 A “cardiac death” transplant saved Zachary
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A report on three heart transplants involving babies is focusing attention on a touchy issue in the organ donation field: When and how can someone be declared dead?
For decades, organs have typically been removed only after doctors determine that a donor’s brain has completely stopped working. In the case of the infants, all three were on life support and showed little brain function, but they didn’t meet the criteria for brain death.
With their families’ consent, the newborns were taken off ventilators and surgeons in Denver, Colorado, removed their hearts minutes after they stopped beating. The hearts were successfully transplanted, and the babies who got the hearts survived.
“It seemed like there was an unmet need in two situations,” said Dr. Mark Boucek, who led the study at Children’s Hospital in Denver. “Recipients were dying while awaiting donor organs. And we had children dying whose family wanted to donate, and we weren’t able to do it.”
The procedure — called donation after cardiac death — is being encouraged by the federal government, organ banks and others as a way to make more organs available and give more families the option to donate.
Good idea?
I think we already established that George Bush will approve when someone can be declared dead.
Let’s move on.
The only ones complaining are the professional complainers. They want the heart to have stopped for five minutes. That would have narrowed the window too much to removing a viable heart.
The longer they wait from when the heart stops beating, the more damage to the oxygen starved organs.
Brain Death, Heart Death, Respiratory Death, No Hope for Recovery, Brain Stem Function Only, Death of the Soul, Neo-Con: these are all simply arbitrary definitions of death.
It doesn’t matter what else is present in the picture, if the family agrees, there is no other relevant issue.
Who cares most about when an organ donor is declared dead?
I think the person who cares the most is the one being declared “dead” when that may not be the case. If it worries you, don’t be a donor.
#4–Hey Paddy==”normally” I wouldn’t call you out on this as what you post is “tangentially relevant.” But to return a similar favor from you a few days ago==why don’t you RTFA!!
This issue is about newborns. So, what you post is absolutely correct, but totally irrelevant.
Just FYI, defibrillators stop hearts before restarting them. Voila, ethically induced cardiac arrest, and then you can take the hearts from healthy people. A technicality, yes. Did that ever stop anybody?
I’m donating my brain.
If they take it too soon, I can complain for the rest of their life.
#8–dusan==while confused and convoluted, I do follow your argument. We disagree. I see no functional reason to delay new born heart transplants until the transplants are no good. You ask for a simple legal standard and I presume you mean brain death? Well, if brain death is considered emminent with no reasonable basis to hope otherwise (eg–kiddies with no brain present?), I think “heart death” confirmed by two independent physicians ALL with the families agreement is more than enough safeguard.
So, we disagree. In general, I don’t support organ transplants until general health care is more widely available, so in practice, I would go with your more luddite position.
#9: “I don’t support organ transplants until general health care is more widely available”
??? By that logic, you shouldn’t get any health care until we have better health care everywhere. Why single out this one particular method of healthcare we have to offer the dying?
I assume if you ever need an organ transplant you will quietly die rather than have one. Right?
In this particular case, I feel enormous sympathy for the parents who made the decision to have their children taken off life support. I can’t imagine the pain.
The only consoling factors would be:
-They were going to help others, and
-Their own children would be spared having to live the life of a vegetable.
If I were stuck in a hospital without any chance of awakening, I’d wish that someone would pull the plug and let the resources wasted on me go to someone who could really use them.
#10–Uncle Dave, I’m honored, now, just don’t run away?
You ask: “Why single out this one particular method of healthcare we have to offer the dying?” /// because it is disproportionately expensive.
You ask: “I assume if you ever need an organ transplant you will quietly die rather than have one. Right? /// Correct.
#12 – Bobbalina
>>You ask: “I assume if you ever need an organ
>>transplant you will quietly die rather than
>>have one. Right? /// Correct.
Yeah. Right.
Need a kidney so you won’t go into end-stage renal failure? “F&ck no, I’ll just die, thank you very much”.
