A ghoulish scenario unfolds in Canada

Canadian baby doesn't get heart transplant

Kaylee Wallace, 2 months old, has Joubert syndrome, which is a congenital brain malformation.

Kaylee's parents met the parents of a sick child, baby Lillian, who is on the list for a heart transplant because she has truncus arteriosus. Having been told there was no hope for Kaylee, Kaylee's parents decided to withdraw her vent support so Lillian could have her heart.

But Kaylee only needs breathing support when she's asleep and to everyone's disappointment, she stayed awake during the one-hour window in the operating room and the surgery was called off, [her father, Jason] Wallace said. .... Wallace said he'd fight to give the surgery another chance and hopefully Kaylee would fall asleep on the second try so the transplant could go ahead.

This is where organ transplantation has taken us -- the the point where a loving father's first reaction on hearing that his child wasn't so sick after all was to be crushed with disappointment.

Is this really a road we want to travel?

Prayers for both these children -- that a better alternative can be found for baby Lillian -- such as surgically correcting the heart defect, and that the doctors who gave Kaylee such a grim prognosis that she was fit for nothing but spare parts will be proved wrong. And let's pray that we turn away from this transplant culture, where we're putting patients and their families onto a ghoulish waiting list where they're disappointed when a child doesn't die.

Read this excellent blog post from Not Dead Yet.

More:

Little Kaylee's fate unclear

Baby Kaylee's parents hope to bring her home

Ill baby shocks parents by breathing without support

Baby Kaylee's parents told she's stable but might still die

Search: Dr. Cicero Coimbra

I mentioned Dr. Coimbra in a post about KOA, 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.

In 1968, the "Harvard criteria" for determining brain death were published in the Journal of the American Medical Association, under the title "A Definition of Irreversible Coma." The article was published without substantiating data. A conference was held in Rome reviewing the "Harvard criteria" and finding the criteria scientifically invalid.

From the KOA site:

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.

See also: Just how dead does an organ donor have to be?

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.