24

I just read a pretty shocking blog post called "Are you an organ donor? After you read this, you will change your mind."

Do you wish to be an organ donor? I'm sure many of you have answered yes, thinking that this is an honorable and responsible practice. I don't blame you. I used to think so also. After all, if I am dead, what do I need my organs for anymore?

This presumes, of course, that I am actually dead. There's the rub. This will probably shock you, but if so, you need to be shocked: There is no such thing as a dead organ donor [...] You are alive [...] you are very much alive. Your organs are, quite literally, cut out of your body while you are still breathing, and your heart is still beating.

It goes on to describe several cases where organ donors were pre-maturely terminated and how the primary motivation for this practice isn't in the interest of saving lives but the huge profit that comes from performing a transplant procedure (side-stepping the fact that human organs cannot legally be sold).

These are some pretty serious claims. Enough that, if valid, I would personally consider removing my organ donor status, as I'm sure many people would.

I'm sure from a utilitarian point of view, it would be easy to argue that overall more lives are saved from this practice, but I'm not interested in that. I want to come at this from the point of view of the common adage: "that it is better 100 guilty Persons should escape than that one innocent Person should suffer", i.e. without equating lives to one another.

Are people who would have otherwise have gone on to live some semblance of a normal life sometimes euthanized due to their organ donor status?

Community
  • 1
Alain
  • 5,052
  • 2
  • 34
  • 35
  • 4
    It seems like this is more a philosophical issue than anything else. If you can't feel anything and you'll never wake up again, does it really matter if you're "dead"? – Brendan Long Sep 12 '12 at 20:36
  • 14
    I don't have time to respond to this now, but I really want to. I'm a living organ donor (type 'drew kidney' into google to see) and advocate for donation in all forms. The short version is he is wrong. The doctors who try to keep you alive *do not* know if your an organ donor for exactly this reason, only once your declared dead do those responsible for harvesting organs come in; without knowledge of rather your a dnor there is no way they could be intenionally letting organ dnors die. The example he gives about your heart still beating is true...for brain dead donors who have a .... – dsollen Sep 12 '12 at 21:50
  • 12
    ...have a living will stating that the plug should be pulled if brain dead. IN this case they make sure to find recipients for your organs before hand and remove them immediately *After* death is offically declared; but in this case your already brain dead and decision to pull the plug was made by you or a loved one. Finally, hospitals don't make significant profits over organ donation, at least no more then they do for ny surgery. You might as well claim they were declaring tumors non-benin or insisting on other invasive procedures. They make same 'profit' for surgery of all types. – dsollen Sep 12 '12 at 21:53
  • Don't know about United States, but in Quebec we have a pretty safe program that I would never doubt (I believe it is pretty much the same accross Canada). Also, I do not care about the probability that someone make money over me after I'm dead. – Zonata Sep 13 '12 at 01:28
  • 1
    I wish it was possible to get crap like this off the internet, scaring away the few organ donors that there are is a terrible thing. Alas all we can do is dutifully point out these claims are woefully exaggerated and untrue. – Ryathal Sep 13 '12 at 12:49
  • That's good to know @dsollen. I think the primary concern is that there are a few examples of people incorrectly being declared brain dead and then making a full recovery. It would be good to clear the net or this skepticism. – Alain Sep 13 '12 at 15:44
  • @Alain there are a few examples of *everything* on the internet. No matter how imporbable or crazy it exists somewhere out there because the world is a huge place and every imporbably thing occures. Just because a fear mongering magazine cheary picks a half dozen examples from a million examples of normal donation does not mean that it is the norm. Besides, most, if not all, examples you hear are cases where brain death wasn't declared. A doctor suggested organ transplant yet, but there is an offical process for declaring brain death immediately before they start with the organ transfer.. – dsollen Sep 13 '12 at 16:13
  • In most examples that process, the final testing for brain death tha would have occured before any organ could be harvested, never had a chance to be preformed. had it been preformed they would have detected that the person was not actually brain dead and never havested. Just because in the *veyr small* number of examples someone short circuts this process by prooving someone is not brain dead early doesn't mean the proper procedure wouldn't have detected brain activity as well. Don't let an extreamly rare cherry picked example scare you away from what is almost always a safe way to help! – dsollen Sep 13 '12 at 16:16
  • 2
    The claim I have heard is that in the case where your insurance status is unknown, no next of kin is available to make a decision, and you are an organ donor the hospital will make the decision not to attempt life saving measures that they would take if you were not an organ donor. The business decision is that the hospital is likely to make more money harvesting your organs than saving your life. BTW this was told to me by an ER Intern... I have no way of verifying that though. – Chad Sep 13 '12 at 16:30
  • For further information - the German Wikipedia article about brain death is much more informative than the English one: http://de.wikipedia.org/wiki/Hirntod – Danilo Bargen Sep 18 '12 at 18:28
  • 1
    @chad belated reply after looking this up prior to my recent question. This is actually the opposite. Many organs of declared organ donors end up being wasted, even if they die in the hospital. Even if the donor has declared he wishes to be a donor the clinic will often insist on next of kin's permission *even after he is definitely dead*, leading to the organs becoming unusable by the time permission is achieved. In any a doctor can not legally be told, or consider, a patients insurance, next of kin, or donor status while in the ER, thus none of these can influence the doctor's decisions – dsollen Nov 14 '14 at 23:22
  • @dsollen - I was not trying to claim that as truth, just that it was a claim I have heard many times. Its also possible that is true in some locations where others are less picky. – Chad Nov 15 '14 at 17:35
  • See also [Has an organ donor ever been at risk of having organs harvested before a sudden recovery?](http://skeptics.stackexchange.com/q/23800/2703) – ChrisW Jan 23 '15 at 11:48

