[release][IMG]http://si.wsj.net/public/resources/images/RV-AG239A_ORGAN_DV_20120309181741.jpg[/IMG]
Photo Illustration Joel Holland, Gallery Stock (photo)Doctors don't have to tell you or your relatives what they will do to your body during an organ harvest operation because you'll be dead, with no legal rights.
The last time I renewed my driver's license, the clerk at the DMV asked if she should check me off as an organ donor. I said no. She looked at me and asked again. I said, "No. Just check the box that says, 'I am a heartless, selfish bastard.'"Becoming an organ donor seems like a win-win situation. Some 3.3 people on the transplant waiting list will have their lives extended by your gift (3.3 is the average yield of solid organs per donor). You're a hero, and at no real cost, apparently.
But what are you giving up when you check the donor box on your license? Your organs, of course—but much more. You're also giving up your right to informed consent. Doctors don't have to tell you or your relatives what they will do to your body during an organ harvest operation because you'll be dead, with no legal rights.
The most likely donors are victims of head trauma (from, say, a car or motorcycle accident), spontaneous bleeding in the head, or an aneurysm—patients who can be ruled dead based on brain-death criteria. But brain deaths are estimated to be just around 1% of the total. Everyone else dies from failure of the heart, circulation and breathing, which leads the organs to deteriorate quickly.
The current criteria on brain death were set by a Harvard Medical School committee in 1968, at a time when organ transplantation was making great strides. In 1981, the Uniform Determination of Death Act made brain death a legal form of death in all 50 states.
The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what's called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)
Here's the weird part. If you fail the apnea test, your respirator is reconnected. You will begin to breathe again, your heart pumping blood, keeping the organs fresh. Doctors like to say that, at this point, the "person" has departed the body. You will now be called a BHC, or beating-heart cadaver.
Still, you will have more in common biologically with a living person than with a person whose heart has stopped. Your vital organs will function, you'll maintain your body temperature, and your wounds will continue to heal. You can still get bedsores, have heart attacks and get fever from infections.
"I like my dead people cold, stiff, gray and not breathing," says Dr. Michael A. DeVita of the University of Pittsburgh Medical Center. "The brain dead are warm, pink and breathing."
You might also be emitting brainwaves. Most people are surprised to learn that many people who are declared brain dead are never actually tested for higher-brain activity. The 1968 Harvard committee recommended that doctors use electroencephalography (EEG) to make sure the patient has flat brain waves. Today's tests concentrate on the stalk-like brain stem, in charge of basics such as breathing, sleeping and waking. The EEG would alert doctors if the cortex, the thinking part of your brain, is still active.
But various researchers decided that this test was unnecessary, so it was eliminated from the mandatory criteria in 1971. They reasoned that, if the brain stem is dead, the higher centers of the brain are also probably dead.
But in at least two studies before the 1981 Uniform Determination of Death Act, some "brain-dead" patients were found to be emitting brain waves. One, from the National Institute of Neurological Disorders and Stroke in the 1970s, found that out of 503 patients who met the usual criteria of brain death, 17 showed activity in an EEG.
Even some of the sharpest critics of the brain-death criteria argue that there is no possibility that donors will be in pain during the harvesting of their organs. One, Robert Truog, professor of medical ethics, anesthesia and pediatrics at Harvard Medical School, compared the topic of pain in an organ donor to an argument over "whether it is OK to kick a rock."
But BHCs—who don't receive anesthetics during an organ harvest operation—react to the scalpel like inadequately anesthetized live patients, exhibiting high blood pressure and sometimes soaring heart rates. Doctors say these are simply reflexes.
What if there is sound evidence that you are alive after being declared brain dead? In a 1999 article in the peer-reviewed journal Anesthesiology, Gail A. Van Norman, a professor of anesthesiology at the University of Washington, reported a case in which a 30-year-old patient with severe head trauma began breathing spontaneously after being declared brain dead. The physicians said that, because there was no chance of recovery, he could still be considered dead. The harvest proceeded over the objections of the anesthesiologist, who saw the donor move, and then react to the scalpel with hypertension.
Organ transplantation—from procurement of organs to transplant to the first year of postoperative care—is a $20 billion per year business. Average recipients are charged $750,000 for a transplant, and at an average 3.3 organs, that is more than $2 million per body. Neither donors nor their families can be paid for organs.
It is possible that not being a donor on your license can give you more bargaining power. If you leave instructions with your next of kin, they can perhaps negotiate a better deal. Instead of just the usual icewater-in-the-ears, why not ask for a blood-flow study to make sure your cortex is truly out of commission?
