The truth about organ donation

This has to be one of the most intellectually backwards arguments I have ever heard. It is almost on par with arguments presented by christian fundamentalists.

Being brain-dead is essentially being dead. Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Being brain-dead, it is also very unlikely that you feel pain. Reflexes can easily still be active even with brain-death, leading to convulsions during surgery. If the author had ever seen a serious car-accident victim in a coma, he wouldn't have second thoughts about organ donation. In his blog post, he is insinuating that you are still a normal, living, conscious human being. You aren't.

Having grown up in a family of medical doctors, I find this blog post appalling.

EDIT: As thebigshane pointed out, my wording is indeed terrible, I wrote my response in a hurry, and I will not edit it to avoid confusion. I do not have any professional medical education, all I know in this field is derived from in-depth conversations and discussions with my parents, whom are both medical doctors. Brain death is indeed classified by the Harvard criteria, but these also include the patient being non-responsive to external stimuli, such as pain (which contradicts the blog post's claim of convulsions during surgery due to the lack of anesthesia).

My wife is an operating room nurse. She sometimes participates in organ transplants. She tells me that there is an anesthesiologist present and giving anesthesia drugs, contradicting the article. The way she describes it they open you up and cut your abdominal aorta, at which point the anesthesiologist leaves the room because you are fully dead. Then they harvest organs and tissues as fast as they can. The people being harvested are clearly, permanently beyond help. The harvests are scheduled to coincide with major surgeries for the recipients. They usually take place in the very early morning as preparation for the transplant later that day.

If I am on a respirator, and will be for the rest of my life, go ahead and harvest me.

I disagree with the conclusion and implications of this article. I also dislike how it implies that organ harvesting doctors have evil motives without coming out and saying it. The factual error that I saw, just as a husband of a transplant worker, also detract from the validity of the article.

This article is terribly manipulative. If there are valid points to be made here, I'm not going to be convinced by an essay that is full of phrases like "an ivory tower decision made by a bunch of men playing God at Harvard". The cited sources are either questionable (as in the website with the statue depicting crucifiction dominating the banner) or do not support the author's conclusions (as in the NEJM article).

The bottom line is still that many lives are saved by organ donors. From a moral point of view it's also pretty clear cut. If you want to accept an organ when you fall ill then you should also be willing to donate your organs.

The concept of organ donation is a little freaky, and the idea admittedly makes me a bit uncomfortable. Especially as I visualize it. But surely selfishly hanging on to something I don't need anymore (being dead and all) isn't the right solution.

I think this article is essentially some elaborate rationalization. The author can't reconcile being against organ donation knowing it saves lives. Hence the absurd stuff about doctors cackling evilly as they chop up their live patients to harvest the organs for fun and profit. Right.

Anesthesia is always used during organ harvests. Anesthesiologists treat the donor just as they would any other patient undergoing surgery. This account by a Georgia anesthesiologist rebuts many of the points made by the article, and does so much better than I would do.

http://theunderweardrawer.blogspot.com/2012/03/death-or-some...

In my opinion this takes an ethical grey area that a very small number of donors would fall into, blows it up, and pretends nothing else exists.

Pain in brain death? Ascending pathways still work but your brain lacks the capacity to feel it. Heart rate spike? Autonomic nervous system releases adrenaline, again, automatic; a physiological reaction.

Is the authour hoping that this will lead to a change in brain death definitions? Is he suggesting that the donor is capable of recovery, of a mormal life given time and our modern miracles? Not going to happen.

If this blog is influential enough to lead to people declining organ donation, or withdrawing from the registry, then I believe he is responsible for the impaired lives of potential recipients

And yes, I read the articles.

Oh gosh. For every one of the 'miracles' of full recovery from brain death, there are thousands more about people being kept alive waiting for a miracle.

It disgusts me how okay people are with mechanical respirators, TPN feeds, and the like even when there is a <.01% chance of recovery. The family says 'do everything you can.' We don't want to pull the plug, we are playing God if we decide if someone lives or dies. Except we already are playing God. This is a person that left alone to God (sans medicine) would be dead! We simple can keep a brain dead person alive indefinitely and essentially take away their option for death.

As far as heart rate spiking when organ donation operations are performed? You do know this happens during normal operations. Pain medication is given not to help control your pain, but to help control this reflex. In a normal operation pain meds are technically necessary as when you are under the gas your body either doesn't experience or doesn't remember pain. The actual mechanism of action for anesthetic gas is not fully understood. My point is the pian medication is not given for the brain.

yes organ donation can be shady, but that doesn't necessitate boycott.

I'm not an organ donor mostly because I think that some Doctor somewhere might give me up for dead since there are 3 people waiting for organs even though there is a slim chance I will live. That might not even be a bad decision on the part of the doctor (1 cripple vs 3 healthy people) but I don't want him to make that choice for me. If I'm alive and explained the situation for myself there is a good chance I would say "sure go for it, I'll be a brain dead cripple anyways" but I don't want that choice taken from me and given to some doctor with a few seconds to make a decision while he holds a knife over my still breathing body.

There are quite a lot of misguided statements in this article, like you are "alive" because your heart is beating, or you feel pain if they don't give you pain killers. You should be "brain dead" to be an organ donor. And brain dead means dead, no chance or recovery, I am sure there are cases that mistakes happen but that is a mistake, you need to be confirmed brain dead by quite a lot of doctors to get harvested!

"Deeper still one finds the profit motive behind the organ donation scam."

The author suggests that misinformation and a philosophical problem is to blame. This is the premise of the article. Then he writes a statement like this. For his assertion he needs to find proof that there's a deliberate campaign to mislead the public.

The author offers nothing of the sort in his citations. His inference is lazy and sensationalist, even before getting into whether his premise is actually true.

I worry this may be little too politicly provocative for HN, it liable to start an argument between two very passionate sides. (http://ycombinator.com/newsguidelines.html)

Does anyone have a link to a none biased look at the science of this? I would like to know a little more.

Let's not gloss over the fact that the sole purpose of organ transplants is to save lives. I have a hard time believing his argument about financial motivation for organ donation - a surgeon's salary should preclude the temptation of "making a quick buck" through questionable organ transplant practices.

On the other hand, I absolutely think that potential donors need to give INFORMED consent when they fill out their donor card - whether advised by a medical professional or with their own research. Obviously, no one should ever be coerced or manipulated into consenting based on false pretenses. I'm aware that I will still be "alive" - at least physiologically - at the time an organ is harvested, but I trust that my family can make the right decision if I'm unconscious, and I'd prefer to have a shot at saving someone's life when I'm on my way out.

Not that I agree with this, but a book written on the subject recently was a fascinating read - "The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers--How Medicine Is Blurring the Line Between Life and Death by" Dick Teresi. Check out this NPR story about it too: http://www.npr.org/2012/03/19/148296627/blurring-the-line-be...

What a brave author. I have to commend their duty to publish this, since there is a good chance it will be quite unpopular. There's been such a homogeneity to Internet published articles recently (whichever factor you wish to interpret, if you agree with this claim). It was refreshing to read someone's perspective on this touchy subject from a completely different perspective. Bravo, author.