Summer CE Week #5: “Infant transplant procedure ignites debate”
Speed of heart extractions raises ethical questions
WASHINGTON – Surgeons in Denver are publishing their first account of a controversial procedure in which they remove the hearts of severely brain-damaged newborns less than two minutes after the babies are disconnected from life support, and their hearts stop beating, so the organs can be transplanted into infants who would otherwise die.
A detailed description of the transplants in today’s issue of the New England Journal of Medicine immediately ignited an intense debate about whether the first-of-their-kind procedures are pushing an already controversial organ-retrieval strategy beyond acceptable legal, moral and ethical bounds.
The doctors who performed the operations as part of a federally funded research project defended the practice, and some advocates for organ donation praised the operations as offering the first clear evidence that the procedures could provide desperately needed hearts for terminally ill babies.
Critics, however, are questioning the propriety of removing hearts from patients, especially babies, who are not brain dead and are asking whether the Denver doctors wait long enough to make sure the infants met either of the long-accepted definitions of death – complete, irreversible cessation of brain function or of heart and lung function. Some even said the operations are tantamount to murder.
“This bold experiment is pushing the boundaries and raising many questions,” said James Bernat, a Dartmouth medical professor who wrote one of four commentaries that the journal published with the report – an unusual step that anticipated the firestorm of reaction the procedures would cause. The journal posted them on its Web site with a videotaped debate among three prominent bioethicists.
“This clearly shows the feasibility of doing this,” Bernat said. “The question is: Should this be done?” This is the issue I would like you to focus on for this post – Kautzman
The operations are occurring as transplant advocates have become increasingly aggressive in trying to bridge the gap between the number of available livers, kidneys, hearts and other organs and the number of Americans on the waiting list for transplants.
Since the 1970s, most organs have been removed only after doctors declared a patient brain dead. But in the hopes of obtaining more organs, federal health officials, transplant surgeons and organ banks have been intensely promoting “donation after cardiac death,” or DCD. DCD usually involves patients who have devastating and irreversible brain damage but are not actually brain dead. Their families consent to removing life support, and their organs are removed minutes after the patients’ hearts stop beating.
While the procedure has become increasingly common in adults, it remains highly controversial. Critics say it endangers the care of dying patients – a California surgeon is facing criminal charges that he tried to hasten the death of a potential DCD donor in 2006 – and has raised questions about whether the donors are truly dead.
To address such concerns, hospitals follow strict guidelines, including requiring a clear division between doctors caring for the patients and those removing and transplanting the organs. Most also require surgeons to wait at least two minutes – and usually five – after a heart stops to make sure it does not spontaneously start beating again on its own, which has occurred in rare cases.
The Washington Post reported last year that doctors at the Denver Children’s Hospital had started removing hearts from babies, sometimes waiting only 75 seconds to increase the chances that the organs would be viable. The new report marks the first time the doctors have described their efforts in a medical journal.
The report details three cases between 2004 and 2007 involving babies who experienced severe brain damage from oxygen deprivation during birth. Their parents decided to discontinue life support several days following their birth after doctors told them there was no hope. The surgeons waited three minutes before removing the first baby’s heart, but just 75 seconds for the second and third after an ethics panel monitoring the research decided that would be sufficient.
Surgeons transplanted the hearts into three babies 1 to 4 months old who were dying of heart problems. Six months later, all three recipients were alive.
“We’re very pleased with the lives we saved,” said Mark Boucek, who led the team before moving to the Joe DiMaggio Children’s Hospital in Hollywood, Fla. “We’re trying to deal with a very difficult situation where children die waiting for transplant and parents of other children want to donate.”
James Burdick of the Health and Human Services Department, which funded the study, agreed.
“In a very important way, it’s a wonderful story. You had three situations with hopeless medical problems who would have otherwise died but got this gift of life,” he said. “It’s an important demonstration of what is possible.”
But critics questioned whether the donor babies were truly dead when their hearts were removed. In those cases, the hearts were restarted in another child’s body, meaning cessation was not irreversible, they argued.
“This practice cannot be ethically justified,” said George Annas, a Boston University bioethicist. “The donors are not dead. I understand that they would like us to change the definition of death, but they can’t do that by themselves. It’s very problematic to start treating a baby as an organ donor before it’s dead.”
Robert Veatch, a Georgetown University bioethicist, went further, saying the deaths were equivalent to murder.
“The whole issue is whether the infants from whom the hearts were taken were dead. It seems very clear to me that they were not,” he said. “I think it’s illegal, and if it’s illegal, what we’re talking about is the physicians causing the death of the three patients, and that would be homicide. It’s immoral. I think it should be stopped.”
Boucek, the cardiologist, argued that the hearts were incapable of functioning in the newborns from whom they were removed, satisfying the criteria for pronouncing the babies dead.
“At the end of the day, we feel we are on very firm ground,” he said. “There is no question these all met the criteria that one would establish for death.”
To answer the question, “should this be done?”, I have very mixed feelings. My first instinct was NO, I agree with the people who say it is murder. The idea that because the heart could beat in another infant, the donor was not dead is scary. Another scary thought is doctors only waithing 75 seconds after the heart stopped. On the other hand, these donors had parent permission to be taken off life support. The infants used as donors would not live anyway. This being said, it is amazing that all three babies who recieved heart donations lived. It sounds horrible to trade one babie’s life for another, but if an infant were to be pulled from life support, and have parent consent for donation it only makes sense to save anothers life. I guess you have to decide if perserving the life of a brain damaged baby is worth letting anther one, whos has a chance of a normal life, die. In all, I really don’t know where I stand.
