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Role of brain death and the dead-donor rule in the ethics of organ transplantation.
Critical Care Medicine ^ | September, 2003 | Truog RD, Robinson WM.

Posted on 10/14/2003 7:09:32 PM PDT by MarMema

Department of Anesthesiology, Harvard Medical School,
Cambridge, MA, USA.

The "dead-donor rule" requires patients to be declared dead before the removal of life-sustaining organs for transplantation.

The concept of brain death was developed, in part, to allow patients with devastating neurologic injury to be declared dead before the occurrence of cardiopulmonary arrest. Brain death is essential to current practices of organ retrieval because it legitimates organ removal from bodies that continue to have circulation and respiration, thereby avoiding ischemic injury to the organs.

The concept of brain death has long been recognized, however, to be plagued with serious inconsistencies and contradictions. Indeed, the concept fails to correspond to any coherent biological or philosophical understanding of death.

We review the evidence and arguments that expose these problems and present an alternative ethical framework to guide the procurement of transplantable organs. This alternative is based not on brain death and the dead-donor rule, but on the ethical principles of nonmaleficence (the duty not to harm, or primum non nocere) and respect for persons.

We propose that individuals who desire to donate their organs and who are either neurologically devastated or imminently dying should be allowed to donate their organs, without first being declared dead.

Advantages of this approach are that (unlike the dead-donor rule) it focuses on the most salient ethical issues at stake, and (unlike the concept of brain death) it avoids conceptual confusion and inconsistencies.

Finally, we point out parallel developments, both domestically and abroad, that reflect both implicit and explicit support for our proposal.


TOPICS: Constitution/Conservatism; Crime/Corruption; Culture/Society; Extended News; Miscellaneous; News/Current Events; Philosophy
KEYWORDS: euthanasia; kotpl; organdonation
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1 posted on 10/14/2003 7:09:33 PM PDT by MarMema
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To: MarMema
Dr. Robinson

Dr. Robinson is a pediatric pulmonologist at Boston Children's Hospital. And the Associate Director of the Division of Medical Ethics at Harvard Medical School, where he runs the Medical Ethics Fellowship and the Program in the Practice of Scientific Investigation.

He received his BA in Philosophy at Princeton University, his MD from Emory University, and his MPH at the Harvard School of Public Health. He was a Fellow in the Program in Ethics and the Professions at the Kennedy School of Government in 1994-95 and 1998-99.

He is actively involved in the CF clinic at Children's Hospital, where he also serves as associate ethicist in the Office of Ethics. Dr. Robinson's academic interests focus on the ethical issues that arise in chronic illness, organ transplantation, and clinical research.

2 posted on 10/14/2003 7:13:02 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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3 posted on 10/14/2003 7:14:35 PM PDT by Support Free Republic (Your support keeps Free Republic going strong!)
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To: MarMema; drstevej; OrthodoxPresbyterian
This should be called the "Rich Man's Organ Farming Rule" or maybe the "Rich Doctor's Cost Reduction Rule" or "The Dying Patient's Don't-Carry-a-Donor-Card-into-an-appendectomy-if-Bill-Gates-needs-a-Heart Rule"
4 posted on 10/14/2003 7:19:59 PM PDT by xzins
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To: MarMema
Ohhhh, where to begin?

"Imminently dying" or "neurologically devastated" are so hard to prove, not bright-line designations. Who has not known stories of people who were thought to be virtually dead, who rallied, sometimes for years more of life? How "devastated" is enough?

Granted, we have mechanisms for deciding when to "pull the plug" now. But it is hard enough to determine when someone is "dead," let alone trying to decide if that person is sufficiently nearly dead.

Close counts in horseshoes, but not in dying.

5 posted on 10/14/2003 7:25:01 PM PDT by nepdap
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To: xzins
From "Peter Singer gets a chair", by Wesley J Smith.

"In Singer’s philosophy, there is a crucial distinction between persons and nonpersons. Only persons have the right to live. Nonpersons can be killed without significant moral concern on the basis that their lives are "interchangeable" and "replaceable."

As one of his chief arguing points, Singer has rationalized the killing of human babies. In Practical Ethics, he supports the killing of newborns with hemophilia. As he writes: "When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed. The loss of the happy life for the first infant is outweighed by the gain of a happier life for the second. Therefore, if the killing of the hemophiliac infant has no adverse effect on others it would . . . be right to kill him."

