For the past several years, a little-known but disturbing revolution has been occurring in organ donation.
In the understandable but sometimes alarming zeal to obtain more organs, the procedure called non-heart-beating organ donation (NHBD) has been quietly added to brain death organ donation in more and more hospitals all over the country.
Although “brain dead” is a term many people erroneously associate with a coma-like condition or use to humorously describe an ignorant person, brain death is a legal and medical term that describes the irreversible loss of total brain function, even when the body can be kept going for a while using technology such as a ventilator.
Since 1970, every state has added brain death to the legal and more familiar definition of death as the irreversible end of breathing and heartbeat.
The addition of brain death as a legal definition of death revolutionized organ transplantation, because waiting until a person died naturally to harvest organs often resulted in organs too damaged for successful transplant.
With brain death, organs could be taken before breathing and heartbeat stopped, and organ transplantation became commonplace. But when brain death did not meet the demand for organs, NHBD was invented in the 1990s as a way to obtain more organs.
NHBD is very different from brain death organ donation.
While brain death organ donation means the person is legally dead but still has a heartbeat when organs are harvested, the potential NHBD patient is alive but termed “hopeless” or “vegetative” by a doctor, usually soon after suffering a devastating condition like a severe stroke or trauma and while still needing a ventilator to breathe.
Because of the legal acceptance of the so-called “right to die”, families or patients can then agree to have the ventilator turned off, a “do not resuscitate” order written and the organs harvested if or when the person’s breathing and heart-beat stop.
In NHBD, the ventilator is usually stopped in an operating room while a doctor watches for up to one hour until the heart-beat and breathing stops.
After an interval of usually just two to five minutes, the patient is declared dead and the transplant team takes over to harvest the organs.
A determination of brain death is considered unnecessary even though Dr. Michael DeVita, one of the inventors of the NHBD protocol, has admitted, “the possibility of (brain function) recovery exists for at least 15 minutes”.
Nonetheless, Dr. DeVita defends waiting only two minutes before harvesting the organs because, as he writes, “the 2-minute time span probably fits with the layperson’s conception of how death ought to be determined”2 (emphasis added).
Just as disturbing, sometimes the NHBD patient will unexpectedly continue to breathe for longer than the one-hour time limit for NHBD. The transplant is then cancelled and the patient is just returned to his or her room to eventually die without treatment. Care is not resumed.
…[T]he rush to declare patients “hopeless” or “vegetative” soon after illness or injury can deprive at least some patients of the chance of survival or even recovery.
Shockingly, NHBD protocols do not even necessarily require that the donor be mentally impaired at all.