What is the definition of death? I believe that if a child has been on life support for it’s first three days of existence and then is pronounced dead, it’s dead. On the other hand, if your killing babies to save other babies it’s not right. It really comes down to a matter of trust. If we think that we can trust the doctors in whose hands the children’s lives are then there is no issue. However, if you are taking someone’s organs before they are dead? That kind of behavior belongs better in a Monty Python shtick (I hope someone knows what I’m talking about). In the event that the doctors are just and fair and the babies are actually beyond the point of recovery I think that saving three lives of six is a good option. It is a 50% recovery of life in an otherwise hopeless option. The issue we find is that some people are bitter that one child can be saved and not another. This is not a good reason to deprive a child of normal life if normal life is an option. Really it comes down to a matter of trusting the trained professionals to do their jobs.
I have mixed feelings about this article, because the thought that one baby has to die for another one to survive seems wrong. In a way it is like murder, because the baby is still alive when the heart is taken out to prevent damage to the tissue. It is also very upsetting that the doctors only wait 75 seconds before allowing the baby’s organs to be used. The doctors say this is to make sure the organs are viable, but is this enough time? There have been some cases where the baby is able to stay alive for more than 75 seconds, and not waiting longer is almost like murdering an innocent child.
On the other hand, the parents allowed the doctors to use the organs from their child. I think that since the parents made this decision, people need to respect the choice that they make. Also, since these babies wouldn’t be able to survive without life support it might be the better choice. Their bodies wouldn’t be able to function without the support of machines, and making a child go through this isn’t right.
It may not sound right to allow one life to be traded for another, but if these children have the potential of leading a normal life, then this procedure may be the best decision. Also, the babies who have brain damage would probably die anyway. The babies who needed the organ transplant could live and have a normal life. It sounds bad to ask to trade a life, but this surgery could save hundreds of children.
Also, when other organs are taken for transplant the donors are still alive. Why isn’t this considered murder? Maybe it is the concept that a child has this done to them without their consent. Maybe it’s the idea that this is child who has their life taken away from them.
I just don’t know where I stand on this issue!
Should this be done is the question. My personal response is yes. But only if the donor is honestly dead. I believe that 75 seconds is far too short of a time span to make absolutely sure that the heart won’t sporadically restart itself. I understand that they are on a time limit to make sure the heart will be viable but 75 seconds is just too short. But yes if the donor isn’t alive and the parents have given their consent, then I see no reason for this not to be done. If I had a child who wasn’t going to make it without life support and there was a chance that their heart would save the life of another infant I would give my consent because if it was the other way around I would want another parent to do the same. It might sound horrible to some but I believe that a life isn’t worth living if for one you don’t know you’re living it and for two if you can’t live without life support. Life support is great if the child has a chance at one day living without it, but if they don’t then why not save the life of another child?
In response to Felica. Don’t forget that the babies had been severely brain damaged as well. Their chances for survival were so incredibly close to none, that even if they had a chance to survive, their lives may have only lasted one or two years at most. Because of their amazing donations, a human being may live throughout an entire life. These are the reasons that the human race continues to advance. As long as we continue to try these things, we will find the solutions to advancements.
In response to Calin, if you were to keep reading my blog I stated that I did agree with this procedure. My first instinct was that it was bad, but upon reflecting on it, it really is an amazing procedure. What I really didn’t agree with was waiting for only 75 seconds. The very first time they tried the procedure they waited for 3 minutes to pronounce the donor dead.
Okay, I think the breaking point is in the last paragraph when the cardiologist Boucek stated that the hearts would already be incapable of pumping in the newborn that it was removed from. Well, without a capable heart, that essentially leads to death, why would there be a question of murder? However, if that incapable heart in one babe could work in another newborn saving a little life, I think that this should be a medical breakthrough. Nevertheless, the doctors should definitely follow at least the two minute rule, waiting to see if there was any chance at all that the heart might work. At that point, there should be no question regarding murder and on the contrary that heart would ultimately save a life. If the brain damage is already “devastating and irreversible” and if the parents have already consented to removing their infant from life support, then the doctors should do all they can to remove that heart in the slightest possibility that another child’s life could be saved. I think the ultimate choice belongs with the parents. If they want to raise a severely brain damaged child with love and patience, then by all means we’ll pray for them. But if the parents make the hard decision to give up their baby’s life for another, then we’ll pray for the doctors.
I completely agree with this procedure. If the infants are dying and can obviously not live without medical aid and the parents have chosen to take them off of life support what is the problem with removing an organ to give another infant a better chance of living. Especially with the increased success rate now that surgeons are perfecting the procedures. I don’t consider this murder; the parents have chosen to take the infants off of life support, indicating that the children will no longer live, so why wait for the brain to die to declare them dead? The organs will be more viable the less time between removal and transplant to the recipient so why risk rejection of the organ, especially in the case of a heart, by waiting to remove the organ? If anything this is more murderous than removing the organ less than three minutes after death because not only does the first infant die, the second infant, who could have lived had he or she received the organ sooner, dies as well. In this case two is certainly not better than one.
In response to this article I believe these procedures are very beneficial to us. But I can’t look at this as right or wrong I look at it in the eyes of the children. The brain dead child will not survive. The child receiving the new organs needs to be considered. Yes, it will be kept alive and its living condition and health may be improved but it could have effects. It is difficult to read something such as this article because babies are so innocent and they cannot speak for themselves. When the parents give the consent for it i think they want to make sure that the child doesn’t have to live a life on machines. That is not fair to the baby and keeping it alive will do it no good.
