… The truth behind organ donation & organ transplants
By Michael Potts, head, Philosophy and Religion Department, Methodist College, Fayetteville, NC
(From British Medical Journal (BMJ 2002;325:598, 14 September 2002)
The fear of being declared dead while still alive, in the case of “brain dead”patients, is a fear with a basis in reason.¹ If such patients are not dead, they certainly will be after unpaired vital organs are removed for transplantation. Rather than being “settled,” the acceptability of criteria for brain death is the subject of intense international debate.
As early as 1974, the philosopher Hans Jonas wrote in opposition to brain death criteria² ; a lengthy article by Byrne et al followed nine years later (reprinted in an anthology by Potts et al³). More recently, the neurologist Alan Shewmon reversed his previous support for brain death criteria.4 …
There are many reasons for this growing opposition. …
This debate should raise serious doubts concerning whether brain dead people are dead and lead to a rethinking of the entire enterprise of removing vital organs from such patients. A fundamental goal of medicine is to do no harm (non-maleficence). Any action that directly causes the death of a patient, even if it is for the good of others, opposes the goal of medicine not to harm that individual patient. Any attempt to downplay the importance of the brain death debate in the interests of organ transplantation is therefore fundamentally wrong. It is precisely whether transplantation kills the donor that is the key issue that cuts to the heart of the goals of medicine.
1. Editor’s choice. Deep fears. BMJ 2002;324(7348). (8 June.)
2. Jonas H. Against the stream. In: Philosophical essays: from ancient creed to technological man. Englewood Cliffs, NJ: Prentice-Hall, 1974.
3. Potts M, Byrne PA, Nilges RG, eds. Beyond brain death: the case against brain based criteria for human death. Dordrecht: Kluwer, 2000.
4. Shewmon DA. “Brain stem death,” “brain death”and death: a critical reevaluation of the purported evidence. Issues Law Med 1998; 14: 125-145[Medline].
5. Coimbra CG. Implications of ischemic penumbra for the diagnosis of brain death. Braz J Med Bio Res 1999; 32: 1479-1487.