Singer reiterated the point, using a different example, in Rethinking Life and Death: The Collapse of Our Traditional Ethics: "To have a child with Down’s syndrome is to have a very different experience from having a normal child. . . . We may not want a child to start on life’s uncertain voyage if the prospects are clouded. When this can be known at a very early stage of the voyage we may be able to make a fresh start. . . . Instead of going forward and putting all our efforts into making the best of the situation, we can still say no, and start again from the beginning."

His use of passive language does not blunt his meaning: Singer is advocating infanticide as a parental prerogative. In the most extreme form of his argument, he has even suggested that parents have 28 days in which to decide whether to keep or kill their infants.

When Singer gives examples of babies who are appropriate to kill, he usually writes or speaks, as above, of children born with disabilities. But it is important to note that under his thesis, disability has little actual relevance. Utilitarian considerations of maximizing happiness and reducing suffering are what count to Singer. Thus, if a parent is unhappy with the birth of a child, if that child’s death will cause them more happiness than keeping it, or if keeping the child will make life less happy for potential future children, then infanticide is an acceptable alternative. (Perhaps Brian Peterson and Amy Grossberg, who recently pled guilty to manslaughter after they wrapped their newborn baby in plastic and then tossed him into a waste receptacle, should have called Singer as a defense witness instead of copping a plea. After all, they were simply maximizing their happiness and ending the life of a replaceable being.)

Singer’s attitudes about cognitively disabled people are equally abhorrent. He argues that cognitively disabled people who are incapable of "choosing" to live or die can be killed. This applies to people diagnosed as permanently unconscious (a notoriously misdiagnosed condition) and those who are conscious but not "rational or autonomous." In other words, brain-damaged people, those with significant mental retardation, and/or some forms of psychosis, are not persons and do not have a right to life. Singer writes in Practical Ethics that, "it is difficult to see the point of keeping such human beings alive, if their life, on the whole, is miserable."

".......Singer is invited to speak at seminars, symposia, and philosophy association conventions, throughout the world. His 1979 book, Practical Ethics, which unabashedly advocates infanticide, euthanasia, and decries "discrimination" based on species (a bizarre notion Singer labels "speciesism"), has become a standard text in many college philosophy departments. Singer is now so mainstream that he even wrote the essay on ethics for the Encyclopedia Britannica."

".....Those who are fighting a rear-guard action to protect the human rights of weak and medically vulnerable people in universities and in debates over public policy in the United States have benefited from the fact that Singer has spoken from the hinterlands-Monash University in Australia. But now, even that cold comfort is gone. Next year, Singer will become a permanent member of the Princeton University faculty, where he will be the Ira W. DeCamp Professor of Bioethics, a prestigious, tenured academic chair, at the university’s Center for Human Values."

6 posted on 10/14/2003 7:30:16 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: nepdap; pram
Pram said it well when she said the slippery slope has become a screaming nosedive.
7 posted on 10/14/2003 7:31:07 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Conservababe; Salvation; ventana; nickcarraway; BlackElk; ArrogantBustard; RnMomof7; NYer; ...
Here is the abstract. Anyone know how to get hold of the entire thing? Sure would like to see these parallel developments....
8 posted on 10/14/2003 7:33:56 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Ethan_Allen
I think actually, that the idea will be to take them to surgery, remove everything they can use, pay the parents or family the compensation money, and let them expire on the table, perhaps.
9 posted on 10/14/2003 7:35:52 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
He was a Fellow in the Program in Ethics

I'm getting the feeling that the main reason that ivory-tower ethics programs exist, is to convince ordinary people, like me, that immoral actions are really ethical actions.

I remember when ethics programs began to sprout up. They were supposed to be the new way to promote morality, without promoting particular religions. We were told that things were much too complex in this modern world and we needed to have experts tell us right from wrong. The simple old idea of decent behavior toward each individual would no longer do.

The ethics-hucksters have thrown out the baby with the bathwater and have left us with a chipped and rusty basin.

10 posted on 10/14/2003 7:36:03 PM PDT by syriacus (Judge Greer---YOU should have looked into Terri's eyes and asked her if she wanted life.)
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To: syriacus
Yup, that's what Wesley says in his books. And he also says the "father" of ethics committees is none other than Ronald Cranford, MD. I suppose you don't need me to tell you how many courts he has testified for death in...
11 posted on 10/14/2003 7:39:23 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
"When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed."

It is amazing the Nazi-like mentality of some of our "compassionate" people who want everyone to be "happy" (everyone they don't kill, that is).