Pffft. I think this is like an “atheists is foxholes” kind of thing. “///”
#12: OK, using you’re argument, I assume you never use health insurance (but happily pay for it) so as to allow the money in the insurance pool you’re in is foolishly spent on you can help others and keep the cost of insurance for them lower.
#14 – Uncle Dave
Watch out, Unc. Bobbo will talk you to death. At that, he is a Grand Master. And his pretzel logic? Arghh! And his “special” punctuation? Gak!
Better to just wait until he needs that kidney transplant.
Let me point out a much bigger issue here, since it seems to have passed under the radar.
Our rights to determine our end-of-life.
In this case, the children were not technically “dead” but, through the decisions of others, were allowed to die so their organs could be harvested.
At what point do we draw the line on the rights of others? If YOU are laying in a hospital bed with low brain function, when can someone come along and harvest your organs?
It sounds like the legality of the situation has moved from “opting-in” to organ donation to “opting-out”. A significant shift.
How much farther is it going to move?
#14–Uncle Dave==I don’t have health insurance. Neither does a friend of mine who just had a heart attack. He got an emergency stent inserted and after a four day stay was sent home “cured.” Only $180K. Like myself, he has no money and told them so. He still got excellent care. So–the system works pretty much as advertised.
I will do the same if I get a heart attack. Like him, I could not stand the pain.
But to chronic conditions. I have been genetically gifted with near perfect health my entire life. Its part of my psyche. When I get a chronic condition, I will accept it and probably go to the street for some pain killers.
I see no dignity in clinging to a bed ridden debilitated life as long as possible. Might I become a hypocrite when actually faced with it? Possible==but such personalization would not change the validity of my position.
Disproportionately expensive end of life or near end of life procedures should not be provided until general health care services are readily available.
#16 “At what point do we draw the line on the rights of others?”
According to bobbo, children aren’t concerned if they are killed to harvest organs. It’s a sick viewpoint and shows psychopathic tendencies but I fear there are more psycho’s out there than we are aware of…
We have to push for some laws.
Getting more organs should be the primary goal. If that requires harvesting of old people with terminal illnesses so be it. Perhaps one day, technology will arrange for people to have themselves cloned, and the cloned people kept in camps until their organs are needed.
#17: You, sir, are a hypocrite already. Your argument against transplants is that the cost is too high, sucking large wads of money that could go to help others. Yet you would have no problem with sucking $180k in ‘free’ emergency care that would result in higher health costs for others who might not get care at all as a result.
What exactly makes a shunt different from a transplant other than one is more expensive than the other? Where is your cut off in price since it appears there is one?
#16–Ah Yea==I think you missed the point of this article. On point, it is ABOUT the very issue you raise. Before the process described here, and now, the presumption is to opt out==for adults, children, adolescents. The exception being made here which is the camel’s nose, is for near new borns? The parents are allowed to apply their values to the near born.
I think its a valid process as heart death for an infant who has no reasonable expectation of long term survival is a pretty thin edge.
For every such terminal infant heart not taken, a viable baby dies.
Seems fair to me==but then I view kiddies pretty much as property any way.
#19: A better idea would be for the clone to not have a conscious brain. Be essentially a large bag of parts that doesn’t even look human hung on a hook until needed. Or have factories of parts (“over there is the liver barn”), each part grown using your cells. If you die before your parts are used, they could be used for people in poor countries who can’t afford parts farms. Or dog food. Either one.
#20–Gosh Uncle Dave, how many clues do you need?
I said I would be weak in view of the pain. The direct application of pain will cause people to do anything available to them to avoid it.
Heart Attacks are ACUTE episodes which I contrasted with CHRONIC conditions. These acute episodes arise in midlife==not end of life where the ROI is limited, nor the beginning of life where investment has not been made.
Pretty simple really.
OK, let’s take it down bobbo. While you may be a miracle of wellness, what if something happened that was not acutely painful? You wouldn’t seek medical care for it?
