Donation after brain death (DBD): The majority of “dead” donors suffer severe head trauma and are determined to be “brain dead.” “Brain death” is defined as the “irreversible cessation of all functions of the entire brain, including the brain stem” [Uniform Determination of Death Act (UDDA)]. However, DBD donors do not meet this standard since they do retain some essential brain functions, for instance, the secretion of hormones by the hypothalamus and certain functions of the brain stem, such as regulation of body temperature. These brain functions, apparently, are simply ignored in the pursuit of organs. Also, some functions of the brain may be only temporarily lost and recover over time, if the patient is given time to recover them. Consider:
“Brain dead” patients have signs of life – vital signs. They are warm and pink, have a beating heart and blood pressure, and breathe with the support of a ventilator (see How a Ventilator Works, p. 5).
Their wounds heal, they grow and mature sexually, digest food and excrete waste.
Many cases of recovery after “brain death” diagnoses have been reported.
In order to determine “brain death,” an apnea test is required. The ventilator is turned off for up to 10 minutes to see if the patient will breathe spontaneously. Carbon dioxide increases to toxic levels that can increase brain damage and may even cause death. The apnea test only proves the patient needs a ventilator to assist respiration; it does not prove he is dead.
Donation after circulatory death (DCD): DCD allows patients who are ventilator-dependent, but not “brain dead,” to be organ donors. A patient or family agrees to stop life-support and a do not resuscitate (DNR) order is written. Then they consent to organ donation. The patient is removed from the ventilator. The medical team waits until no pulse or breathing can be discerned. A short 2-5 minutes later the patient is pronounced dead and organ removal begins. The definition of death used to justify DCD is the “irreversible cessation of circulatory and respiratory functions” [UDDA].” In DCD, the common meaning of irreversible—“not capable of being reversed”—is abandoned. The intent in DCD is to not attempt reversal by resuscitation, but that does not mean loss of circulation is irreversible nor that the patient is dead yet. Like DBD, DCD requires sleight of hand.
The Uniform Anatomical Gift Act was revised in 2006 and most states have adopted it. Everyone who has not explicitly refused to be an organ donor is now considered a “prospective donor.” This means that, if you are “at or near death,” your hospital must notify an Organ Procurement Organization (OPO). While the OPO searches for a “reasonably available” family member or other person who can legally consent or refuse to donate your organs, the medical team can treat you like a donor, subjecting you to medical procedures—not beneficial to you—solely to make certain your organs are in tip-top condition for the potential recipient.
Before organ transplantation was possible, physicians waited long enough to be certain that circulatory and respiratory functions had irreversibly ceased.Death was declared only when there were no vital signs—the body was cold, blue and stiff. Today, however, in the haste to procure vital organs before they begin to deteriorate due to loss of circulation, death is often declared to enable organ transplantation, not to protect the donor from a death-dealing mistake.
Human Life Alliance (HLA) recommends signing and carrying a “Refusal to be an Organ Donor” wallet card at all times.
To request cards, call HLA, 651-484-1040. or order one online here.
Numerous cases such as Israel’s show the great need for medical facilities —safe havens— ready and willing to provide life-sustaining treatment to patients who are denied such care against their or their families’ wishes.
The source of most vital organs (heart, lungs, liver, kidneys and pancreas) for transplantation is patients who have been declared dead. Are they truly dead? The answer to this question is crucially important, for, if organ donors are not dead, removal of their vital organs will kill them.