There is no foundation for ethics once a purely hedonistic standard ("happiness") is used. Any system based on hedonism is a reductio absurdium that will fail. Life is struggle. Life can still have meaning, whether circumstances are happy or not. These glib fools who talk about maximizing the happiness of the lucky few by killing many people judged to be "inferior" in some way (they are of the wrong class, or are physically unfit, or they think differently, or they don't belong to some "Master Race") -- these fools seem to think that they will live forever if only they can kill enough of the "inferior" people who are in their way.

It is instructive to see how many of the hedonistic philosophers immediately seek to maximize "happiness" by killing ever-increasing categories of "those people" (whoever "those people" happen to be at the moment). A system is truly bankrupt when its primary ethical question is not, "How must I live?" but is instead, "Who must I kill?"

12 posted on 10/14/2003 8:58:23 PM PDT by Wilhelm Tell (Lurking since 1997!)
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To: MarMema
We're lost.
13 posted on 10/14/2003 9:55:30 PM PDT by Marie (I smell... COFFEE! coffeecoffeecoffeecoffee! COFFEE!!)
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To: xzins; MarMema; RnMomof7; the_doc
This should be called the "Rich Man's Organ Farming Rule" or maybe the "Rich Doctor's Cost Reduction Rule" or "The Dying Patient's Don't-Carry-a-Donor-Card-into-an-appendectomy-if-Bill-Gates-needs-a-Heart Rule"

I admit to being a "Double-Minded Man" on this subject -- as I, for one, have always offered myself as an "Organ Donor" since the first time I earned a Driver's License. While I am no Gnostic Heretic who denies the Resurrection of the Body, I am also convinced that, when I depart this mortal coil and my spirit rests (temporarily) in the Bosom of Abraham, I shall have no further need of my fleshly organs until the Day when the Final Resurrection is commenced; others, who have more need of them, may borrow them in the meanwhile.

I admit that there is a danger of "active euthanasia", which is a prospect to be abhorred; but as concerns myself, I have little worry. I try to be a good Calvinist of the "General Stonewall Jackson" school:

As dangerous as the State's attempts to seduce the Medical Establishment into the expedience of Active Euthanasia may be, I do not fear them over-much. Personally, I think that this whole "active euthanasia" issue is a trivial matter, a red herring, an also-ran of a Medical Ethics issue.

At the risk of beating a dead horse, I think that the entire foundation of Medical Ethics in America comes always and only down to ROE VS. WADE, and this is also the fulcrum on which the whole weight of Medical Ethics turns.

I am not a great fan of Doctors, Nurses, and Medicine in general; I have visited a Doctor only once in 15 years (when I was recently stricken with a case of Palsy), and I never visit the Dentist (I could chug sugary Colas all day long, every day, and my teeth are still perfect. Guess I chose my genetic parents wisely!!) For me, it always comes back to Roe Vs. Wade.

"Euthanasia" is a red herring. It all comes back to Roe Vs. Wade. It always comes back to Roe vs. Wade. IT'S ALL ABOUT ROE VS. WADE.

The Liberals understand this. This is why, though 25-35% of all Registered Democrats are at least nominally "Pro-Life", the Liberals will never permit a Pro-Lifer to speak at the Democrat National Convention. The EVIL Party (the Democrats) understand the Stakes better than the STUPID Party (the Republicans).

(/rant over)

14 posted on 10/14/2003 10:11:30 PM PDT by OrthodoxPresbyterian (We are unworthy Servants; We have only done Our Duty)
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To: MarMema
Soooo....this guy's organs can be harvested right now? Not much brain activity there. Why wait?
15 posted on 10/14/2003 10:59:16 PM PDT by lorrainer (Oh, was I ranting? Sorry....)
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To: MarMema
This is why I don't have a "organ donor" on my driver's license.

The next step is to allow "organ donation" from "higher brain death". Then they wouldn't have to starve Terry ...they could just take her organs out and kill her that way...
16 posted on 10/15/2003 5:35:27 AM PDT by LadyDoc (liberals only love politcially correct poor people.)
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To: LadyDoc
Yes. I think that is what Wesley is trying to say. That the killing of Terri, and all the others, is only a step in this direction. A method of dehumanizing people like Terri as a means of another end down the road.

MAY GOD BE WITH HER TODAY.

