Organ Donation & Transplantation

Where Is the Public Outcry? Infants also Have Human Dignity When They Are Dying and Donating Organs!

The story goes back to 1993. During the early era of transplantation, “death” for the purpose of organ donation had been defined as irreversible cessation of all brain function (that is brain death, both “higher” and “lower” centers) as a result of a seminal report by the ad hoc Committee of Harvard Medical School.[1] The transplant community and society then asked a question: Since the traditional definition of death for everyone else had always been irreversible cessation of heart function, might that definition be ethically applied to donors too?

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Donor after Cardiac Death: What Is the Christian’s Response?

The notion of organ donation after cardiac death (DCD) came into prominent public view in 1993, with the national awareness of the Pittsburgh Protocol.[1] More recently, the U.S. Department of Health and Human Services, through the Organ Transplantation Breakthrough Collaborative, strongly encouraged increased recognition and use of DCD in an attempt to increase the number of organs available for transplantation. Even more recently, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has stipulated that hospitals must have a DCD policy in place as of January 2007 in order to maintain accreditation. Consequentially, whereas some years ago, we might have sagely nodded our heads thinking, “this too will pass,” it is now quite apparent that the issue will not.

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Please UNOS--Transplantation is a Fragile Public Trust

It has been said that, “. . . it takes years to build up trust, and it only takes suspicion, not proof, to destroy it.”[1] The words themselves tell us something about human nature, and unfortunately, are prescient in the context of organ transplants. At a time when a severe shortfall in donation has become emotionally palpable—approximately 18 people die every day while waiting—transplantation survives, imbedded within a fabric of trust. Those who donate their or their loved one’s organs expect that certain precepts will be honored. For example, there is the dead donor rule. If someone has agreed to donate organs after they die, either by whole brain or heart criteria, they must be dead and not merely dying when organs are retrieved. As a result, fiction like Robin Cook’s Comacan send a shudder throughout the transplant community. Similarly, in the mid 1990s, when newspapers intimated that cardiac criteria for death may have led to premature organ retrieval, concern was immediate and intense. Americans also respect a “level playing field.” Remember the public outcry surrounding Mickey Mantle’s liver transplant? Allowing the famous or rich to jump ahead of the vulnerable is not the American way. Finally, in an era of quality and safety concerns, the lifesaving process of transplantation should be transparent, compassionate, just, and as safe and quality laden as possible. There are diverse “patients” involved: donors, recipients, and both families. The public should continue to be very sensitive to potential abuses. This necessary vigilance represents transplantation’s critical check and balance.

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