I also think these procedures need to be very strict. The parents have the right to be informed that their child is not going to be completely dead when removing the organs. Doctors need to wait longer than 75 seconds or until the point comes when the child has an irreversible brain cessation. Meaning it is not repairable.
One cannot say this should be done and this shouldn’t be done. I think it depends on the case because each may be different. The child receiving the new organs needs to be thought of. What the effects could be and what kind of problems will occur as a result of the transplant. I am not educated enough to know that each transplant will give another child a NORMAL life. You never know what sort of complications could come up.
Therefore I think the question, “should this be done?” is not a yes or no question but depends strongly on the case. If a brain dead child, who will not live anyway, can give its organs to a child that through the procedure will live normally, then I call this a miracle. However, if the child receiving the new organs is not able to live normally or happily, then I question if it is right to do this. It is in the end the parent’s choice what kind of life they are giving the child.
Oh my, well I can clearly see why this is an extremely controversial issue. It seems the concepts of life and death, especially in the touchy context of babies, are terms that aren’t as simply defined as I once had though. Previously, I always though death would just be when the heart stopped beating… and life was when the heart began beating and first breaths were taken. However, I suppose the brain does enter into it as well, since organs can begin being taken once a patient has been declared brain dead. The question that was presented about this article was “Should it be done?” Now, I see the ethical debate surrounding the procedure. Taking a newborn babies heart only a matter of SECONDS after it’s been declared unable to live seems a very inadequate amount of time to put on a life. But if those seconds made a difference in the quality of the heart for the recipient and could possibly save one life then maybe it’s worth it? To take a heart from one dying/”dead” baby and give it to another dying baby and save that baby’s life maintains a status quo of one baby. But to not get a high-quality heart in time and keep a recipient waiting could maybe result in not just one baby dead, but two. And that would be a problem. I believe ultimately the concept of life should be help before that of death and if the imminent death of one could give life to another, than it seems as though death has been evaded altogether. One heart still beats in a situation in which two could have stopped. That should be considered an accomplishment.
In response to Shelby Hulme, I totally agree with you when you rhetorically questioned, “Life support is great if the child has a chance at one day living without it, but if they don’t then why not save the life of another child?” I also believe that life support obviously is a miracle but at the same time can also be something of a controversy. Like that case with Terri Schiavo. If a person is only staying alive, and barely functioning at that, with life support, I can only think that taking them off life support is the humane, gentle way of doing it instead of prolonging a life in pain with severe damage. And if that life can save another, who has a complete chance for a normal life, I believe that as bad as it sounds, that person should be taken off life support. Those parents must realize that their child would live a life hooked up on tubes, not recognizing those around them or even realizing that they’re alive, suffering in quiet unresponsive pain. As hard as it would be to let your child go, just imagine the joy of another family to have their terminally ill baby receive the gift of life.
To be done or not to be done, that is the question. If the answer was up to me to determine, I would say yes. However, it would only be so if the organ donor was, in all ways that mattered, dead. I say for all ways that matter because if a person’s brain is damaged so severely that all they can do is stare at a wall and not do, feel, see, hear, smell, or comprehend anything else, all the while on life support, is that really living? Controversies such as this come up every couple years, like the Terri Schiavo case. Taking organs from severely brain damaged people can save so many more lives that would otherwise be lost due to waiting for the right donor to appear. The doctors also only perform the operation only with the consent of the family. The only issue I have is the wait. Seventy-five seconds is way to short of a time to wait before starting the operation. It is also rather disrespectful to the family that barely a minute after their loved one dies, they are being operated on. However, if one life is already gone, why not allow another to be saved?
I am trying to see this article as being politically correct and as a procedure that is saving lives. I am very supportive of scientific research, especially in the cases of how to save potential lives. However, this article hits home for me and unlike my opinions on abortion, i would strongly agree that this is murder. A child has already been born and they are taking the hearts out of it before it is “dead”. Scientists can define death in all the ways they want, but in reality and all truth, “death” is when a life has passed and there is no life WHATSOEVER left in that individual body. When scientist are taking organs and hearts out of babies bodies only 75 seconds after they are “dead” is extremely unethical and is murder.
I was born with VSD (ventricle septic disease) and the doctors predicted after I was born that I would have zero capacity for any speech, movement, learning development, or “any other normal functions or growth development of a child”. If this procedure were around 18 years ago, I would not be here today and I would have been cheated out of a very fulfilling and successful life. I have a 3.8 GPA, I take several AP classes, I play varsity sports, and although I am rather short for normal high school students standing at 5 ft. 1″, I still grew under normal development. Everything the doctors predicted was wrong. How do they know that there couldn’t be other cases such as mine? This procedure may be saving some lives, but it’s killing others and should be stopped immediately.
This procedure sounds like it is very good. But who are we to decide, let alone discuss whether or not it should be done. The only ones that are involved are the parents of the two separate children. People always want to change what people think, based on morality and religious views and a whole bunch of other factors dear to them. But we can’t speak for others. If any one of us was in that situation to decide whether or not the child should be taken off of life support and have it’s heart removed, then we would have all the power in the world to make that decision for ourselves and the family. But until we are in that position we have no right to influence how others make their decisions. We can argue that it’s immoral or not but we can’t tell people they are bad for making the decision they made. This statement is true for almost every moral issue. Take abortion for example. We can discuss it but we have no right in influencing people to think one way or the other and make decisions based on how people will view them afterwards. This is the issue that is wrong. Not whether or not babies that aren’t even ours will be taken off of life support. Keep your opinions only as opinions and don’t push guilt and change on others.
Along with many other people who responded to this article, I have mixed feelings about whether or not this should be done. Both answers to the question have valid points.