17 posted on 10/15/2003 6:23:58 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: PleaseNoMore
ping
18 posted on 10/15/2003 6:37:12 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Libertina
ping...
19 posted on 10/15/2003 1:44:32 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
We propose that individuals who desire to donate their organs and who are either neurologically devastated or imminently dying should be allowed to donate their organs, without first being declared dead.
Exactly how "not dead" should they be? Comatose or just lying down resting? /s More steps in a WRONG, Godless direction.
20 posted on 10/15/2003 1:50:48 PM PDT by Libertina (Steadfast loyalty - The sign of a true friend and leader.)
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To: Humidston
ping for your thread....which doc was on the show? I am dying to know, so if you can remember, please post to me.
Thanks.
21 posted on 10/15/2003 6:49:32 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
Ohmygosh! THANKS for pinging me on the other thread!! (I'm going to post a link to yours as soon as I've answered you here.)

No, I don't recall - unfortunately. He was a PhD though, and not a medical doctor. Maybe someone else will have the answer??
22 posted on 10/15/2003 7:02:53 PM PDT by Humidston (Do not remove this tag under penalty of law)
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To: MarMema
I've been on FNC's website, trying to locate the name of the "doctor" who appeared, but they haven't updated the list yet....
23 posted on 10/15/2003 7:19:50 PM PDT by Humidston (Do not remove this tag under penalty of law)
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To: Humidston
Boy if you ever find out, I would love to know, as I am keeping track of the right to kill scum in this country.

Once they show their ratlike little eyes on TV, I want to know who they are. Thanks and keep trying, please.

24 posted on 10/15/2003 7:27:18 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
>>ratlike little eyes<<

Thanks! The first and only chuckle I've had today. And I certainly will keep trying. Maybe someone else may have written it down. (Apparently they brought this guy in at the last minute because he wasn't listed in the Previews. And BTW, it was O'Reilly's show where he appeared.)

I can always wait for the second viewing late tonight. I'll try to stay awake.
25 posted on 10/15/2003 7:39:04 PM PDT by Humidston (Do not remove this tag under penalty of law)
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To: MarMema; Big Giant Head
Just Chilling!

We now return you to your regularly scheduled playoff games...
26 posted on 10/15/2003 7:52:22 PM PDT by Marie Antoinette (Caaaarefully poke the toothpick through the plastic...)
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To: MarMema
We propose that individuals who desire to donate their organs and who are either neurologically devastated or imminently dying should be allowed to donate their organs, without first being declared dead.

Over my dead body. Literally.

27 posted on 10/15/2003 7:58:22 PM PDT by BlessedBeGod
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To: dixiegrrl
You might want to see this.....
28 posted on 10/15/2003 8:17:49 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Marie Antoinette
We now return you to your regularly scheduled playoff games...

BUZZ! You get the award of the day. The professional medical journals are filled with this stuff today. It is enough to send you packing, which is in fact, what we are considering.

It's like this...what if you lived in Germany in about 1928 and you said, Nah, this can't really be happening...and you stayed.

29 posted on 10/15/2003 8:20:47 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Humidston
Bless you if you make it.
30 posted on 10/15/2003 8:21:05 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: BlessedBeGod
Well they aren't looking at those who work and pay taxes you see. The disabled like Terri, have good livers still and expecially those brain-damaged kids in the ICU at Boston Childrens, where both of these docs practise.

They're looking at those kids and seeing very young and working organs, hardly used.

31 posted on 10/15/2003 8:45:12 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: RichardMoore
And look at this post I put up a few days ago, as well.....
32 posted on 10/16/2003 4:31:47 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: G.Mason
here is another thing you have no control over...ties in quote closely to the threads about Terri.
33 posted on 10/16/2003 9:16:54 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Capitalist Eric
And how do you feel about this, btw?
34 posted on 10/16/2003 2:38:12 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
And how do you feel about this, btw?

I don't particulary like the idea of "harvesting" organs from live donors, but (again) I have discussed such possibilities with my family. And of course, my drivers' license has the donor sticker, as well as the donor card...

But the key sentence here, is "and who are either neurologically devastated" would seem to apply this woman Terri, would it not? After all, her autonomic functions are all intact, but cognitive functions are (from all accounts) destroyed. Did she not suffer from "neurological devastation," to use their term? Food for thought...

I don't know if such "guidelines" are meaningful, from either a moral perspective or legal perspective. In such circumstances....? The legal system follows the guidelines and stare decisis, however repugnant the side-effects may be...