1 Answers1

8

TLDR It doesn't seem to be the case that organ donars would be intentionally harvested when they could have lived.

This fact sheet by Southwest Transplant Alliance explains... http://www.organ.org/v2/assets/documents/brochures/Brochure_DonationAfterCardiacDeath.pdf

DCD (Donation After Cardiac Death)

DCD is an option for families of patients with severe brain injuries, who do not meet the criteria for brain death. After the decision has been made that the patient has no chance of survival and the family has decided to withdraw treatment, the family is offered the option of Donation After Cardiac Death. If the family agrees, the patient is moved to an operating room where support is withdrawn. In some situations, support may be withdrawn in the intensive care unit/ICU. Once the patient’s heart stops beating, the physician declares death. Following an additional five minutes of waiting to ensure the heart does not start beating again, organ recovery begins. The organs are then recovered.

DBD (Donation After Brain Death)
According to the article DBD is similar but the patient does meet the criteria for Brain Death. In this way, it's similar to the claim.

-Brain death is declared by a physician
-Patient is on ventilator until organs are recovered
-Transplant team recovers organs
-Heart, lungs, liver, pancreas, kidneys and intestines can be recovered

On the other side of the coin
As this news article points out, mistakes happen.
http://abcnews.go.com/Health/patient-wakes-doctors-remove-organs/story?id=19609438
After looking through the linked report, it seems the article might be a bit sensational in claiming

...Burns opened her eyes at the last minute, saving herself from the organ harvest procedure...

http://www.scribd.com/doc/148583905/U-S-Centers-for-Medicare-and-Medicaid-Services-report-on-St-Joe-s

...the patient began showing signs of neurological improvement and so the DCD was not further pursued.

It's also not clear if things would have been different if the family hadn't decided on organ donation. But it does make sense that they might be less inclined to pull her back from the brink of death considering it was an attempted suicide. (she succeeded a couple years later)

Caveats I imagine it's in the vested interest of an organ donation non-profit to paint things better than they are. This answer is focused on the US.

Conclusion Organs are only harvested from donors after the decision has been made that the patient has no chance of survival. Mistaken assessments are made, but this doesn't mean the plug wouldn't be pulled anyway.

Adam Phelps
  • 2,020
  • 17
  • 19
  • 2
    I would add that removing someone from medical support can potentially cause them to come out of a comma. It's a known fact that the shock of loosing support occasionally is enough to revive someone. This is why they wait until the heart stoped and stayed stopped to harvest. Articles sensationalizing someone reviving 'right before' being harvested miss the key point that this is a known potential and they wait to harvest just for the unlikely claim that removing of support will lead to revival; the people in question were never at risk of being harvested prematurely... – dsollen Sep 20 '17 at 16:53