First of all, doctors do have to have parental consent before going through with this. So, the fact that the parents have all the power in making the decision relieves some of the immorality. Also, one life is better than no life at all. You could say that it is worth the controversy to go 1 for 2 as opposed to 0 for 2. You could also go as far as to say that giving another baby life outweighs the immorality of removing a baby’s heart before letting it have a chance to come back to life.
The article says, “…sometimes waiting only 75 seconds to increase the chances that the organs would be viable.” This is where doctors are running into all of this controversy. Waiting just 75 seconds between death and removal of the heart seems too soon. As stated in the article, there have been times where the heart has restarted itself and brought the baby back to life. The amount of time before removal of the heart is obviously a very fine line. Either you wait too long and the recipient doesn’t survive, or you eliminate the chance of the donor’s heart restarting.
At first, when i started reading the article, i thought that this type of procedure is wrong and should be looked more into. But, as i got farther along, I started to get the idea that it should be done. For one, the doctors examine and then tell the parents that their baby will not able to live. To me, that seems that it’s not caused by a problem with the heart, but with a problem with the baby itself, and since the doctors are telling the parents that there is nothing that can be done to save the baby, it’s the parent’s choice whether or not they want the baby to live for as long as it can, which could only be a few days or even hours, or if they would be ok with taking the working organs out and use it for a baby that can benefit from it. To me, i would much rather have one baby live and one die than both dying when i had the knowledge that i could have saved at least one life.
Also, it’s not like the doctors are killing the babies themselves. They can’t lie to the parents or anything of that sort, they would lose their job and get put away.
Though in some cases these doctors could be wrong about situations as such, there are very few cases where the baby in question will prove them wrong.
I am strongly against murder, and I personally don’t think it is murder. If these doctors wait for more than a minute and a heart doesn’t start up, well then that shows me that it probably won’t.
There are many cases where a person can be in a coma, or like the article said, brain dead, or even in so much pain but you can ‘t see any of that. Would you want your loved one to have to suffer?
Just because other parts of them are working that makes them not dead? I don’t understand that. Someone would rather know that their loved one is going to be suffering that way instead of doing the right thing and letting them go. Now that is being selfish. I would never want to see my loved one in pain, it would be too difficult. I mean, i would wait of course to see if a miracle would occur, but after awhile i would do what’s best for them and set them free.
This is a very controversial topic, and I believe that this is not murder. Murder, to me, is purposely killing someone. Murder is having that intention to harm another person to death. Setting one life free and away from pain to save another life that actually has the chance to live does not seem like murder to me, but that’s just my opinion.
I agree with what Michael Townshend has to say, it isn’t our place to say what we think is right or wrong with this subject. It is all up to the people in that position. Like I said in my post, if it were me, I wouldn’t want my loved one to suffer and i would rather save one life than lose both, but that’s just me. Everyone has their own way in which they would deal with the issue at hand, and that’s the beauty of an opinion and individuality.
I also agree that it is wrong to try and change how someone thinks and to try and make a person feel guilty for what they believe is right or that is right for them and or their families.
Everyone has their own beliefs and ways of handling things that suits them, something that works for one may not work for another, that’s just how it is.
When we go into the DMV to get our licences we have the choice to be a donor or not. For us that is a choice, but for baby infants who suffer of brain damage and are cut-off from life support are not being given a choice whether to donate their hearts or not. I’m not saying that doctors just take the heart without parents consent, but in some cases they start to remove the heart before they are technically considered dead. I believe that medical technology has helped our world trememndously and I have nothing against someone trying to save a life, but for me there is still something that holds me back in this case.
In this article it says,”Boucek, the cardiologist, argued that the hearts were incapable of functioning in the newborns from whom they were removed,” I find this statement troubling because just because it does not technically work that doesn’t mean they have the right to take it and give it to someone else. I mean just because someone’s parylized and their legs don’t work doesn’t mean that they are going to take them and put them on someone else.
I also find this article wrong in the sense that before they would wait two-five minutes after the heart stops beating incase of it spontaneously starting up again, which it has before, but now they are waiting only 75 seconds to get better results from the heart in other patients.
I can definitely see why this article presents such a controvery because honestly I had to think about what I believe is morally correct.
I agree with the procedure. I think that if the mother is on board, why not give the dying life of one baby, to another one that has a good chance of making it. It would be like a liver transplant or something. It is sad that the baby has to die, but its not like they are purposely killing it to allow another baby to survive, it is basically pronounced dead, and then the switch is made. In the article they are calling it a murder, but how is that true? The babies they are using are ones that have a very little chance of surviving and that are on life support, why watch two babies die when you could save one? I think it is sad, yet logical. This issue is as debatable as abortions, but I think it is a yes. As long as the mother is kept in the loop and makes the decision herself, it can be very beneficial to our society. Why would you kill two babies when you could give one the opportunity of life and the other one that would have had a horrible time trying to survive would be giving that life to the other baby, it is kind of a beautifully sweet thing if you think about it.
Why is it okay to take a heart from one baby who might be dead, two minutes is very little time to establish death, and give it to another baby that is dying as well? A death for a life comes out even, is that it? Does that mean if I, well anybody, has a baby and immediately goes out and murders someone, it is okay in the eyes of the law? I realize that murder is against the law… but I guess that is my point. This new procedure, I am sure, is going to be thrown in to the debates over abortion. It should be. If the doctor finds that the baby is really and truly dead before they remove the heart… than saving another baby’s life is a noble cause. It must be stressed that rules must be put down on paper as to how to determine the baby is dead. Two minutes is not enough. Babies are the most precious gifts on this earth. A doctor must do everything in their power to save their life as long as it does not include harming another human life. Technology and advances in science can be wonderful and save many lives but we must be EXTREMELY careful with what we allow and what we do not. Rules must be established or else we will get into moral predicaments that could have been avoided.