Contrary to accusations on the other thread, I don't really have a firm opinion on how it should be, simply because I'm somewhat familiar with the legal system, and can see both sides... The husband is within his rights, and no person without legal standing can make a credible challenge.

That's the way it is.

Be well,

35 posted on 10/16/2003 5:26:53 PM PDT by Capitalist Eric
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To: Capitalist Eric
You may be surprised that I agree with you. The husband is well within his rights. That is the problem for me, however.

The physician/authors above are pediatricians, if that makes any difference. It seems like a very very slippery slope to agree to take organs before death, especially from ( yet again) a vulnerable population such as injured children.

The problem with the term "neurologically devastated" is that it means nothing, and that may actually be intentional. I am a medical professional and this term is completely meaningless. Therefore it is open to lots and lots of interpretation, of course. Guess who gets to be the interpretor?

Thanks for reading and good luck with medical care in the future, an an organ donor. :-)

36 posted on 10/16/2003 5:50:24 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
good luck with medical care in the future, an an organ donor. :-)

ROFLOL!

Thanks- I think! :-P

37 posted on 10/16/2003 6:29:22 PM PDT by Capitalist Eric
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To: xzins; MarMema; MHGinTN
When people have a materialist world view - when they think that the flesh and blood body is their only identity, when they think that their existence ends with the death of the body; when they think that the only goals worth pursuing are money, power, influence, sex and its attendent attractiveness and seductions, even the honing of talents, or any worldly goals - then the extension of bodily existence is worth any cruelty, any unnatural contortions, any amount of money, and any extremist scientific experimentation. Because such people have no conviction in the existence of the eternal Supreme Godhead, His eternal kingdom, and the eternal nature of the individual souls, they grasp like limpets to their own temporary existence, even if it means hastening the bodily death of others.

People who understand that the body is but a shell holding the eternal spirit have respect for the shell - knowing that it is up to the Owner when we come into the world, and it is up to Him when we leave. Only those who understand that "life" doesn't really start with a birthday and doesn't end with a deathday can truly respect the living and the dead, or show true compassion for those who suffer, who are dying (and actually that encompasses each and every one of us) and those who are disabled in some way. Because we understand that the *person inside* is not disabled, just the vehicle is. And if we respect the living soul, we naturally take care of the vehicle, as it is illuminated with the holy light emanating from the soul, and God within each heart.
38 posted on 10/18/2003 10:07:13 PM PDT by First Amendment
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To: MarMema
pay the parents or family the compensation money

Is there actual compensation money? I thought donors only received a pat on the back. That is, if there's anything left of their back after all their internal organs have been removed . . .

39 posted on 10/18/2003 10:25:16 PM PDT by nepdap
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To: Libertina; All
Have you all seen "Princess Bride"? Sorry to inject a comedy into a very serious subject, but there's this whole plot development when Wesley (hero) is thought to be dead, but then the Billy Crystal character reveals that Wesley is only mostly dead, and Wesley goes on to recover.

Maybe not funny unless you know the movie. But perhaps unwittingly the movie is making "our" point.

40 posted on 10/18/2003 10:28:28 PM PDT by nepdap
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To: MarMema
I've written "Not an organ donor" on the back of my driver's license.

I do not think it is ethical to actively hope for someone to die so that an organ transplant can take place; this article describes something far worse, hastening death for someone who might even be curable, for the purpose of harvesting "spare parts."
41 posted on 10/18/2003 11:23:18 PM PDT by exDemMom (Society is nameless and faceless and doesn't care.)
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To: MarMema; OrthodoxPresbyterian; LadyDoc
I not only have the organ donor box checked on my driver's license, my very detailed Advanced Directive specifies that none of my cells may be used in any sort of cloning, nuclear transfer or reproductive effort. And, I ask not to be given hydration or nutrition if I can't respond (actually, I wrote that I'd want any artificial support, feeding tube or IV withheld or removed if I can't read, argue, and interact -- to please let me go to Heaven). However, that's a very personal decision, based on my belief that I have the right to refuse intervention --- not that anyone else has the right to refuse to make that decision for me -- and my security in what is waiting after I die.

The author of this proposal is attempting to redirect the brain-death discussion from a priority of determination of irreversible brain stem death (which is inevitably followed by cessation of adequate heart beat).

No medical professional should allow the philosophy to be perverted from recognizing natural death to an opportunity for organ harvesting.

