Showing posts with label euthanasia. Show all posts
Showing posts with label euthanasia. Show all posts

Saturday, February 23, 2008

Before their time

Organs harvested before their time

Brain death is defined as "irreversible coma with absent brainstem reflexes (such as reactions of the pupils to light and other 'automatic' reflexes)."

Yet, "irreversible" implies that doctors can predict the future of a patient in coma; but medical science hasn't reached this degree of perfection. In newspapers as well as in medical books and journals, I've read about many patients who seemed to be in a permanent coma but who then woke up days, months, or even years after doctors incorrectly make the diagnosis of irreversible coma.

Likewise, "absent brainstem reflexes" simply means that the brainstem isn't working properly and generating electrical impulses. But this can be due to what I would call "sleeping" brain cells. Damage to the cells (for example, from lack of oxygen or nutrients) can make them temporarily too weak to generate nerve impulses or EEG signals. With reversal of the damaging condition, the brain cells often heal and resume normal function.

....

Other diagnostic factors such as "low body temperature (hypothermia), sedative or paralytic medicines, or the presence of severe metabolic disorders . . . might confuse the diagnosis of brain death." according to Doctors Steven Laureys and Joseph J. Fins....

....

In an internet report ... neurologist Lawrence Huntoon, M.D., Ph.D., editor-in-chief of the "Journal of American Physicians and Surgeons" writes, "In plain, straight talk, the survey indicates a high likelihood that some patients are being 'harvested' in some hospitals before they are dead! In hospitals with aggressive transplant programs (hospitals make a huge amount of money on transplant cases), making sure a patient is dead before going to the 'harvesting suite' may be viewed as a minor technicality" (http://www.aapsonline.org/newsoftheday/0010 "Top hospitals typically disregard brain-death guidelines").

....

It's a very good idea to designate an agent for healthcare, to make decisions on your behalf when you're unconscious or aren't able to do so yourself. The International Task Force on Euthanasia and Assisted Suicide (ITF) http://www.internationaltaskforce.org/ has very lucid Advanced Health Care Directive language adapted the meet the requirements of different states.

No law or person should demand the life of an innocent person, under any pretext. Whether a person is unborn, disabled or extremely ill, I believe life is sacred and is our most fundamental right.

Friday, February 01, 2008

Typical: State backs mom who wants daughter dead, father desperate

Life for Lauren

Due to a brain injury at age 23, Lauren Richardson is in what her doctors are calling a "vegetative state". She was pregnant at the time of injury. She gave birth a year ago, while on a respirator. Now she needs only a feeding tube and is no longer vent-dependent. Nevertheless, her mom wants her Schiavoed, and her dad wants her to live. Guess who the State is siding with.

The one who wants her dead, naturally. That's the motto when dealing with the weak, defenseless, and vulnerable. "Kill 'em all and let God sort 'em out."

More on this story:

  • Lauren Richardson
  • Pray for Lauren Richardson, Being Starved to Death in Delaware
  • Do not remove Lauren's feeding tube
  • Parents battle over life of brain-damaged daughter
  • Monday, October 15, 2007

    "Back off! I'm not dead yet!"

    Read this wonderful op-ed in the Washington Post. It's pithy and full of good sense. Not to metion good humor:

    I found something weasely in the way all those options were presented, as though my only real choice were between being dispatched into the hereafter at the first sign of loss of consciousness or being stuck with as many tubes as needles in a voodoo doll and imprisoned inside a ventilator until global warming melts the ice caps and the hospital washes out to sea.


    HT: The Point

    Monday, July 16, 2007

    On "brain death"

    KAO is an organization of parents who found out what happens to "brain dead" transplant donors only after they had signed consent for their children's organs to be harvested. Below are some excerpts from their web site.

    Background

    In 1968 the "Harvard criteria" for determining brain death were published in the Journal of the American Medical Association, under the title of "A Definition of Irreversible Coma." This article was published without substantiating data, either from scientific research or from case studies of individual patients. For this reason, a majority of the presenters at the conference in Rome stated that the "Harvard criteria" were scientifically invalid.

    In 2002 the results of a worldwide survey were published in Neurology, concluding that the use of the term "brain death" worldwide is "an accepted fact but there was no global consensus on the diagnostic criteria" and there are still "unresolved issues worldwide."

    ....

    Philosophical considerations

    ....

    As he put it: Scrutinizing the existence of the symptoms of death as perceived by common sense, science no longer presupposes the "normal" understanding of life and death. It in fact invalidates normal human perception by declaring human beings dead who are still perceived as living.

    The new approach to defining death, the German scholar continued, reflected a different set of priorities:

    It was no longer the interest of the dying to avoid being declared dead prematurely, but other people’s interest in declaring a dying person dead as soon as possible.