In response to Michael:
This is in response to the bringing up of the abortion issue. Michael stated that we should not push are guilt or moral convictions on others but is that not exactly what a person is doing if they are telling others not to? Does that also mean that if I think it alright to steal from someone because, “hey, they have plenty of money and I have none,” the law should not be allowed to do anything? We have laws in our nation for a reason… to protect our citizens from tyranny and to enable each human being to be treated as such. There is right and wrong in our world. There are right and wrong morals. As such… abortion is murder and murder is against the law. If a pregnant woman is hit by a car and killed, the driver is charged with two counts of vehicular homicide. This charge is carried out no matter what trimester the woman is in and yet abortion is still debated over as being murder or not being murder. Where is the logic in that? Abortion is a whole different issue but you must realize, Michael, that laws are put in place for reasons and the majority of laws have moral issues behind them. To tell a person they are not allowed to “impose their morals on others” is, in the act, doing so to them.
“Surgeons transplanted the hearts into three babies 1 to 4 months old who were dying of heart problems. Six months later, all three recipients were alive.” Three babies were given a life, because they were able to have that transplant. That means three less families had to go through the heartbreak of losing a child. I’m all for the heart transplants in infants. If the parents give full consent, and the baby has minor or no chance of living, I don’t see why we shouldn’t allow the procedure. I’m aware it’s an ethical issue, but I’m not about to run around with a whistle, calling out people over their individual ethics. If the parents are fully informed, and give full permission, that is their choice and their ethics.
If I was a parent, and I was placed in this situation, I think that I would choose to donate my child’s heart. Why shouldn’t I try to help another family, and save another life? As I see it, parents of terminally ill infants can level with each other. They all share the same pain, and it goes back to the quote I mentioned at first. Three lives were saved because three families were generous and understanding enough to help another family in the same situation.
Of course this should be done. I believe in NO WAY that this is murder. These babies were dying anyway. Starting out life on machines is what naturally happened to them, the doctors didn’t make the babies sick just so they could maybe save another infant with the organs. The thing is, the waiting period in which the doctor waits to pronounce the baby’s death; seventy five seconds? Hmm… well how long do they wait for adults? I guess there could be damage to the heart if they wait too long, but maybe they should just stick to the original three minutes. There should be no worry of murder, but saving another life.
Saying that this should or shouldn’t be done isn’t completely ethical because there are different situations. Every situation is a little different because some babies could be a little more dead than others, or the doctor could have waited a little longer to take them completely off of life support.
If the parents say it’s a go, then it is all right. If the parents have second thoughts, then the doctor should respect their wishes. It’s as simple as that; all up to the parents with a little persuasion from the doctor.
In response to anyone saying that this procedure is like abortion, I completely disagree.
If that poor innocent little baby has been on life support all its life and is not really living in the first place, then it is not murder taking them off of life support. If you had a child, would you rather see them suffering with a bunch of tubes hooked up to them or see another child with their organs lively?
That is how it is nothing like abortion. The baby can give life to another infant and live within another being. The donor baby will not be fully gone of forgotten.
In Response to Maddy,
I completely agree with you and I like how blunt you are about it. This procedure could save another human life, when one is about to be taken away. If the parents have signed the consent form for the baby to be taken off of life support and it is okay with the parents for the transplant to be done, then by no? It isn’t murder if the baby is going to die anyway (not to be insensitive).
In response to a comment Vanessa made: it should be considered an accomplishment. If one heart is still beating when two have stopped that is an achievement and in many ways a miracle.
I don’t think there should be a question of whether they should take organs from a dead baby to save a life of another baby. The question regarding all of this comes down to –What is the definition of dead? I really don’t know the answer to this. If someone has to rely on machines the rest of their life in order to stay alive are they really alive? One very important thing to remember about these cases is that the parents allowed the doctors to take the babies off life support and use its organs. If there is no hope at all for the baby to live and the parents agree to take the baby off life support then there is not an issue. Yes, the doctors need to make sure the baby is dead before they rip out its heart. Hospitals across America need to set guidelines on procedures to follow in order to take organs from babies on life support. There should be a time, like two minutes of no signs of life, before organs can be removed. Not only does this make sure that the baby is dead, it also shows respect for the baby as its life is ending. Doctors will not get blamed for killing babies or making the wrong decision if these predetermined rules of the hospital are followed.
This is such a complex issue that a lot needs to be taken into consideration. First of all, I believe that, in order for the procedure to be moral, the donor baby must have no chance of surviving without life support at any point in the near future. Many babies, including some born prematurely, are forced to spend some time on life support but soon become able to survive on their own. If a baby has any chance at natural survival, it would be completely immoral to take that opportunity away from them. A brain-damaged child is not any less deserving of life than any other child. The second factor to consider is the manner in which the doctors approach the parents. The parents should not feel pressured to choose between their child’s life and the life of another infant. The doctors should present the brain-damaged child’s prognosis fairly and honestly. Under no circumstances should the doctors try to convince the parents that a child with normal brain function is more worthy of life. In some cases, where multiple organs might be donated to several other infants, a parent might feel as though they are choosing between the life of their child and the lives of many. That would be absolutely unfair. I cannot imagine the pain that a parent would be experiencing just with the knowledge that their child might never have a fair chance at life. They do not need any more strain or pressure. The final consideration should be the amount of time after a declared death that must elapse before the organs can be harvested. I understand the time crunch, but 75 seconds? That is absolutely ridiculous. I honestly cannot say whether the procedure in question is moral. I think each situation must be approached individually, with the understanding that every human life is precious.
