Wednesday, Aug 20, 2008
A procedure called “donation after cardiac death” is being allowed and encouraged by the federal government, organ banks, and medical doctors as a way to increase organ donations. This protocol used now more commonly for infant heart transplants is frighteningly immoral and sets to redefine death declarations.
The method, technically known as “transplantation after declaration of cardiocirculatory death (DCD),” allows doctors to declare death following stoppage of the heart, rather than by the more certain brain death criteria. Then, as quickly as 75 seconds to five minutes after the declaration, doctors can slice into the baby’s chest to harvest the heart.
The new method of death declaration has been brought to light because of a report in the New England Journal of Medicine that highlighted three cases of DCD studied at Children’s Hospital In Denver. Three babies on life support who showed little brain function but who did not meet the criteria for brain death were taken off ventilators and their hearts harvested and transplanted in other infants.
article continues below
Of course, legal and ethical issues immediately come to mind. Most state laws, including Colorado’s, specify that declarations of death must be based on total loss of brain function, or heart function that is irreversible. Many ethicists believe that the Denver cases do not meet either criterion. But there’s no move to investigate or prosecute as of yet.
Robert Veatch, professor of medical ethics at Georgetown University said: “In my opinion, it’s an open-and-shut-case. They don’t have irreversibility, and they don’t have death.” Dr. Michael Grodin, professor of health law, bioethics and human rights at Boston University School of Public Health, echoes Veatch’s position and calls the procedure a misguided endeavor. “If you’re going to take out the heart, obviously the heart starts up again or you couldn’t do the transplant, so it’s clearly not irreversible,” Grodin says.
Technically, the heart could certainly be restarted in the donor infant, but it is not. That’s of great concern to Dr. Grodin. “To my standard, the person is not dead. Taking the heart of somebody [when there’s a] question of whether they’re dead or not is a serious concern.”
Study participant Dr. Mark Boucek, who supports the new declaration of death criteria, says concerns of the conscience can be eliminated by transparency in the process of deciding when and how to donate infant organs, based on whether further treatment is futile. “I think the public knows when death occurs,” he said.
While the public likely understands when death occurs, it’s the medical establishment that is clearly redefining the term “death” to suit their own agenda. Removing the moral certitude in death declarations as defined by the laws of God and under civil law opens the door to egregious ethical abuses that we’re just beginning to see.
Dr. John Lantos, another bioethicist and pediatrician at the University of Chicago says problems will arise, creating “a temptation to bend the standards of futility in order to increase the supply of donors.” That sentiment is reiterated by Dr. Steven LeFrak from the Washington University School of Medicine. He says, “While it sounds very erudite for the authors [of the study] to refer to withdrawing ‘futile’ care in their population, what exactly this means is neither defined by them nor is there a generally accepted meaning of this term in medical or medical ethics circles.”
On the other side of the ethical aisle are the usual bleeding-heart arguments (honestly no pun intended given the serious nature of the topic at hand). Some reasons given by doctors and bioethicists for employing DCD and the accompanying organ harvest include: preserving life-saving resources by not wasting viable organs; offering families a chance to make an act of kindness and get some solace out of a bad situation by having their child’s organs live on in another; serving a need for parents wanting to donate their infants’ organs; and increasing infant organ donations.
Clearly the handwriting is on the wall. Any unwanted but viable baby’s treatment could be conveniently designated as futile so the killing/harvesting/transplanting process can begin. Priorities that once served the best interests of the dying by administering treatment that would avoid premature death are now being perverted to serve society instead.
Dr. Robert Spaemann, philosopher from the University of Munich, believes that this points to a societal change that is being forcibly engineered. In 2005 he told the Pontifical Academy of Sciences that the goal is to move to a society where people see organ donation as a “social responsibility” and where donating organs would be accepted as a normal part of dying. Already in place are federal regulations that require institutions to contact local organ procurement organizations concerning death, or impending death, to insure that the family will be approached at the appropriate time by a professional skilled in presenting the proposal of organ donation.
DCD is a logical extension of the abortion-prone mercy-killing culture of death that is advancing in this country and the world. Really, what else can we expect but the continued blurring of the line between life and death until the eventual elimination of that line is reached?