    Two reasons are given for this third party interest:

  • guaranteeing legal immunity for discontinuing life-prolonging measures that would constitute a financial and personal burden for family members and society alike, and

  • collecting vital organs for the purpose of saving the lives of other human beings through transplantation. These two interests are not the patient’s interests, since they aim at eliminating him as a subject of his own interests as soon as possible.

    The arguments against the use of "brain death" as a determination of death are being made, Spaemann noted, "not only by philosophers, and, especially in my country, by leading jurists, but also by medical scientists." He quoted the words of a German anesthesiologist who wrote, "Brain-dead people are not dead, but dying."

    Medical evidence

    Dr. Paul Byrne, a neonatologist from Toledo, Ohio, offered a medical perspective - he testified:

    When organs are removed from a "brain dead" donor, all the vital signs of the "donors" are still present prior to the harvesting of organs, such as: normal body temperature and blood pressure; the heart is beating; vital organs, like the liver and kidneys, are functioning; and the donor is breathing with the help of a ventilator.


    ....

    Defending the criteria

    Some participants in the February meeting defended the use of the "brain death" criteria. Dr. Stewart Youngner of Case Western University in Ohio admitted that "brain dead" donors are alive, but argued that this should not prove an impediment to the harvesting of their organs. His reasoning was that there is such poor "quality of life" in the "brain dead" patient that it would be more beneficial to harvest their organs to extend the life of another than to continue the life of the organ donor.

    Dr. Conrado Estol, a neurologist from Buenos Aires, explained the steps that should be followed in determining the "brain death" of a prospective organ donor. Dr. Estol, who is strongly in favor of harvesting human organs to extend the life of other patients, presented a dramatic video of a person diagnosed as "brain dead" who attempted to sit up and cross his arms, although Dr. Estol assured the audience that the donor was a cadaver. This produced an unsettling response among many participants at the conference.

    ....

    The apnea test

    In his presentation at the conference, Dr. Cicero Coimbra, a clinical neurologist from the Federal University of Sao Paolo, Brazil denounced the cruelty of the apnea test, in which mechanical respiratory support is withdrawn from the patient for up to 10 minutes, to determine whether he will begin breathing independently. This is part of the procedure before declaring a brain-injured patient "brain dead." Dr. Coimbra explained that this test significantly impairs the possible recovery of a brain-injured patient, and can even cause the death of the patients.

    He argued:

    A large number of brain-injured patients, even in deep coma, can recover to lead a normal daily life; their nervous tissue may be only silent, not irreversibly damaged, as a consequence of a partial reduction of the blood supply to the brain. (This phenomenon, called "ischemic penumbra," was not known when the first neurological criteria for brain death were established 37 years ago.) However, the apnea test (considered the most important step for the diagnosis of "brain death" or brain-stem death) may induce irreversible intra-cranial circulatory collapse or even cardiac arrest, thereby preventing neurological recovery.

    During the apnea test, the patients are prevented from expelling carbon dioxide (CO2), which becomes a poison to the heart as the blood CO2 concentration rises.

    As a consequence of this procedure, the blood pressure drops, and the blood supply to the brain irreversibly ceases, thereby causing rather than diagnosing irreversible brain damage; by reducing the blood pressure, the "test" further reduces the blood supply to the respiratory centers in the brain, thereby preventing the patient from breathing during this procedure. (By breathing, the patient would demonstrate that he is alive.)

    Irreversible cardiac arrest (death), cardiac arrhythmias, myocardial infarction, and other life-threatening detrimental effects may also occur during the apnea test. Therefore, irreversible brain damage may occur during and before the end of the diagnostic procedures for “brain death.”


    Dr. Coimbra concluded by saying that the apnea test should be considered unethical and declared illegal as an inhumane medical procedure. If family members were informed of the brutality and risk of the procedure, he stated, most of them would deny permission. He pointed out that when a heart attack patient is admitted to the emergency room he is never subjected to a stress test in order to verify that he is suffering from heart failure. Instead the patient is given special care and protection from further stress to the heart.

    In contrast when a brain-injured patient is subjected to the apnea test, further stress is placed on the organ that has already been injured, and additional damage can endanger the patient’s life. Dr. Yoshio Watanabe a cardiologist from Nagoya, Japan, concurred, saying that if patients were not subjected to the apnea test, they could have a 60 percent chance of recovery to normal life if treated with timely therapeutic hypothermia.

    The question of a brain-injured patient's possible recovery also concerned Dr. David Hill, a British anesthetist and lecturer at Cambridge. He observed: "It should be emphasized first that it was widely admitted, that some functions, or at least some activity, in the brain may still persist; and second that the only purpose served by declaring a patient to be dead rather than dying, is to obtain viable organs for transplantation." The use of these criteria, he concluded, "could in no way be interpreted as a benefit to the dying patient, but only (contrary to Hippocratic principles) a potential benefit to the recipient of that patient’s organs."

