brain to establish whether all activity there has actually ceased or not.
As a result, people are declared dead while their heart is still beating unassisted and blood is still circulating round the body. Most of us would think such patients are not dead but very much alive...

Brain stem death is in fact merely a convenient definition that allows surgeons to remove organs from a living body while they are still being nourished by its blood supply.
Such observations provoke outrage in transplant doctors who claim there is no basis for such "scaremongering", which will cause more people to die because potential organ donors will be unreasonably frightened off. But among such doctors, their own behaviour gives the game away.

Some give "brain stem dead" patients a general anaesthetic before removing their organs. But whoever heard of anaesthetising a corpse?
The reason they do it is because of a sharp rise in blood pressure during the organ removal...

In recent years, "brain stem death" has been increasingly questioned as we realise how little we know about the brain.
Doctors are discovering that, among patients in a persistent vegetative state whose brains are presumed to have stopped functioning, there is in fact a large amount of brain activity. The implications for what patients presumed to be "brain dead" might be experiencing are simply unknowable.

More and more experts have been expressing increasing concern about brain stem death and organ donation.
Three doctors wrote in a medical journal last year that declaring patients dead for the purposes of harvesting their organs was in effect a fiction, and that prospective organ donors were not being told the truth.

And a professor of philosophy and expert in medical ethics, Michael Potts, has drawn the horrifying conclusion: "Since the patient is not truly dead until his or her organs are removed, it is the process of organ donation itself that causes the donor's death."...