are you an Organ Donor?? You might want to think twice...

[rudywoofs (Pam)]

Based on this article, I'm going to remove the "Organ Donor" designation from my Driver's License. It won't eliminate the possibility that I *could* be an organ donor, but it **will** allow for the testing to make certain that I am really dead, i.e., no EEG waves present. And, PLEASE! Use anesthetic!!!

Quote:

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."

[phkrause]

Hmmmm very interesting.

[LifeHiscost]

Hmmmm very interesting.

The advanced directive places some of that in greater clarity, and even if they make a mistake somewhat before time to check out, it just means I'll get a little longer sleep before the call from the Lifegiver. He's made it clear where He wants me to be eventually and I agree fully with Him.

"But you belong to God, my dear children. You have already won a victory over those people, because the Spirit who lives in you is greater than the spirit who lives in the world."1 John 4:4 NLT

God blesses!

[rudywoofs (Pam)]

My point in posting this was the fact that harvesting organs from someone who isn't **completely** brain-dead could potentially be an extremely painful, agonizing process for the donee. If one, as a potential donee, is cool with that, then, by all means, let 'er rip...

I'm not opposed to organ donation in the least. My cousin had a heart transplant over 20 years ago. It's failing him now, but if he makes it to next January, he will be 60 yrs old.

I also worked for one of the first kidney transplant programs in the US back in early '80's. My boss was the person who started up the kidney transplant program at King Faisal Medical Center in Riyadh, Saudi Arabia, at the request of the Saudis. Interestingly, the population there has a very high incidence of kidney failure due to the sand that is commonplace in much of their food. (just your daily "trivia dose")

[Stan]

interesting about the sand..... thinking I should remove that from my diet. :)

[rudywoofs (Pam)]

[LifeHiscost]

All except that big surprise. Just about blew me out of my chair, like this. You know. Curiosity killed the cat but my wife told me satisfaction brought it back.

God blesses!

[Liz]

When my step-neice had her car accident (she wasn't driving she was in the backseat), the doctors kept saying she was brain dead and wanted to harvest her organs. Her mother kept refusing and asking for one more test, just one more. The doctors finally admitted she did have some brain activity but told the family that she would be a vegetable.

Now 13 years later, she works at a supermarket bagging groceries and walking them out to customers' cars. She has no short term memory which has its own challenges, she does have long term memory as she remembers everything up to the accident.

I thought our story was an isolated incident, this article certainly makes me think.

[Nic Samojluk]

rudywoofs wrote:

“Based on this article, I'm going to remove the "Organ Donor" designation from my Driver's License. It won't eliminate the possibility that I *could* be an organ donor, but it **will** allow for the testing to make certain that I am really dead, i.e., no EEG waves present. And, PLEASE! Use anesthetic!!!”

rudywoofs quoted the following:

“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.”

I wish I knew this a year ago when my son was declared brain dead following a massive stroke. The pressure from everybody that his wife should allow for the harvesting of his organs was incredible. I had nothing to say because I was totally ignorant of the higher brain test alternative and totally unprepared for the terrible agony and ordeal.

The tests were performed, and he was disconnected from the machine. Following the tests, he was again connected to the machine. I wish some tests had been done to determine the presence of higher cortex brain activity. I do not think this was done. I wish I had more reassurance that my son was really dead!

Loosing a son is an agonizing experience. How I wish I knew the existence of a higher brain test; had I known, I would have recommended this to my daughter in law who was the legal caretaker of my son. She asked me for advice, and I was silent because of my ignorance.

Thanks, rudywoofs, for sharing this with others. This knowledge came rather late for me, but it may prove to be of great help for others.

[phkrause]

The crazy thing is, this year when getting a license here in Florida for the first time, I signed up to be a donor! I guess I'll have to change that. Greed haunts every part of life.

[Bravus]

I wouldn't change it. I'm a donor and will stay one.

A friend here in Australia has just had an older brother die, much too young, and one of the consolations for the family was the new life that his organs could provide for other people.

Once I'm no longer using my organs, I would far rather that they live in another person than rot in a hole in the ground, or burn up.

I think it's *massively* improbable that there's any real, subjective feeling of pain - but even if there is, so what? You're dead! You won't have to experience it for long, or live with the memory.

If there's greed, it would be in taking organs to the grave that could save lives, not in giving those organs away.

[Naomi]

[rudywoofs (Pam)]

As I wrote, I'm not opposed to organ donation, and taking "organ donor" off of one's driver's license does not preclude one from being an organ donor. However, even if one wishes to be an organ donor, family members still have the option to refuse harvest of a clinically dead loved one's organs.

I think it's *massively* improbable that there's any real, subjective feeling of pain - but even if there is, so what? You're dead! You won't have to experience it for long, or live with the memory.

okay

[Nic Samojluk]

I'm glad I didn't sign the donor card.

[Nic Samojluk]

I have no problem if my organs are transplanted to somebody else to save his/her life after I am truly dead. But the current brain death criteria does not assure me that I am really dead.

There have been documented cases when a supposedly dead person shows sign of life unexpectedly against all odds.

I remember a case related by a student who entered a morgue and noticed that what he believed was a cadaver showed signs of being alive.

Many centuries ago people buried the dead and provided the dead individual with a string to pull on which would ring a bell in the event he woke up from a comatose state. This practice was responsible for the saying: “Saved by the bell.”

There have been many documented cases where the casket had been scratched by the person who had been buried while in a comatose state.

There was a case in Argentina where a man was scared to death when a casket was suddenly opened by the cadaver like person that had been declared to be dead.

The current death criteria was designed with organ transplantation in mind—-not the desire to make sure a person is truly dead!

I have a friend who was in a comatose state for two weeks, and suddenly woke up and asked why he was in a hospital bed. Physicians believed he was brain dead but the family refused o have his organs removed from him.