    "The deception"

    Dr. Hill recalled that the earliest attempts at transplanting vital organs often failed because the organs, taken from cadavers, did not recover from the period of ischemia following the donor's death. The adoption of brain-death criteria solved that problem, he reported, "by allowing the removal of vital organs before life support was turned off - without the legal consequences that might otherwise have attended the practice."

    While it is remarkable that the public has accepted these new criteria, Dr. Hill remarked, he attributed that acceptance in large part to the favorable publicity for organ transplants, and in part to public ignorance about the procedures. "It is not generally realized," he said, "that life support is not withdrawn before organs are taken; nor that some form of anaesthesia is needed to control the donor whilst the operation is performed." As knowledge of the procedure increases, he observed, it is not surprising that - as reported in a 2004 British study - "the refusal rate by relatives for organ removal has risen from 30 percent in 1992 to 44 percent." Dr. Hill also suggested that when relatives see with their own eyes the evidence that a potential organ donor is still alive, they harbor enough doubts so that they are not ready to consent to the organ removal.

    In the United Kingdom, Dr. Hill reported, there is mounting pressure for individuals to sign, and always carry with them, donor cards authorizing doctors to use their vital organs. Today only about 19 percent of the country's people have registered as organ donors, but vehicle-registration forms, driver's-license applications, and other public documents provide "tick boxes" allowing citizens to give this advance directive; even children are encouraged to sign. All such documents specify that organs may be harvested only "after my death," but there is no definition of what constitutes "death."

    Again, Dr. Hill remarked, the acceptance of transplants hangs on the public's lack of understanding about the procedure. And yet, he pointed out, "For any other procedure, informed consent is required, but for this most final of operations no explanation nor counter-signature is required, nor is the opportunity given to discuss the question of anaesthesia."

    ....

    The Signs of Death

    ....

    Many in the medical and scientific community maintain that brain-related criteria for death are sufficient to generate moral certitude of death itself. Ongoing medical and scientific evidence contradicts this assumption. Neurological criteria alone are not sufficient to generate moral certitude of death itself, and are absolutely incapable of generating physical certainty that death has occurred.

    It is now patently evident that there is no single socalled neurological criterion commonly held by the international scientific community to determine certain death. Rather, many different sets of neurological criteria are used without global consensus.

    Neurological criteria are not sufficient for declaration of death when an intact cardio-respiratory system is functioning. These neurological criteria test for the absence of some specific brain reflexes. Functions of the brain not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient on a ventilation machine is declared "brain dead," these functions not only are present but also are frequently active.

    The apnea test - the removal of respiratory support - is mandated as a part of the neurological diagnosis and it is paradoxically applied to ensure irreversibility. This significantly impairs outcome, or even causes death, in patients with severe brain injury.

    There is overwhelming medical and scientific evidence that the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem) is not proof of death. The complete cessation of brain activity cannot be adequately assessed. Irreversibility is a prognosis, not a medically observable fact. We now successfully treat many patients who in the recent past were considered hopeless.

    ....
  • Thursday, June 28, 2007

    His lawyer will be talking to her lawyer....

    Wife: He's dead. Yank his feeding tube and stop giving him water.

    Husband: I'm not dead yet.

    Wife: Hi, Honey! No hard feelings, right?

    Injured man's awakening called 'miracle'

    Monday, March 19, 2007

    TX mom fighting for son's life -- against DOCTORS!

    Toddler Forced Off Life Support - Help Needed

    A 16-month old Texas boy, who appears to have a somewhat treatable metabolic disorder (he could live 6 - 8 years, with current life expectancies, if treated) is being denied care and taken off the respirator by doctors who, against the mothers' wishes, just think it would be better if the child died.

    Emilio Gonzales is fighting for his life, his mother is fighting for his life.

    We have been in touch with the Bishop of the Austin Diocese--Bishop Aymond--who you would THINK would stick up for the life of this little child, but who instead supports killing little Emilio Gonzales. I guess if you're on Medicaid, your life just isn't as worthwhile as it would be if you had good insurance. Bishop Aymond's number is: 512-476-4888. Please call him and if you can't get him on the phone, leave a message, letting him know how you feel about the Catholic Church's approval of the murder of this small child. Keep in mind: This is a CATHOLIC-owned hospital! The head of the Catholic Conference of Bishops is Andrew Rivas. His phone number is: 512-339-9882; please call him and let him know how you feel about this issue.

    Please, also get in touch with Brackenridge Children's Hospital, in Austin, TX. Their number is: 512-324-8000. Let them know how you feel about their murdering Emilio Gonzales. Maybe if they get enough calls through their switchboard, they might change their mind about killing this little boy.

    You may also contact the physician's group (Pediatric Physicians Alliance of Central Texas) that is handling Emilio's treatment, composed of several doctors who have actively campaigned to have this child's treatment withdrawn at: 512-324-8009.

    Please post these numbers on any blog or website you can think of and help this mother stop the hospital from killing her little boy!


    And I don't have a phone!!!! However, I'm spreading the word as best I can. Pass it on