"Organ Donation: A Matter of Life and Death" now available in English

https://a.co/d/4i4zkdr

I was honored to be asked by Maatkamp Publishing in the Netherlands to help smooth out the English translation this book by Ruud van der Ven. This is a valuable addition to the bioethics literature, which comprehensively explores the ethical quandaries inherent to organ donation worldwide.

Here's my translator's foreword: The book you are holding represents the last words of a dying man. Sadly, the author, Ruud van der Ven, passed away from a brain tumor shortly after his original book was published in the Netherlands. I wish I had met him. He wrote “Organ Donation: A Matter of Life and Death” with great energy and intensity, but also with great humility and compassion — perhaps he knew his time was short. When Maatkamp Publishing approached me about smoothing out this English translation from the original Dutch, I was happy to help. And I was immediately impressed with the amount of thought and study van der Ven had poured into this work: everything is thoroughly researched and referenced. But this is not just a scientific treatise. Van der Ven also considers organ donation from a human perspective: those of the donor’s grieving family, of doctors and researchers, of people who have been hurt by unethical procurement practices, and also from the viewpoint of organ recipients. 

Brain death is still a relatively new idea. In 1968, thirteen men at Harvard Medical School published a landmark paper, “A Definition of Irreversible Coma,” in which they proposed that certain comatose people on a ventilator could be considered to be dead already. They had no tests, studies, or evidence that these people (who had always previously been considered to be alive) were now somehow “dead.” Their paper has no scientific references whatsoever. The authors simply presented this new idea on utilitarian grounds: they thought these people were a burden to themselves and to others, and that declaring them to be dead already would free up valuable ICU beds and facilitate organ donation. Despite the lack of evidence supporting the brain death concept, the idea was codified into US law in 1981 in the Uniform Determination of Death Act.

But are these people actually dead? Before 1998, the usual justification for brain death was that the brain was the "master integrator" of the body: it was thought that without a functioning brain, death would very quickly occur. But this old concept was disproven by Dr. D. Alan Shewmon in 1998 when he published a paper detailing 175 cases of people with brain death whose bodies did not disintegrate. In fact, one of these people remained alive, living at home with his family, for more than 20 years! Because of Dr. Shewmon’s findings, a US Presidential Council was convened in 2008. Since it was clear that “brain dead” people were not biologically dead, this council proposed a new justification based upon a questionable philosophy: that people who can't do the work of being people are "dead." They very conveniently made the criteria for this new justification the lack of conscious awareness and the lack of spontaneous breathing. That this justification lacks credibility is obvious: in the womb we neither breathe nor at early stages are we consciously aware...yet no one thinks fetuses are dead, even though some don't think that they deserve full human rights. And so today, worldwide, “brain death" continues to be a diagnosis in search of a justification, and which only continues for the sake of the organ transplantation industry which has come to depend upon it.

And so, this book from the Netherlands is a valuable addition to the literature. For an American reader, it’s interesting learning how death, an inevitable universal reality, is actually variable both medically and legally in different countries. A person who is dead in the Netherlands is considered alive in Germany! I was particularly moved by the multiple personal stories the author obtained from healthcare professionals throughout Europe, who frankly shared their gut-wrenching experiences with organ procurement. To my knowledge, never before has such a compilation of personal testimonies been published. Also, the book honestly confronts some of the difficulties faced by transplant recipients, ranging from complications of immunosuppression to survivor guilt and altered personality traits (possibly handed down to them along with their organ). And van der Ven’s chapter on the multitude of neuro-protective innovations for brain-injured people that we are missing (because we are channeling all the difficult cases towards organ donation) is exciting and intriguing. 

As a translator, it was important to me to keep Ruud van der Ven’s voice speaking as much as possible. I have added a few footnotes to correct a few medical errors and to add information about the US situation. Even though this is a European book, it has much to say on the topics of life and death which pertain to everyone. I believe “Organ Donation: A Matter of Life and Death” is too thought-provoking to be available only to Dutch speakers, and will be a valuable resource for the English speaking world. I’m glad I was asked to help make it available!

Heidi Klessig MD, retired US anesthesiologist and pain management specialist, and author of “The Brain Death Fallacy,” June 2025.