42 posted on 10/18/2003 11:43:01 PM PDT by hocndoc (Choice is the # 1 killer in the US)
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To: hocndoc
The two authors of this proposal are pediatric specialists with offices in or near the pedi ICU at Boston Childrens. One is a pedi anesthesiologist, and the other a pedi pulmonologist.

They are proposing that brain damaged and ill children in the ICU be used for organ harvesting without dying first.
What they must mean is the killing of children who are seriously ill in order to harvest their organs successfully, because the children are likely to die soon anyway.

43 posted on 10/18/2003 11:50:42 PM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: Capitalist Eric; MarMema
Terri Schiavo's husband has no right to starve his wife, as she is not brain dead, did not write out her wishes or execute an Advance Directive, and she can evidently swallow and so may not even *be* dependent on "artificial" nutrition. (and, the woman shown on her parent's website is most definitely not in a "persistent vegetative state.")

Another factor is that the "tube" was placed. It was there to use and no machines are actually necessary. Removing the feeding tube was an action, requiring the use of people and devices that are regulated by the State of Florida, under their Medical laws and regulations. That makes the removal the business of the State and her citizens.

One of the Op-Ed pieces on the Schiavo case made a great comment about Terri's supposed wishes that every lawyer should understand: under what other circumstances would such hearsay testimony be allowed, much less used for the justification of a death penalty?
44 posted on 10/18/2003 11:51:51 PM PDT by hocndoc (Choice is the # 1 killer in the US)
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To: MarMema
I understand who the authors are and see the logical fallicy in the following two sentences:

""The concept of brain death was developed, in part, to allow patients with devastating neurologic injury to be declared dead before the occurrence of cardiopulmonary arrest. Brain death is essential to current practices of organ retrieval because it legitimates organ removal from bodies that continue to have circulation and respiration, thereby avoiding ischemic injury to the organs."

Although at this late hour I can't remember the formal name for this error, the fact that brain cells die before the heart cells and that we transplant hearts from brain-dead donors does not mean that the justification for the ethical and legal history of the concept of "brain death" is organ transplantation.
45 posted on 10/18/2003 11:57:32 PM PDT by hocndoc (Choice is the # 1 killer in the US)
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To: hocndoc
Don't you think it is about her brain damage and dehumanizing the disabled, not about her husband's right to act as her surrogate in determining her right to die?

Don't you see this sometimes.....care for a patient is thought to be far less necessary and certainly less important if the patient is already either:
A. brain damaged or mentally delayed ( significantly)
B. has cancer
C. is suffering from a terminal disease of some kind (MS, etc)
D. has diabetes or another serious chronic illness
E. is a drug user, alcoholic, or transient

46 posted on 10/19/2003 12:00:23 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: hocndoc
does not mean that the justification for the ethical and legal history of the concept of "brain death" is organ transplantation.

Well said. But what else can be driving the push to re- define death, expand PVS dx to include all inconvenient family members, and completely (it seems to me) abandon all previous efforts/research in rehab of brain-damaged people.

47 posted on 10/19/2003 12:11:29 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: hocndoc
This makes the case I was unable to make well in my post #46.
48 posted on 10/19/2003 12:15:58 AM PDT by MarMema (KILLING ISN'T MEDICINE)
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To: MarMema
Sorry I conked out last nite -- and I'm in an airport today, so I'll be hit and run, now.

I was trained to treat even ded bodies and those who are brain dead with respect and care. (good teachers)
Humans are self centered, often lack empathy, and are being told that we are - and treated as - animals. We are not like other animals....We have these conversations. And we most admire the more loving and life-protecting side of the conversation.

The US is based on the Declaration of Independence. Without those inalienable rights, our government does not have the legitimacy of King George.
We must teach rights of humans and force ourselves as governors under our republican form of government to protect those rights.
49 posted on 10/19/2003 11:59:58 AM PDT by hocndoc (Choice is the # 1 killer in the US)
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To: MarMema
Sorry I conked out last nite -- and I'm in an airport today, so I'll be hit and run, now.

I was trained to treat even ded bodies and those who are brain dead with respect and care. (good teachers)
Humans are self centered, often lack empathy, and are being told that we are - and treated as - animals. We are not like other animals....We have these conversations. And we most admire the more loving and life-protecting side of the conversation.

The US is based on the Declaration of Independence. Without those inalienable rights, our government does not have the legitimacy of King George.
We must teach rights of humans and force ourselves as governors under our republican form of government to protect those rights.
50 posted on 10/19/2003 12:00:33 PM PDT by hocndoc (Choice is the # 1 killer in the US)
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