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Here is the information people need in order to make an informed decision about organ donation

A US House Committee is investigating organ procurement practices
A US House Committee is investigating organ procurement practices

This morning, I sent this formal complaint to the Organ Procurement and Transplantation Network (OPTN), HRSA, and US House Committee that is investigating organ procurement practices. It was signed by over 300 doctors, nurses, lawyers, philosophers, and citizens, expressing their concerns regarding the lack of informed consent given to people registering as organ donors.


We are writing to request your urgent attention to the grave lack of disclosure given to people who are registering in good faith to become organ donors. Important information that any reasonable person would want to know before making end-of-life decisions should be made available to the public.

Our concerns are summarized below as pertains to brain death determination, donation after circulatory death organ procurement, and normothermic regional perfusion organ retrieval.


1.      Whereas the Uniform Determination of Death Act (UDDA) requires that there be an irreversible cessation of all functions of the entire brain, including the brain stem for a diagnosis of brain death, the American Academy of Neurology brain death diagnosis guideline [1] for physicians explicitly allows brain death to be declared in the presence of ongoing brain function.


Americans should be made aware that the way doctors diagnose brain death does not comply with the law under the UDDA. [2]



2.      Donation after Circulatory Death (DCD) organ procurement begins after just 2-5 minutes of pulselessness. But everybody knows that people are routinely resuscitated within this timeframe. Dr. Ari Joffe published a list of patients who auto-resuscitated up to 10 minutes after cardiac arrest, with some making a full recovery. [3] A case report from Illinois of a young DCD donor whose heart began beating again and who began gasping for breath during the removal of her kidneys also shows that people cannot be known to be dead within this short timeframe. [4] (The county coroner determined her death to be a homicide.)


DCD donors are not known to be dead at the time that their organs are removed, and the public deserves to be informed of this.



3.      Normothermic Regional Perfusion (NRP) organ retrieval begins by declaring death according to the UDDA’s circulatory-respiratory standard: the irreversible cessation of circulatory and respiratory functions. But then surgery begins with clamping off the circulation to the brain, following which a full resuscitation of the remaining organs takes place, such that the heart starts beating again in the patient’s own chest. Of course, this shows that the UDDA’s legal definition of death under the circulatory-respiratory standard was never met because the patient’s circulatory-respiratory function had obviously not irreversibly ceased. But, because doctors are planning to restart the patient’s heart, they take steps to make the patient brain dead on purpose so that now the patient’s death becomes defined by the UDDA’s brain death clause. This technique plays fast and loose with the legal definitions of death under the UDDA as well as with the dead donor rule. The American College of Physicians (ACP) called for a pause in the practice of NRP in 2021, as "the burden of proof regarding the ethical and legal propriety of this practice has not been met," but this concern has been ignored. [5]


People should be informed about the particulars of the NRP donation process, and that the largest medical specialty organization in the world (ACP) has called for a pause in this practice because of concerns regarding its ethical and legal propriety.



We believe that each of our points listed above is of sufficient magnitude to deserve immediate remedial action, and in aggregate constitute a severe breach of public trust by the current organ procurement and transplantation system. The determination of death affects us all, and reflects deeply held philosophical, cultural, and religious value systems. The public has a right to know in what ways their deaths are being determined prior to registering as an organ donor. We urge you to take immediate steps to remedy this situation.

 

 

 
 
 

© 2022 Respect For Human Life

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