Surgical Preparation For Organ Donation For Non-Brain Dead Patients?: Australia

By Hilary White
  CANBERRA, July 13, 2006 ( – The Australian Health Ethics Committee is lobbying to have legislation passed that would allow those patients who are “certain to die” but not classified as “brain dead” to be surgically prepared for organ donation before death.
  Currently, those patients who are declared “brain dead” are prepared by a procedure that involves inserting tubes into major arteries to prepare for cleansing of organs after death, blood tests and drug administration to better preserve organs.
  The Committee’s working party has asked for legislation that would extend the preparation to those patients who are not “brain dead” but who are expected to die when the heart stops beating.
“There is only one state of death, but there are two ways in which a doctor can certify death as having occurred: brain death and cessation of circulation,” said working party chair Peter Joseph. The Committee argues that the preparation is required because of the speed with which soft tissue deteriorates when blood is no longer circulating.
  The distinction between so-called “brain death” and what is now being called circulatory death, the cessation of blood circulation and heartbeat, is coming under increasing criticism from religious organizations and classical ethicists.
  An Australian ethicist, in response to the Committee’s discussions,  expressed concern that patients who agree to organ transplants are not prepared for such an invasive procedure. The Sunday Age quoted Ray Campbell, a lecturer in medical ethics at St Paul’s Theological College, saying, “I don’t believe anyone who has consented to be an organ donor at this time would have envisaged this kind of procedure.”
  Campbell made a submission to the ethics committee saying he was concerned that such changes would increase the eagerness of doctors to cease therapeutic treatment on organ donor patients. “Any attempt to water down our current definition of death should be resisted,” he said.
  Organ donation and transplantation has developed into a multi-billion dollar industry since the first successful organ transplants and the development of immunosuppressant drugs in the late 1950’s. The international demand for organs has helped create the field of modern bioethics in which ethicists fear seriously ill patients are seen as living organ farms rather than persons with their own needs.
  In 1999, when the Canadian government was looking for ways to increase organ donations, a Parliamentary committee heard testimony that the brain death criterion was unreliable at best.
  Dr. John Yun, a Richmond, B.C. oncologist told the committee that the desire to acquire more organs was the motivation behind the invention of the brain death criterion. “We must not jump to the conclusion that a dubious definition of death—the medical hypothesis of brain death—is in fact death,” he said.

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