A growing push has arisen from the medical community to increase the number of available human transplant organs by removing organs from non-brain-dead organ donors who experience “cardiac death” (CD) or 5 minutes of cardiac arrest. A recent article in the New Scientist, entitled “Not brain-dead, but ripe for transplant,” once again brings the contentious procedure back into the limelight.
The procedure, known as “donation after cardiac death” (DCD) or non-heart beating organ donation (NHBD) gained notoriety earlier this year in Canada after an Ottawa hospital announced in June its first DCD transplant. Currently the Australian Health Ethics Committee (AHEC) is considering recommending that the government encourage DCD, and government support in the United Kingdom has swelled numbers of DCDs by six-fold in the last 15 years to 120 in 2005 [New Scientist].
Yet the procedure is fraught with pitfalls, with many expressing fear that more doctors may be willing to sacrifice patients in order to harvest their organs to supply the worldwide demand. The New Scientist article relates the story of a 20-year-old “Janet,” who, following a car accident, suffered such extensive injuries that she would have been deemed eligible to have her organs harvested according to DCD’s standards. Janet, however, subsequently recovered and is “wheelchair-bound but happy to be alive.” In many countries, transplant surgeries only take place after doctors determine that a donor-patient is “brain-dead”…and therefore has no chance of recovery. Heart and lung function are maintained by way of life support in order to preserve the donor’s organs until surgeons find a suitable moment to harvest them.
The typical DCD donor patient, however, would have his life-support or ventilators removed in order to bring about cardiac death. The doctors would remove ventilation from a patient who typically has measurable brainwaves but is deemed unlikely to recover, and then wait for the heart to stop beating. If the heart stops for 5 minutes, death is pronounced and the organs are harvested by another surgical team.
“These situations put the physician in the difficult decision-making position between the care of their patient and balancing that care against the possibility of passing on the patient’s organs to someone else,” said Mary Ellen Douglas [Campaign Life Coalition’s National Organizer]. “The code of the physician is to do no harm and a heart-wrenching decision between two patients places the physician in the role of playing God.” Christopher Doig [critical care specialist, Canada’s Foothills Hospital, Calgary, Alberta] according to the New Scientist, described the use of CD to increase the number of organ donations as “inherently bothersome.”
According to the New Scientist, a presentation at the World Transplant Congress in Boston, MA, claimed that the widespread practice of DCD could increase the number of available transplant organs by 20 per cent and treat many of the estimated 6000 people in the US who die each year while waiting for a matching organ donation. However, pro-life advocates and many doctors are strongly against changing the determination of death to put more harvested organs in the medical market, especially since there have been a number of cases where patients have recovered after the proposed 5 minutes for determining “cardiac death”.
The New Scientist also reveals that 3 US transplant centers use a 2-minute interval, since they claim at this time there is complete loss of brain function, and the heart could only rarely start beating again. Dr. Moira McQueen [Pres, Canadian Catholic Bioethics Centre] told LifeSiteNews.com that waiting only 5 minutes after cessation of cardiovascular circulation was “frankly . . . not nearly enough” and noted cases of auto-resuscitation after more than 5 minutes without a heart beat, a condition doctors describe as the “Lazarus phenomenon.”
“The laudable purpose of saving lives does not justify the donation of an organ whose removal could cause the death of a donor,” said Jim Hughes [Click’s National President]. “Harvesting organs just five minutes after the heart stops is just plain frightening. There are cases of people whose hearts have re-started after a longer period of time.” Related: Controversial Organ Donation Method Begins in Canada – Organs Extracted 5 Minutes after Heart Stops http://www.lifesite.net/ldn/2006/jun/06062707.html [8Aug06, Smith, LifeSiteNews.com]