Usually I have no trouble making up my mind but on this one it was difficult. There are certain points that keep reoccurring in my mind:
*The baby still had a chance to live, call me selfish but I would keep my child on life support as long as I could. Almost no chance is still a chance. Parents are letting their kids die.
*Letting your child die who has no chance to let one who has some could be viewed a saving a life. Or rather trading.
*The child is not dead yet so ordering its death seems murder, a truly dead heart can’t be used.
*Because the child is not completely dead a heart that is otherwise useless is usable.
I feel like Tavion “On the other hand…”
In the end I feel that this procedure should be illegal unless it can be effective with a baby who has completely died and it becomes simply organ transplant.
P.S. If they need the heart so fast then are babies with brain damage who are about to die always near babies with heart problems who are about to die?
The way I see this is a new way to exercise the idea of triage. The concept is to treat those who cannot survive without immediate attention first, leave those who will inevitably die, and let people who could survive on their own for a while wait. These babies would be those who could not be saved, they will die, they are the ones who will be sacrificed to give life to one who could live. People give their lives to save others everyday in this world, and they are glorified as heroes. The babies that will die should be under the same banner, and the ones that they save would be victims as surely as those who are trapped in a burning building fighting for their life. Instead people are trying to say that these people are being murdered and denouncing those performing the surgery as killers. Triage has been in practice for thousands of years, with this new development more lives are being saved, no new threshold has been crossed merely a new technique developed. Perspective is an amazing thing and it colors everything in this world.
If the physician performs this operation successfully, he has effectively saved a life.
If these forms of surgery become illegal, we stand the risk that two lives will be lost.
Wouldn’t it be nice to atleast break even?
Organ donation has saved lives, and brought comfort to the survivors of the organ donors. To now find objection with organ donation because of a mere technicality seems nonsensical.
Laws should certainly be in place concerning the health level at which organs can be removed, but people have reacted to these experiments as if it were suggested that we start harvesting organs from healthy fetuses. But when organs are taken from a fetus that in all likelihood would have died outside of the womb, or been severely brain damaged, it just seems like a pragmatic, life saving option.
On the other hand, why are these physicians now being accused of homicide? Abortionists kill fetuses all the time and they aren’t put on trial for murder. Why don’t we stop taking organs from fetuses that are kind of “iffy” as to whether or not they’re dead, and start going to abortion clinics and getting the organs from babies that are going to be killed anyways.
The problem with these critics of this surgery is that they get emotionally biased and don’t look at the situation with a clear mindset.
The fact of the matter is that the potential donor is completely unintelligent, has next to none in brain activity, and is only going to live long enough as its parents pocketbooks will suffice.
This may be harsh, but the facts are true. The critics only hear that babies are dying and react harshly. Just because they are babies doesn’t mean that certain sacrifices shouldn’t be made. These babies that are eligible are and will remain next to brain dead. This means that they will be able to blink. They won’t be able to walk. They aren’t able to comprehend a human language. They are barely alive. In my opinion, a life not lived is still lost.
We may argue and debate about the ethics of the situation, but when it comes down to the moment, only the parents can decide if they are emotionally ready to let their child go to save another. I know that if that moment came in my life, I would choose to save another child’s life.
To be discussed: controversial organ-retrieval strategy beyond acceptable legal, moral and ethical bounds.
At a first glance, this procedure seemed to be highly unacceptable to me and against what I believe in. But reading deeper into the article caused me to have a different approach. Save a life. This seems to be so simple, but when you throw in severely brain damaged infants and a 2-5 minute period that will determine this newborns future: life or death, things become quite complicated. It has come to my attention that parents are consenting to have their infants be taken off of life support. Consent means to give fullest permission. It is a choice. If the parents are allowing, doctors are following the right procedures to pronounce the newborn terminated. This way, a heart can be transported to another ill little body and possibly save a life and create existence for a baby that might have not survived. Yes there is more to it than this and yes it become complex, intricate, and might raise feelings of obscurity….but put yourself in the position of the helpless infant that needs a heart, an organ that will allow them to lead a normal life. The baby with brain damage unfortunately has a very minute chance of surviving. It’s awful to think you have to trade one baby’s life for another, but that’s life and that’s how it sometimes just has to be. Whoa. That sounded heartless.
Response: Kathrine Kruse blows my mind once again!>>>>>more thoughts arise.
This time I actually don’t disagree with you. You read my mind. I completely agree with you. How could this possibly be “murder”? The baby is on life support. It is dead without it. So….parents in response to looking at their child suffer and are aware that their baby is most likely going to die anyways decides to take their infant off of life support. This allows opportunity.
Abortion?! Whoa. When did that get brought up? Of course it is NOTHING like abortion. Abortion is terminating a pregnancy, a life that could be lived normally. These brain damaged babies need a miracle to lead a normal lifestyle.
All in all brain damaged babies have been saviors, donating hearts so their fellow infants might see another day. This procedure has been successful in my eyes.
In response to Blake Nelson:
I completely agree with you when you say, “Doctors will not get blamed for killing babies or making the wrong decision if these predetermined rules of the hospital are followed.”
A predetermined set of rules for infant transplants should eliminate most of this controversy. A set time would prevent the doctors from removing the organs too early. Included in those guidelines should be a definition of dead.
