When does life belong to the living?
Years ago, physiological failure was a simple matter: a person was either dead or alive. Now, medical technology has blurred the line and raised important ethical questions about death and its relation to organ donation. According to the "dead-donor rule", organs can only be taken from donors declared dead. However, because early removal raises the chances of a successful transplant, transplant surgeons must act quickly yet without ethical violations.
In some cases, death is an obvious condition. The concept of brain death finds its origins in a 1968 panel from Harvard Medical School, who definied it as the destruction of the cerebral cortex and brain stem. The cerebral cortex controls consciousness and emotion; the brain stem regulates breathing and homeostasis. Despite biotechnology that can maintain basic functions enough to keep the body oxygenated, brain death is a legally accepted standard in the United States. With these types of patients, removal of organs is easy to time with the disconnection from life support, and they account for 85% or more of vital organ donors.
However, the real issue is determining the moment that organs can be removed from the other 15% of donors. Without the definition of "brain death", we are left only with our very first concepts of life: breaths and heartbeats. Organs cannot be harvested from these patients until they are removed from all life support. Yet, the process of death may irreversibly damage organs that could save another person if removed early enough. The heart must cease beating within an hour of removal to remain eligible for transplant. Furthermore, the Pittsburgh protocol dictates that transplant surgeons wait a further two minutes before removing the organ to ensure that the heart does not resume beating spontaneously. Only then can organs be removed.
Some ethicists oppose the dead-donor rule in cases in which the donor's family has agreed to organ donation and the patient is beyond recovery. They argue that death due to removal of organs and natural death are ethically synonymous, and healthy, vital organs can be transplanted to recipients who desperately need them. However, unconditional supporters of the dead-donor rule anticipate the possibility of fewer people registering for organ donation due to fears that they will be killed before they are truly past the point of recovery.
This article engaged my interest due to its relevance in both the classroom and the real world. In a recent lecture, we discussed the properties of living organisms and the significance to ethicists. Additionally, my family and I are all registered donors.
Article by Robin Marantz Henig
"When does life belong to the living?"
Scientific American, Sept. 2010: 50-55
Accessible online at http://www.scientificamerican.com/article.cfm?id=when-does-life-belong
In some cases, death is an obvious condition. The concept of brain death finds its origins in a 1968 panel from Harvard Medical School, who definied it as the destruction of the cerebral cortex and brain stem. The cerebral cortex controls consciousness and emotion; the brain stem regulates breathing and homeostasis. Despite biotechnology that can maintain basic functions enough to keep the body oxygenated, brain death is a legally accepted standard in the United States. With these types of patients, removal of organs is easy to time with the disconnection from life support, and they account for 85% or more of vital organ donors.
However, the real issue is determining the moment that organs can be removed from the other 15% of donors. Without the definition of "brain death", we are left only with our very first concepts of life: breaths and heartbeats. Organs cannot be harvested from these patients until they are removed from all life support. Yet, the process of death may irreversibly damage organs that could save another person if removed early enough. The heart must cease beating within an hour of removal to remain eligible for transplant. Furthermore, the Pittsburgh protocol dictates that transplant surgeons wait a further two minutes before removing the organ to ensure that the heart does not resume beating spontaneously. Only then can organs be removed.
Some ethicists oppose the dead-donor rule in cases in which the donor's family has agreed to organ donation and the patient is beyond recovery. They argue that death due to removal of organs and natural death are ethically synonymous, and healthy, vital organs can be transplanted to recipients who desperately need them. However, unconditional supporters of the dead-donor rule anticipate the possibility of fewer people registering for organ donation due to fears that they will be killed before they are truly past the point of recovery.
This article engaged my interest due to its relevance in both the classroom and the real world. In a recent lecture, we discussed the properties of living organisms and the significance to ethicists. Additionally, my family and I are all registered donors.
Article by Robin Marantz Henig
"When does life belong to the living?"
Scientific American, Sept. 2010: 50-55
Accessible online at http://www.scientificamerican.com/article.cfm?id=when-does-life-belong
Labels: bioethics, death, organ donation
posted by Nicole Cordner at 12:25 PM
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