March 31, 2012

Harvesting body parts

I have no intention of donating organs, for the simple reason that I don't believe any person is entitled to demand the body parts of another individual - it's not a right, it's not an obligation. 

I don't care how great the need or how dead the donor, there will never be an obvious case for bleating over the low rates of organ donations (in Australia, not all countries). Donation depends entirely on an individual dying in exactly the right circumstances to allow successful harvest of spare parts, and even then, a good match has to be found.  One easy way, for example, to increase donations is to tell everyone to stop wearing seat belts in cars - problem solved!  Many hundreds more dead / undead people would suddenly be eligible to donate.  

The practice of organ transplants is so common place, so normal, that the debate around what it means to be dead, the ethics and provable science around taking organs from people (thus ensuring their death) is not even aired - it's not up for debate, yet it should be.
Adopted in 1981, the Uniform Determination of Death Act states that in order to pronounce brain death, “the entire brain must cease to function, irreversibly.” But the act is silent on how this function is measured (in one study, 65 percent of physicians and nurses couldn’t identify the established criteria for brain death). Most physicians look at the brain stem, which controls heart and lung functions, but not the cortex, which coordinates consciousness. Teresi reports on an apparently unconscious patient who “could have been calculating the cross section of the bottom quark using Heisenberg’s matrices, and no amount of ice water squirted into her ear would have detected it.” The patient was unplugged, her organs harvested. 

The Harvard criteria assume that the brain-dead will quickly move to conventional heart-lung death. But Teresi learns that the brain-dead can maintain a long list of bodily functions, including some sexual responses, stress responses to surgery and the ability to gestate a fetus. 

After making a case that brain death is easily misdiagnosed and that death can be a construct of convenience, Teresi next places his body between the transplant team and patients who exist in a sort of “death lite” netherworld, with a non­responsive cortex but a functioning brain stem. And now things get really creepy. A tiny minority of patients in minimally conscious or persistent vegetative states have been known to sit up and speak. And one “locked in” patient (with a brain stem irreparably damaged but a healthy cortex) even wrote a best-selling book about his condition, “The Diving Bell and the Butterfly.” But the onus is on patients to prove they are aware or in pain. “We would all sleep better at night if we could believe that patients in unendurable situations were unaware, but that does not make it so,” Teresi writes. Off they go to be harvested, despite the potential for surgeons to be distracted by their “screaming during organ retrieval.” 
Book review - Signs of Life ... The Undead by Dick Teresi 


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