blog.bioethics.net

Horrible reporting. Looks like something from a supermarket UFO reporter. The side bar includes a statement that donors would include "those in a persistent vegetative state."

- by Beverly on Jan 24, 2006 at 10:20 AM | link

I really do not agree with organ donation from a patient who is only partially brain dead. I work in a CCU and we have to perform so many breathing trials (ventilated pts) and perform so many tests in order for the doctor to legally say the patient is brain dead. If there is any sign that the patient is not brain dead then the doctor must do everything in his power to help that patient. At this point, their organs are not able to be donated due to brain function.

- by Stacey on Jan 26, 2006 at 8:32 PM | link

I also work in the ICU and feel that while organ donation is very important, one should not take organs from a person that is partially brain dead. If the person can survive off of the ventilator on his own,even though he is in a vegetative state he should not be euthenized for body parts. How does a person deal with the fact that they are alive at the expense of another person who is for all intensive purposes is not dead.

- by Karen Nellis on Jan 27, 2006 at 10:07 PM | link

I currently work in an operating room, and have personally witnessed several of these procedures done, and also seen some of the reciepents of the organs fail due to procuring the organs in this manner. As a nurse in the OR, it is hard to watch a patient deliberately die in the OR, we are usually trying to save them. Also, they don't always die once they get in the OR, just because the breathing tube is removed, they might live for minutes or hours after. I don't agree with this method of getting organ donation at all, and usually refuse to be part of these cases. I understand the need for organs, but if the results for the reciepient are not favorful, why take the chance.

- by Angie on Jan 28, 2006 at 4:01 PM | link

I was able to watch an organ retrieval through our local organ procurement program, CORE. CORE only accepts organ donations from clinically pronounced brain or cardiac death patients. I'm not sure how you could harvest organs from a person that is "Partially brain-dead" and have any positive results for the patient?! I'd like to think that the organ procurement agency is a little more selective when accepting donations from such patients. With all the controversy surrounding organ donation, these organizations need to be cautious with such cases. I'm hoping that the increase in organ donations is due to an increase in education to the area about the benefits of the program, not that the procurements are coming from "partially brain-dead" patients.

- by Karrah on Jan 28, 2006 at 4:36 PM | link

I personally think that using the term "partially brain dead" is misleading the public and even the professionals. "Brain Dead" is the now ambiguous term to indicate death by neurologic criteria which is now accepted as legally dead. If the patient is brain dead, the patient is dead. There is no "partially brain dead" as there is no "partially dead". Dead by cardiac and respiratory criteria, the original classical criteria, is also dead. Once the criteria are met (absence of spontaneous respiration and no heart beat for at the very minimum 5 minutes, the patient is dead and will not resume life. There is no perfusion for at least 5 minutes or longer to the brain stem or the cortex and the patient will not resume consciousness or breathing even if the heart somehow resumes beating which is very unlikely. With no heart beat or breathing for over 5 minutes, if the patient is not dead by the transient resuming of heart beat, certainly the patient would be dead by neurologic criteria. ..Maurice.

- by Maurice Bernstein, M.D. on Jan 28, 2006 at 10:05 PM | link

I agree, there is no partial brain death, it is one or the other-one is clinically brain dead, or one has suffered cardiac arrest. Organ procurement from patients who have suffered from cardiac death is no different from those that suffered from brain death. It is only because of medical advances such as ECMO that we may even procure solid organs from cardiac death donors, as before these organs were not viable because they were not perfused after cardiac death for obvious reasons. Only with brain death in the past were we able to use solid organs. There is a huge national shortage of organ donors. If more cardiac death cases could be used for organ donation--hundreds even thousands of lives could be saved. After both cardiac and brain death--the patient is not coming back-very stringent criteria must be met before any organ donation process-however if the family is willing and the patient is eligible, then there should be no reason not to use these organs--this is not an issue of just taking someone off of the ventilator--it is an issue of suffering from clinically proven brain death or cardiac arrest with no hope for recovery. And in that tragedy, having the ability to bring hope to another person through organ donation.

- by Kasey O'Neil on Jan 29, 2006 at 3:41 PM | link

Just to clarify, in DCD donation the organs are not recovered until death has occurred, hence the term "after cardiac death". There seems to be some confusion about this based on the comments here.
The reporter's use of the made-up term "partially brain dead" is indicative of the problem of editors counting words instead of ensuring a concept is clearly explained.
DCD kidneys have an equivalent 3-year graft survival to kidneys from brain dead donor, though it is true that there is a higher "delayed graft function" intitially.

- by Mike on Jan 29, 2006 at 11:16 PM | link

If there is such a term as “partially brain dead” to me it means the patient does not respond to any stimuli but is able to breathe and maintain a heart beat on their own. If this is the case then no I do not agree with organ donation at this point that would be considered euthanasia of a human being. But if we were talking about a patient who is unresponsive to all neurologic tests and could not survive once the machines are turned off, irregardless of how the patient became this way, then my opinion would differ, I would say it would be okay to donate the organs. But the decision is up to the family to decide whether or not to turn off the machines and allow for organ donation. I think if they are well educated about the situation and the doctors have done all they can to prove the patients status of brain dead then I don’t see a problem with organ donation. The answer relies on the family wishes at this point.

- by Desiree on Jan 30, 2006 at 11:05 AM | link

As a nurse I am split on this issue. Seeing patient in desperate need for organs yet respecting life. Who will be making this decision? I think it lends for situations from bad science fiction movies.

- by Lori on Jan 31, 2006 at 12:38 PM | link

I am very much for organ donation. I worked in the ICU for many years and had to deal with this issue. The problem here is the terminology being used. The term partial brain death is misleading. In fact these patients are brain dead. There is no higher function left, only the brain stem which controls heart rate and breathing. These patients, even if they can survive without life support,typically will do so for a short time only. It is at this point that family members help make the decision to terminate life support for donation or to keep their loved ones for as long as they can despite quality of life. It is ultimately their decision. Organ donation is a very delicate issue. I do however think that everything needs to be done so that the donors organs are protected as much as possible. If they are going to donate then they need to ensure high quality retrival.

- by Jan B. on Feb 5, 2006 at 2:55 PM | link

I have never heard of anyone being "partially" dead. I think this article is written to be misleading to the public. Regardless of the situation, if the patient is brain dead with no hope of survival and if it is the patients wishes by advanced directive or families wishes to discontinue life support and participate in organ donation, who are we to say they are in the wrong?

- by C.Wolbert on Feb 13, 2006 at 11:04 PM | link