Saturday, March 17, 2012

Arguments in the press against deceased organ donation

Dick Teresi, the author of  a new book called The Undead, has been in the recent press. His argument is related to how we determine if a patient is dead enough to be a deceased organ donor,while still having organs that are alive enough to be donated.

In the WSJ: What You Lose When You Sign That Donor Card: Giving away your organs sounds noble, but have doctors blurred the line between life and death?

And in McCleans: Dick Teresi: On the debate over when life really ends, and the possibility cadavers can feel pain 

Even if you think this author is alarmist, if we want to make transplantation more available, we have to understand and address the barriers--informational, psychological, esthetic--to becoming a donor.  That being said, the comments I've heard on this subject from people at organ procurement organizations suggests that Teresi is indeed alarmist, and that people declared brain dead are adequately tested to make sure they are very dead indeed.

Here are my previous posts on deceased donation.

Update: today's WSJ published a letter in reply, which I reproduce in full below (Thanks for the pointer to Zeeshan Butt at Northwestern):

Dick Teresi's "What You Lose When You Sign That Donor Card" (Review, March 10) grossly misinforms the public about both the medical determination of brain death and the organ donation process in the U.S.
First, there has never been a documented case of patient recovery after a properly performed determination of death by neurological criteria. Ever.
Second, the diagnosis of brain death requires extensive neurological examination, irrespective of a patient's organ donor status or the family's support for donation. Electroencephalography is generally no longer used because it's outmoded, not because physicians have something to hide. When donation is an option, the organ recovery agency must verify that all clinical testing has been done and all legal documentation is in the patient's chart.
Organ donation saves lives. Eighteen Americans will die today waiting for a life-saving organ. We hope that Mr. Teresi's misinformed comments do not add to that number.
Tia Powell, M.D.
Director, Montefiore-Einstein Center for Bioethics
Bronx, N.Y
James Zisfein, M.D.
Chief, Division of Neurology
Lincoln Medical Center
Bronx, N.Y.
Helen Irving
President and CEO
New York Organ Donor Network


Anonymous said...

"...there has never been a documented case of patient recovery after a properly performed determination of death by neurological criteria."

Wouldn't it be nice if we could rely on medical procedures always being "properly performed"?

Unknown said...

I sincerely appreciate the critique of Teresi's article in the Wall Street Journal. I am an estate planning attorney and, having read Teresi's article, thought that perhaps I should make some changes to my Advance Health Care Directive (with living Will provisions) template. The additional perspective is most helpful.