Op-ed: Donor Organs Are Too Rare. We Need a New Definition of Death
nytimes.com
nytimes.com
While an argument certainly could be made that the permanently comatose on life support should be considered dead, the logic that this change should be made to increase the supply of organs available for transplant fundamentally taints it.
From a more pragmatic standpoint, the authors don't seem to consider that this could predictably lead to a decrease in organ donors as people don't want to risk being prematurely declared dead so that their organs can be harvested. It does not matter that such premature declarations are rare, and would not occur if everything were done correctly, people don't want to bet their life on everything being done correctly.
Further, the procedure is currently done on willing donors. The law may not currently have a good way to handle pumping blood through someone who has already been pronounce dead, but it doesn't seem like that big a deal. The important thing is they are still considered alive until the life support is removed, and retain their rights as a living being. If a person is declared dead while still on life support, that could mean there is an extended period of time where someone who is culturally and functionally a living patient, who would normally have decisions made by power of attorney, is treated as a corpse and handled by the executor. Maybe those people would be one in the same, but there are plenty of good reasons why someone might choose different people for the roles.
I don't see enough benefits to justify the costs of implementation even if there were no ethical concerns.
In relation to TFA: normothermic regional perfusion and ECMO seem like basically the same medical technology being performed on the bodies of people who only differ in legal status.
I'm no medical expert, but Claude tells me "About 32-40% of ECMO patients survive to hospital discharge, with 1-year survival around 32-33%," but also notes that "Among those who make it past the critical first 30 days, 5-year survival rates improve significantly to 71-73%."
It is sobering to consider that potentially a third of the population who could be eligible for involuntary organ donation without their informed consent (what's being proposed) might otherwise reach a point of sufficient capacity to be discharged from the hospital, and a further third of those may go on to live for a year, with rapidly improving outcomes past the 30 day mark.