#24–Uncle Dave. Thanks again.
As I understand it, without an insurance policy, I cannot get treatment for something that is chronic but not acutely painful. I think that is true==legally as well as practically. So==even if I chose to seek medical help, I don’t think I would get any without means to pay for it and for general diagnosis, doctors would require upfront payment.
So, I would google and attempt self diagnosis and probably fake a visit to an emergency room for “a real diagnosis.”
From there, everything would be fact dependent. I “basically” have never been sick, so I don’t know.
I need dental care right now and I have refused to use my life savings to pay for it==planning to become a healthcare tourist in Thailand to be able to pay for tooth removal and bridges, maybe an implant if the dollar doesn’t lose more value.
The history of my dental experience is long and convoluted with my reporting of a dentist for fraud. Imagine a millionaire dentist overbilling just to make a few more bucks AFTER being on notice that I refused to pay for it? Rest easy==the dental board accepted his explanation that it was his office managers fault.
For profit medicine. Best in the world.
So–when heros like myself and my heart attack friend can’t get good general preventative care, why should I, or any of the other 48 Million uninsured patients support disproportionate expensive procedures for a very few?
Life and death consequences are still best explained in terms of “God’s will” so they don’t have to make any sense. It is so much easier to accept it when little Billy dies as part of God’s marvelous plan, a plan far too complex and wonderful for anyone but God himself to understand. When the Lord is your HMO, you just know it will always work out for the best.
“Little Billy went to be with Jesus.”
#27–Ah Yea==thanks much. Budapest and Cabo both look good. I am motivated by Thailand because they have accredited services built specifically to service the medical tourist.
The biggest drawback of course is the “uncertainty” of foreign medical quality==but in my personal experience==USA has many horry stories motivated by GREED if not by deficient training, equipment, and so forth.
I think I have a bias against Mexico with their drug fueled anarachy and corruption==and same with anything too close to Russia. Plus, I want to see those elephants in Chang Mai?
I’ll study your sites closely. Post back if you go tourist? I will if I ever get my passport.
I agree that we need to look at new definitions of when an organ is available for transplant.
My father had a heart attack that left him braindead and, as per his wishes, we told the Dr.s to take him off life support and donate as much tissue as possible. The only problem was his lungs were still trying to breathe with the respirator once per minute – making him ineligable for donating anything but his eyes.
We had the option of leaving him in ICU on life support for at least 2 days, so see if his lungs stopped trying to breathe. We couldn’t see the sense of using up such valuable space, staff and resources for a “just in case”. The Dr.s shared our frustration – knowing that there was so much that could have been donated, but for wording of whatever paper decides in Ontario when someone is dead enough.
#9 – Bobbolina
>>In general, I don’t support organ transplants
>>until general health care is more widely
>>available
Hey! You’re just like Brangelina, who won’t get married themselves until everyone who wants to get married have that right!
Rock on, dude! You’re aligning yourself with the same-sex marriage advocates.
I knew you’d come around.
Bobbo – I live in Thailand and the dental care is excellent. You’d have a hard time telling my clinic apart from a very good US clinic except for two things: the doctors may not speak great English and the prices are half to a third of US prices. I could get even cheaper but I insist on using the best clinics instead of those that cater to locals. BTW, think about the implants before you go to get one. It’s not a quick procedure. It can take several months to complete.
#31–Nimby==thanks much. Every physician I have spoken with here in the USA (all 2 of them) say the medical care is good. The websites look good from what I can tell.
The hard part has been trying to do a price comparison because the terms are undefined and vary slightly from site to site, so its hard to tell what could be afforded.
BUT==I certainly had the impression that implants could be done over the course of a week or so, so your information is very valuable==thanks.
If you check back and have an opinion==would you go with the hospital based facilities in Bangkok, the dental specialty clinics in Bangkok, or is there a “well known” facility elsewhere in the country?