I know this might be getting a little to technical, and I know the chances of this idea actually being used are slim, but it’s something to consider…
I do not think taking the heart of the infant has died after 75 seconds is wrong. There have never been any infants whose hearts started after 60 seconds. A heart sitting in an oxygen-deprived, warm chest cavity is less likely to be transplanted successfully. That ought to be taken into account. No parent should be told of a possible donation until after they have decided to remove the infant from life support. That seems obvious. However, whether or not a heart transplant should take place among infants is certain for me: yes. Saving lives is saving lives, whether the lives involved are infants or otherwise. And the 75 second discussion? Well, if the heart sits too long and does not work in the transplant, then there is twice as many deaths, twice as much waste. When it comes down to saving lives that could be saved, I believe that people ought to be realistic and not sentimental. If no heart has restarted after 60 seconds, then the heart should be removable at 75. Otherwise we stand the chances of two infants dying, and that is ridiculous when one could live. It’s terribly sad that the brain-damaged infants died, but it’s wonderful that the terminally ill ones get to live. They get to have wonderful lives and do whatever they want. That’s a beautiful thing, and it’s not worth waiting over 75 seconds for.
Well, now here is a predicament. The babies are supposed to be dead, but their hearts still work in other babies bodies’. Wow. Also, the donor babies are severely brain damaged, I’m assuming that means they have little chance for survival anyways and zero chance for a “normal” life. And the parents seem to like the idea that their child, although dying will allow someone else’s child to live on instead of die at such a young age. I don’t think its murder, at the worst its martyrdom, the one baby’s life is sacrificed for another’s so I suppose its alright, especially seeing how the parents are willing to allow it and the donor baby is super brain damaged, maybe even brain dead, which to me is dead. Its is sad, but I do believe that these doctors are not killing innocent lives, these unfortunate babies with brain damage seem to be born with only one purpose, to allow some other child to live on with their hearts, kidney’s and livers.
To answer you question Mr. Kautzman, I believe procedures like these should be done, and some third party member should not step in and act like the parents of the donor baby should be ashamed for giving up their child in order to save somebody else’s baby.
In response to Meagan Barnes: I completely agree with you. It cannot be so black and white. I agree that number one before taking the life of a child, the child should have no chance of surviving with their given heart. I also think a doctor has much power over their patients or the parents of the patients.They are smart which makes them intimidating. The doctor is only there to state what could be done and performing the procedure. The parent shouldn’t have to choose between the life of their child or of a different child.
In response to Alena Shoonmaker when she states “If no heart has restarted after 60 seconds, then the heart should be removable at 75. Otherwise we stand the chances of two infants dying, and that is ridiculous when one could live.” I think it’s important to see it realistically. I cannot put myself in the shoes of a parent who has just made the decision to take their infant off life support and allow a doctor to transplant its heart into another infant. I don’t think i can ever understand what that feels like. But in my opinion, the greatest gratification would be that because of my child, another one could live. Why let two die, when we can save one.
I do think that this procedure should continue, but because it is so complex in process and in morals, several matters need to be taken into consideration.
In order for this to continue, doctors MUST be sure that the infant is COMPLETELY dead, or will be dead if taken off life support, before organs are removed. It would be immoral to take the heart out of an infant who is admittedly going to die, but is still barely clinging on to life. The brain will not survive long without the heart supplying oxygen-rich blood – doctors can wait a few more moments for the patient to be pronounced brain-dead before harvesting organs.
The main problem, I believe, lies in the fact that protocol is very unclear. Some doctors wait a mere 75 seconds after a baby’s heart stops beating – others wait three minutes, while others wait five minutes. If a procedure as complex and controversial as this is to be performed, strict, uniform laws must be put in place to alleviate concern. Either doctors must be given exact times to work with or, in my opinion, rigid laws must be exacted so that organs are removed only after the patient is pronounced brain-dead.
One of the main issues here is whether or not the donor baby is actually dead. This is a controversial issue that, like abortion, has no concrete answer than everyone will agree on. I do agree, however, that this issue needs to be addressed at the national level.
Personally, I feel that if the all the parents of the babies that are affected consent to what is going to take place, the procedure is legal and moral. To call it blatant murder and homicide is a little ridiculous. There is a gray line, but to call it murder? I’m not so sure. Most parents, I would think, would be willing to give up their dying baby who has no chance to live to another baby that needs help. I would anyway. It would give me assurance that my child came into the world to do something most people never do – to save another life. While doctors and ethicists will not always agree on everything, I also think that these issues will eternally be extremely controversial and never have a clear answer. Until our courts rule otherwise, these procedures will continue. And a court ruling may not come for another decade.
I’m with Brennan and Blake. There is no way these doctors should be put on trial. You can’t punish a doctor for following the strict and precise guidelines that were already predetermined. If anything, these doctors could use abortion as a defense; an abortion involving the ACTUAL killing of babies isn’t considered murder, but this situation might?
“I think it’s illegal, and if it’s illegal, what we’re talking about is the physicians causing the death of the three patients, and that would be homicide. It’s immoral. I think it should be stopped.”- Robert Veatch.
OK, Rob: if it were illegal and doctors were running rampant and wild, killing and sucking the life out of poor helpless babies, I THINK there might be some repercussions. Oh, plus the parents MIGHT have something to say about it. So besides the fact that it isn’t illegal and actually quite exceptionally defined and fine tuned, it is still up to the parents to decide if they are able to let their life support child go. These types of articles interview extremists of the opinions and extremely biased people.
And if what Alena said is true, then I think it only strengthens this argument.
This is so difficult for us to comprehend as teens, since none of us are parents yet. If it was your child you would probably always wonder if he or she would have lived life to the best of their ability for years to come, or died any way. If you were the parent of the child who was saved beacuase of the death of another you would be eternally grateful. SO many emotions are in this and I think it tends to clouds people’s decisions. It the baby is already dead, and they decide to take the organs two minutes after it is pronounced dead. Why not? To save another child- this is great. However to kill one to save another is not right. Just because a child has brain damage or any other handicaps does not give you the right to make that choice. Who are we to decide when to end another’s life?? I don’t believe that should ever be our decision. Let life take it’s course. It is not okay to intervene like that.
