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New York - NY Times In-Depth Report On Organ Donation: When Does Death Start?

Published on:   Dec 20, 2009 at 02:21 PM
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New York - Organ transplantation must abide by the so-called dead-donor rule: a person has to be declared dead before any vital organs can be removed. Yet organs have to be alive if there is any hope of successful transfer to a recipient. Medical professionals have handled this paradoxical situation — finding a dead body with live organs — by fashioning a category of people with beating hearts who are said to be brain-dead, usually after a traumatic head injury, and who are considered just as dead as if they had rigor mortis.

To diagnose brain death, doctors typically go through a checklist of about a dozen items, including assessing reflexes like blinking, coughing and breathing, which are all controlled by the brainstem. The criteria are extremely strict, and only a tiny fraction of severely brain-injured people meet them.

D.C.D. requires doctors to confront the shadowy question of exactly when somebody dies after the heart stops. To authorize D.C.D., doctors must follow a strict procedure.

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Read the full story at The NY Times Magazine 

The reporter is Darshak Sanghavi, the chief of pediatric cardiology at the University of Massachusetts Medical School.


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1

 Dec 20, 2009 at 02:43 PM Anonymous Says:

After reading this ,it is obvious that some doctors have arbitrarily decided on therir own rules about killing people in order to harvest their organs . Torah believing people can not rely on these types of arbitrary rules . It is clear that you can not kill even one 100 year old very sick ;person in order to save many younger people .

2

 Dec 20, 2009 at 05:26 PM Lawyer Says:

This article is absolutely chilling. Turns out that even with the new definition of "brain death" in most cases they cannot harvest the organs in a usable way. So now they need a new definition -- not dead, but dying.

Read the story of the girl who was killed in an accident and whose death was hurried up so they could harvest her organs. Absolutely chilling. I keep replaying a scene in my mind. When R. Aharon Soloveichik zt"l was still alive, one of his talmidim once asked him why he was so outspoken about brain death when there were so many other issues facing the Jewish community. He answered: "Because they are mattir retzichah!"

"Brave New World" is here. Those of us who adhere to the Torah are going to be put in more and more difficult situations.

3

 Dec 20, 2009 at 05:51 PM Anonymous Says:

Even if you hold by brain death, this is frightening. There are no two ways about it- read the whole article it's mamesh retzicha!

4

 Dec 20, 2009 at 06:10 PM Raphael Kaufman Says:

Reply to #2  
Lawyer Says:

This article is absolutely chilling. Turns out that even with the new definition of "brain death" in most cases they cannot harvest the organs in a usable way. So now they need a new definition -- not dead, but dying.

Read the story of the girl who was killed in an accident and whose death was hurried up so they could harvest her organs. Absolutely chilling. I keep replaying a scene in my mind. When R. Aharon Soloveichik zt"l was still alive, one of his talmidim once asked him why he was so outspoken about brain death when there were so many other issues facing the Jewish community. He answered: "Because they are mattir retzichah!"

"Brave New World" is here. Those of us who adhere to the Torah are going to be put in more and more difficult situations.

In the case of the poor girl in the story, they apparently engineered, not "brain death", but "halachic" death per rov poskim. Of course they had to kill her to do it. If brain death were the recognized criterion, the girl would not have had her organs "harvested" since she was not, in fact, brain dead. What the doctors did was remove her life support (assur) and wait for cessation of heart beat (halachic death per most poskim). In most cases, a person can survive up to ten minutes without a heartbeat before irreversable brain damage occurs. In the usual case of cardiac arrest they attempt to restart the heart in the short window of opportunity In this case let her heart stop long enough to be sure that it would not spontaeously restart and then harvested it.

5

 Dec 20, 2009 at 06:17 PM Raphael Kaufman Says:

Reply to #2  
Lawyer Says:

This article is absolutely chilling. Turns out that even with the new definition of "brain death" in most cases they cannot harvest the organs in a usable way. So now they need a new definition -- not dead, but dying.

Read the story of the girl who was killed in an accident and whose death was hurried up so they could harvest her organs. Absolutely chilling. I keep replaying a scene in my mind. When R. Aharon Soloveichik zt"l was still alive, one of his talmidim once asked him why he was so outspoken about brain death when there were so many other issues facing the Jewish community. He answered: "Because they are mattir retzichah!"

"Brave New World" is here. Those of us who adhere to the Torah are going to be put in more and more difficult situations.

According to rov poskim what, in fact, is the halachic status of someone in cardiac arrest? Is he dead? What happens when he is resuscitated? Or how about someone undergoing heart surgery? His heartbeat and breathing are stopped for, perhaps, more than an hour while the surgery is performed and the heart-lung machine keeps his blood oxigenated and circulating. Is he halachically dead? If not, why not?

6

 Dec 20, 2009 at 09:08 PM Anonymous Says:

Its ironic that the same people that are so against the death penalty because of an almost nonexistent chance that you "might kill an innocent person" are the first ones who condone organ harvesting even though they admit that brain activity is not a perfect science. Our sages said it 2000 ears ago " kol amrachim al hachzorim sof lihachzir al harachmim'

7

 Dec 21, 2009 at 02:22 AM Bugsy Siegel Says:

I read the article. Thing is this girl died on her own after being removed from a ventilator. Her heart stopped beating at the time of transplant, therefore she fulfilled the criteria of ALL poskim that she was deceased. Some poskim say brain death is enough, others says only cardiac death. (she fulfilled both criteria at time of transplant.) The only question is whether the doctors did wrong by removing her from the ventilator. I think not. (Now I am no posek so I may be wrong, I would like to hear what you think.) Since, the ventilator was actively keeping her alive, once it was removed, it let her continue the process of dying. I am not sure if one is allowed to turn off the ventilator of a dying person. After all, it does hasten the death, yes, but the ventilator was put in before and was delaying the death.
Alternatively, a possible workaround to this issue of hastening death (in this case), if it is against halacha, is to put a timer on the ventilator? I believe that would be ok according to poskim?

8

 Dec 21, 2009 at 11:04 AM Anonymous Says:

I'm sure all you bashers will take a kidney in a heartbeat.

9

 Dec 21, 2009 at 11:25 AM Anonymous Says:

I want to just quote the full article to showhowtruly frightening it is.

"To diagnose brain death, doctors typically go through a checklist of about a dozen items" typically, not always.

"The procedure to diagnose brain death, however, was never codified into law, and as a result, it varies from hospital to hospital." there is no consistant standard.

"Last year, in the journal Pediatrics, researchers from Loma Linda University reported that of 277 brain-dead children in California who were referred to the regional organ bank over many years, only a single child received the full set of diagnostic tests." no further comment required

"Such sloppiness is potentially tragic, but it is also exceedingly rare." this just shortly after the previous quote. 276 of 277 is exceedinly rare.


In response to #8, I would gladly accept a donated kidney, I woould not kill for it.

10

 Dec 22, 2009 at 08:53 AM Anonymous Says:

When my cousin was on a ventilator, The DOCTORS told me my cousin's lungs were "beyond repair" with "days to live"

The DOCTORS said "let's make it comfortable for him"

Doctor, is there a chance his lungs will recover and heal? "No."

HERR DUKTOR: He is now, Boruch Hashem, off the ventilator. Do not pretend to be G-d.

"brain dead" "lung dead" = very much alive!! Fight for life to the last minute.

11

 Dec 23, 2009 at 07:52 AM matzahlocal101 Says:

Simple definition of when death begins:

Immediately after a major organ is removed.

12

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