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Showing posts with label Cardiac dead. Show all posts
Showing posts with label Cardiac dead. Show all posts

Wednesday, October 29, 2008

When Is The Moment Of Death?

Imagine being a transplant surgeon. You can't tell the parents of a dying kid when to pull the plug, but you have to be there, ready, the minute he expires. You have to wait until he's dead, but not so long that his organs become useless. You can give him drugs to keep his organs healthy, but you mustn't technically revive him. And you can't remove and restart his heart until it's been declared kaput. I was reading this article in the New England Journal of Medicine. In the journal, doctors at Children Hospital in Denver describe how they removed hearts from infants 75 seconds after they stopped. The infants were declared dead of heart failure, even as their hearts, in new bodies, resumed ticking. My question is who determines who's dead? Is it sinful man are a Holy God? Who is the Creator of all man kind? I think this is so wrong.

We like to think that moral lines are fixed and are clear but are they? "Dead" means irreversibly stopped, and no longer active or functioning. Are we the people redefining death? First we coined "brain death," which let us take organs from people on ventilators. Then we proposed organ retrieval even if non-conscious brain functions persisted. Now we have "donation after cardiac death," the rule applied in Denver, which permits harvesting based on heart, rather than brain, stoppage. When is the moment of death? So how can death be declared based on irreversible heart stoppage when the plan is to restart that heart in a new body?

The Dr. offers two answers. First, even if the heart resumes pumping in a new body, it couldn't have done so in the old one. (That used to be true, but today, hearts can be restarted by external stimulation well after two or even five minutes.) Second, the Dr.says the heart is dead because the baby's parents have decided not to permit resuscitation. What if the parents are not given all the facts? In other words, what if the parents think dead mean dead but the Dr. has a different definition of dead? You see were I am going with this? So who is deciding who's dead? The Dr. should tell parents there's more to it than resuscitate. Also at what point can organs be harvested is it Brain death? Cardiac death? or Persistent vegetative state? Who Determines?