And how about some anesthetic? Although he doesn't believe the brain dead feel pain, Dr. Truog has used two light anesthetics, high-dose fentanyl and sufentanil, which won't harm organs, to quell high blood pressure or heart rate during harvesting operations. "If it were my family," he said, "I'd request them."
—Mr. Teresi is the author of "The Undead: Organ Harvesting, the Ice-Water Test, Beating-Heart Cadavers—How Medicine Is Blurring the Line Between Life and Death."[/release]
[URL]http://online.wsj.com/article/SB10001424052970204603004577269910906351598.html[/URL]
Really good read.
If you are brain dead you are dead. Your consciousness is inside your brain.
Good read and pretty eye opening to the 'brain-dead' patients.
I am paranoid about this. I am afraid that if I become a organ donor that I will more likely let to die so they can get my organs.
What organ is #5&6
[QUOTE=The Baconator;35110351]If you are brain dead you are dead. Your consciousness is inside your brain.[/QUOTE]
Plants are living. They have no consciousness. Therefore a fully functional body with brain death is alive. Please go away.
[QUOTE=The Baconator;35110351]If you are brain dead you are dead. Your consciousness is inside your brain.[/QUOTE]
I'm going to disagree, the person is still breathing and the blood is still pumping and the body is healing. Even though they are declared brain dead the body is still alive and quite obviously working.
[QUOTE=Bomimo;35110469]Plants are living. They have no consciousness. Therefore a fully functional body with brain death is alive. Please go away.[/QUOTE]
A fully functional human body with no conciousness if pretty bloody useless though. Especially if that person is brain-dead, so why not harvest the organs and help someone else? Just because you can't consent to how they treat the harvesting process doesn't mean you shouldn't do it.
Oh and plants are pretty aware, they move to maximise sunlight, react to physical changes, etc. A brain-dead body doesn't do anything.
In all honesty, I've always been terrified about these things. I mean, what if they declare you dead but you're actually fully aware of everything going on, sort of like that case where a guy was in a coma for years but could hear everything around him. I once woke up and couldn't move for a good 5 or so seconds. I mind was completely active but my body would not respond. I tried to scream but nothing came out of my mouth. It was a terrifying several seconds, but I'm terrified if I were ever declared dead by accident, but completely aware of everything going on and unable to communicate that to the doctors. This all probably sounds a bit grim, but it's a true fear of mine that I never really stop thinking about. I did tick myself off as an organ donor when I got my license, but even if it's completely selfish, I would rather keep my organs. I'd just feel a lot safer knowing I'd be in one piece because just the thought of what was once a live, human being getting sliced up and butchered like any other animal is pretty distressful.
Sorry, I've always had these thoughts on my mind and this thread seemed like the only relevant way discuss my fears, and thus (hopefully) easing them a bit. Anyways, I'm done talking about this all. I guess I just had to talk about it, so thanks for reading, if any of you bothered.
Yeah, doctors are insane and evil people who are trying to kill everyone. Those spasms are actually signs of a conscious person, and doctors are just lying to us.
I'll trust doctors to figure out what's brain dead and what isn't, not some blogger. Thanks anyway.
This reminds me of that monty python scene where they butcher someones husband to take his organs :v:
well to be honest if I can't ever do anything other than sit and have food shoved into my gullet via a tube for the rest of my life, pull the plug and harvest what you want
[QUOTE=Protocol7;35110611]well to be honest if I can't ever do anything other than sit and have food shoved into my gullet via a tube for the rest of my life, pull the plug and harvest what you want[/QUOTE]
BUT
BUT
BUT
THE EVIL DOCTORS MIGHT IGNORE THE SIGNALS THAT YOU'RE ALIVE
[QUOTE=Esrange;35110636]BUT
BUT
BUT
THE EVIL DOCTORS MIGHT IGNORE THE SIGNALS THAT YOU'RE ALIVE[/QUOTE]
it's ok i got bored of counting dots on the ceiling tiles
Read it all and I am unimpressed. I'm a donor and I don't give a flying fuck what happens to my body if my goddamn brain has stopped working. Better make good use of what is functional while you still can.
[QUOTE=Rubs10;35110567]Yeah, doctors are insane and evil people who are trying to kill everyone. Those spasms are actually signs of a conscious person, and doctors are just lying to us.
