The last time I renewed my driver’s license, the clerk at the DMV asked if she should check me off as an organ donor. I said no. She looked at me and asked again. I said, “No. Just check the box that says, ‘I am a heartless, selfish person.'”
Becoming an organ donor seems like a win-win situation. Some 3.3 people on the transplant waiting list will have their lives extended by your gift (3.3 is the average yield of solid organs per donor). You’re a hero, and at no real cost, apparently.
But what are you giving up when you check the donor box on your license? Your organs, of course—but much more. You’re also giving up your right to informed consent. Doctors don’t have to tell you or your relatives what they will do to your body during an organ harvest operation because you’ll be dead, with no legal rights.
The most likely donors are victims of head trauma (from, say, a car or motorcycle accident), spontaneous bleeding in the head, or an aneurysm—patients who can be ruled dead based on brain-death criteria. But brain deaths are estimated to be just around 1% of the total. Everyone else dies from failure of the heart, circulation and breathing, which leads the organs to deteriorate quickly.
The current criteria on brain death were set by a Harvard Medical School committee in 1968, at a time when organ transplantation was making great strides. In 1981, the Uniform Determination of Death Act made brain death a legal form of death in all 50 states.
The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what’s called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)
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I like the comment to the clerk. Last time I looked there was freedom of choice without coercion (even unstated) in this country.
THIS IS A MUST READ ARTICLE!! CLICK TO READ THE ENTIRE “WSJ” ARTICLE.
If you ever doubted the Rabbonim when they said ONLY heart-failure is real death, READ THIS FULL ARTICLE.
From the article:
The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what’s called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)
Here’s the weird part. If you fail the apnea test, your respirator is reconnected. You will begin to breathe again, your heart pumping blood, keeping the organs fresh. Doctors like to say that, at this point, the “person” has departed the body. You will now be called a BHC, or beating-heart cadaver.
Still, you will have more in common biologically with a living person than with a person whose heart has stopped. Your vital organs will function, you’ll maintain your body temperature, and your wounds will continue to heal. You can still get bedsores, have heart attacks and get fever from infections.
More:
You might also be emitting brainwaves. Most people are surprised to learn that many people who are declared brain dead are never actually tested for higher-brain activity. The 1968 Harvard committee recommended that doctors use electroencephalography (EEG) to make sure the patient has flat brain waves. Today’s tests concentrate on the stalk-like brain stem, in charge of basics such as breathing, sleeping and waking. The EEG would alert doctors if the cortex, the thinking part of your brain, is still active.
But various researchers decided that this test was unnecessary, so it was eliminated from the mandatory criteria in 1971. They reasoned that, if the brain stem is dead, the higher centers of the brain are also probably dead.
But in at least two studies before the 1981 Uniform Determination of Death Act, some “brain-dead” patients were found to be emitting brain waves. One, from the National Institute of Neurological Disorders and Stroke in the 1970s, found that out of 503 patients who met the usual criteria of brain death, 17 showed activity in an EEG.
And more:
But BHCs—who don’t receive anesthetics during an organ harvest operation—react to the scalpel like inadequately anesthetized live patients, exhibiting high blood pressure and sometimes soaring heart rates. Doctors say these are simply reflexes.
What if there is sound evidence that you are alive after being declared brain dead? In a 1999 article in the peer-reviewed journal Anesthesiology, Gail A. Van Norman, a professor of anesthesiology at the University of Washington, reported a case in which a 30-year-old patient with severe head trauma began breathing spontaneously after being declared brain dead. The physicians said that, because there was no chance of recovery, he could still be considered dead. The harvest proceeded over the objections of the anesthesiologist, who saw the donor move, and then react to the scalpel with hypertension.
Organ transplantation—from procurement of organs to transplant to the first year of postoperative care—is a $20 billion per year business. Average recipients are charged $750,000 for a transplant, and at an average 3.3 organs, that is more than $2 million per body. Neither donors nor their families can be paid for organs.
Thank You Yeshiva World for posting this EXTREMELY VITAL article from the Wall Street Journal!
Sorry but at t’chiyas ha’maysim I want to wake up with all my organs where i left them.
Gabi–it wasn’t really necessary to copy the article! 😉
Seriously, the article is not so much news as an opinion piece and has some significant medical errors: the eyes don’t “shiver” and the cold water is used to irrigate (not “splash”) the ears, not the eyes.
While the author makes a point about the possibility of brain activity in the absence of an EEG, implying that there is some sort of a cover-up, the use of the EEG isn’t necessarily appropriate. The fact that individual cells are electrically active does not mean that the organ (e.g. the brain)is alive.
This is a complex area. People should seek advice from a competent Rav, not the WSJ.
AND Jews still believe that we cannot be a donor and must be buried intact.
Rav Moshe Tendler (R’ Moshe’s son-in-law) is a huge proponent of organ donation based on R’ Moshe’s opinion that brain-stem death IS halachic death (as written in Igros Moshe).
If you really want to know the facts, go to HODS.org (halachic organ donor society) and listen to the video of Rav Tendler saying this. He also states that R’ Moshe held that organ donation is a MITZVAH!
It has unfortunately become known (at least in the US) that Jews will accept an organ but are the least likely to donate.
Yanky, your last point about accepting and not giving is irrelevant. If the person’s personal Rav says it is Assur to donate, then that is the person’s faith and this country will respect that. Nobody should pasken anything, especially something so important, from anything one happens to see on the Internet, no matter how impressive the presenter.
Pirkei Avos exhorts us “Asei Licha Rav”. Don’t think you can replace that with YouTube videos.
i like the give and take!