Wrongly Declared "Brain Dead"
This kind of story sends a chill. Doctors at a Fresno hospital wrongly declared a patient to be dead by neurological criteria (a.k.a. brain death) when he wasn't actually dead, resulting in a near harvesting of organs from a living patient. Luckily, the mistake was caught in time. The man died eleven days later.
There are several lessons to learn from such a story. First, organ procurement centers nation-wide need to create and agree to uniform and mandatory tests that are to be applied in determining death by neurological criteria. Second, the idea of having an organ donor card superseding advance directives needs to be rejected. Third, presumed consent to donate--wherein people would have to explicitly opt out of donating--needs to be rejected. The already required firewall between the medical team in charge of a patient's care and those who would be involved in procuring organs must be continually reinforced and maintained.
Public confidence in organ donation is an inch deep. To maintain trust, it is absolutely necessary that the public never come to believe that doctors take short cuts to brain death declarations and they must be assured that no medical person will ever perceive a patient's organs to be more valuable than their lives.
Labels: Organ Donation. Brain Death
posted by Wesley J. Smith @ 9:54 AM
1 Comments
1 Comments:
Mr. Smith,
I am a former organ procurement coordinator, and I see several flaws in your conclusions.
1) It is not just organ procurement organizations (not centers) that need to agree to uniform standards in determining brain death, but rather medical institutions and the medical community itself. When a hospital's policies regarding the pronouncement of brain death have been met, it is not the position of the OPO to question or challenge them. Regardless, many OPOs have policies and practices that go over an above those put in place by the hospitals. My organization required it's coordinators to carefully document what appeared in the hospital chart regarding a patient's pronouncement and ensure they met the criteria set forth by the American Academy of Neurology. On several occasions our coordinators would walk away from a potential donor because they weren't comfortable with the circumstances under which a patient was pronounced brain dead. You would be remiss to assume that OPO coordinators ever put pressure on a hospital's staff to expedite the pronouncement of brain death.
2) There is NO legislation either being considered or already in place that states an organ donor card or driver's license supersedes a living will or advanced directive. It is important to recognize, however, that an organ donor card or signature on a license IS a legally binding document. The most important thing for any individual to do to prevent confusion between these documents is ensure agreement among them and to inform his/her family of the decision.
3) Presumed consent, the presumption that an individual who has not indicated their decision for or against donation WOULD want to donate, does not exist in the United States. Several other countries have enacted and follow such legislation.
The next time you're considering a post regarding organ donation or transplantation, please contact an organ procurement representative. We are more than willing to provide any and all information. As you say yourself, public confidence in organ donation is an inch deep. Let's work together to ensure the efforts of those who work to protect that trust arent in vain and that all of those elligible for a transplant have the best chance possible.
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