I'll trust doctors to figure out what's brain dead and what isn't, not some blogger. Thanks anyway.[/QUOTE]
I think the main thought is that, because they (the doctors) have no major attachment to you, they may be more likely to give up on trying to save you. Even though they're legally obligated to do their best, I'd imagine most doctors wouldn't bother trying to save somebody with something like a 5% survival chance (or less, like .01) even though it isn't completely certain. Think about all those people out there whose parents were told by their doctor(s) that they wouldn't survive past a certain age, but have. The emotional connection of somebody (like parents) who insisted on continued efforts paid off in those cases, so it's possible that some others could be saved as well from an emotionally-irrational person. Without an absolute 100% guarantee, nothing is completely certain.
Take my organs when I'm dead, just make sure to do something totally awesome with my body. I hear you can be cremated and turned into fireworks. That sounds neat.
Ughh, imagine you were still alive and they did the eye water/poking tests and you could feel it.
I dont want anyone to have a piece of me, i said hell no when they asked me. Besides, from the amount of drinking and other shit ive done i dont think id be the best candidate....
[QUOTE=rodent-man;35110566]In all honesty, I've always been terrified about these things. I mean, what if they declare you dead but you're actually fully aware of everything going on, sort of like that case where a guy was in a coma for years but could hear everything around him. I once woke up and couldn't move for a good 5 or so seconds. I mind was completely active but my body would not respond. I tried to scream but nothing came out of my mouth. It was a terrifying several seconds, but I'm terrified if I were ever declared dead by accident, but completely aware of everything going on and unable to communicate that to the doctors. This all probably sounds a bit grim, but it's a true fear of mine that I never really stop thinking about. I did tick myself off as an organ donor when I got my license, but even if it's completely selfish, I would rather keep my organs. I'd just feel a lot safer knowing I'd be in one piece because just the thought of what was once a live, human being getting sliced up and butchered like any other animal is pretty distressful.[/QUOTE]
We still haven't reached the level of technology to "cure" people that are brain dead. Perhaps they are really alive like the above said. The word "breathing-heart cadaver" really gets to me.
It also brings images of a Ghost in the Shell future
I'm pretty sure when your (brain) dead, you won't know to give a damn... really, does it matter? Even if you could, do you really want to lay there for all eternity, being a vegetable?
[QUOTE=Bomimo;35110469]Plants are living. They have no consciousness. Therefore a fully functional body with brain death is alive. Please go away.[/QUOTE]
Ummm
Plants aren't animals. That's completely different, but still true that a brain dead body is still alive.
it's not really useable at all, though, so you might as well be called dead.
[QUOTE=J!NX;35110720]I'm pretty sure when you die, you won't know to give a fuck so... really, does it matter?
Ummm
Plants aren't animals. :downs: great job comparing the two but no.[/QUOTE]
It's an analogy. The term "vegetable" is surprisingly accurate at times (when it's not being used because you're a fucking terrible person).
No one is getting my organs. My body and casket is going to be shot into space, away from everyone else so I may truly rest in peace.
If you have no control over your body, why live? I'd rather get killed than live in a mind prison.
Speaking as someone who finds the concept of brain death and what causes it fascinating and has studied it(though I don't pretend to have done so extensively,) my opinion is that there should be more extensive tests to consider whether or not brain death means that a human is still capable of feeling what's happening to him or her. Logically, though, there is more evidence that they can than there is that they cannot. In any case, seeing as we're never going to know for sure because Brain Death is usually irrevocable, I'd rather keep my organs anyways. The point another poster made about doctors being more willing to let someone die to get their organs is also another reason I didn't sign up to be an organ donor.
I think if I was in such a condition that I was considered brain dead, and even if my consciousness was really still there but medicine was completely incapable of helping me, I'd rather be dead.
Some of his facts may have no standing, but his point is valid.
Maybe doctors should do some more studies in this type of stuff.
[QUOTE=AceOfDivine;35110802]If you have no control over your body, why live? I'd rather get killed than live in a mind prison.[/QUOTE]
So are you seriously saying you'd rather feel doctors cut you open and extract your organs - without anesthetic - before dying instead of living in a mind prison? At any rate, doctors should at least let the body actually die before taking the organs out. In all honesty, this is only a way for doctors to get organs at peak freshness, and it really pisses me off to think about it.
I really don't like the idea of the body 'reacting' to organ removal after brain death - it could suggest the donor is still feeling pain. They should, at the very least, anesthetize the donor before removal.
That said, there are an awful lot of complications caused by anesthetics in surgery.
If a doctor thinks you've got no real change of recovery and you're brain-dead, then I'm not sure I'd disagree with somebody taking my spare parts.
[QUOTE=Ninja Duck;35110783]No one is getting my organs. My body and casket is going to be shot into space, away from everyone else so I may truly rest in peace.[/QUOTE]Are you some rich millionaire? Because if not I doubt that's going to happen.
Rest in space.
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