I would like to defend the doctors in this one.
First of all, i would like to point out that the patients in question were declared brain dead. That is, zero brain activity. Their bodies are only an empty shell kept living though life support. If that isn’t dead, i dont know what is. You could figuratively fix them up with bionics and make them dance around for as long as you like… but it will not chance the fact of the matter: they’re dead. There is nothing anyone can do about it.
Secondly, babies are VERY fragile. The faster they can get the new tissues, the better. They would not take the loss in cells that comes from waiting around very well. In many cases, the bodies would reject it, and the baby would die. Is it really necessary to risk that amount of time?
“The report details three cases between 2004 and 2007…” Three cases in three years. seriously? What is all the drama about? Its not like they’re doing this every day…
For those of you who saw the newest x-files movie, it is nothing like that. They aren’t kidnapping babies and taking their organs. It is completely different. They are taking lemons and making them into life.
In response to Alena Shoonmaker:
I totally agree with you. Its not as if the infant is still alive, and it is really senseless for two lives to be lost. I believe that if I was a parent and my child died I would be okay with them using a heart for a transplant. I think it would be the right thing to do and I would be very upset that my child died, but at least another parent would not have to feel that pain because of my selfless decision. I can’t believe anyone wouldn’t want the same thing.
I think this should be done. I mean, on the one hand you have medical professionals, who all agree that the babies satisfied the criteria for being dead, and saved the lives of other babies via organ transplants. The babies were off life support, and were going to die anyway. Why you’d potentially waste the viability of the transplant hearts by waiting the arbitrary time limit I can’t fathom. The way opponents of this procedure talk about it, they’re gleefully setting into the babies with scalpels the moment their heart stops. This isn’t the case.I think, in a way, this is tied to the abortion debate, and by further extension, assisted suicide. Should you kill someone or abort a baby if they’re only going to die anyway, and probably be in pain for the interim? Logically, you’d most likely say yes, less suffering is for the better, considering the their fast approaching end. However, with assisted suicide, it’s usually thinking adults that can make that decision for themselves. The sticky situation of this procedure and the abortion debate is that the babies cannot decide for themselves, and it’s up to their parents and the doctors to choose for them. The parents gave their consent to remove the children from life support, and the doctors took the initiative to save lives. I think it should be done in that case, as the babies are going to die anyway, and being both brain damaged and on life support, it’s doubtful they were savoring their last hours.
A response to Nicole Thompson. You were more than a bit vague in your comment when you said. “ Scientists can define death in all the ways they want, but in reality and all truth, “death” is when a life has passed and there is no life WHATSOEVER left in that individual body.” Now, you clearly have your own definition of what constitutes death, and based on your words, heartily disagree with anyone who holds another definition. I’m curious at what point you exactly define as the threshold of death. Their hearts stopped, so beyond that? What else had to happen to these brain-damaged, clinging to life support babies before they’re considered dead in actuality or just in time? Exactly how are doctors supposed to tell when all the life has bled away from someone, which you state as if it’s some measureable quantity that doctors can measure. Clearly taking the heart out meant they were dead, you called it murder after all. Hoping you can narrow that gray area for me.
Now, the predictions doctors made about your disease were wrong, which I’m not denying there. They don’t know everything, after all. However, I’m wondering about the relevancy between your case and these babies. They had brains so thoroughly damaged that their hearts would not function inside of them without mechanical aide. Were you that bad off? I’m not being sarcastic, I honestly want to know. Based on what you relayed in your comment, you were predicted to be mentally stunted in all areas, but not a metaphorical “dead-man-walking” as these babies were, given how they couldn’t live off life support. It would also be interesting to see at what point in your development these predictions were made. In answer to your rhetorical question, they can’t know, because they don’t have all the answers. They’re just people doing the best they can, for the most amount of people they can. If a child’s heart cannot work inside them because they’ve suffered so much damage, then it’s probably safe to say that they aren’t saveable. If you had been projected to have lived despite your illness, it would have been up to your parents to decide. Even in this case, it was still the parents of these babies who made the final decision regarding what was going to happen to them. With doctors advising them, of course, but just because all doctors can make mistakes doesn’t mean they don’t have valid advice to give. Until I know more all I can say is that you seem to be taking this more personally than you should be. Also, most of your argument consists of declaring your opinions to be absolutes, and extrapolating on that basis without any coherent backing. But that’s probably me being overly critical.
Also, I agree with Brennan Waller’s response. We could use a definition of death, ironclad and immutable to free us from guilt in sensitive cases like this. However, since everyone’s view of death is so subjective and specific it’s unlikely anything meaningful would come of trying to set a standard, if people even managed to agree that there should be one.
Should this be done? Perhaps, but who are we to say who can live and who is worth sacrificing for another. We should never end a life to possibly save another. Only brain damaged children would be used now but what if doctors evolved their opinions that since an aborted baby would be dead anyway, they could use it as an organ donor. If this gets out of hand, doctors may ask someone contemplating getting an abortion, “why not let the baby live so we can use his organs to save another?” I’m sure this won’t happen but it adds a lot of words to my blog.
“This practice cannot be ethically justified,” said George Annas, a Boston University bioethicist. “The donors are not dead. I understand that they would like us to change the definition of death, but they can’t do that by themselves. It’s very problematic to start treating a baby as an organ donor before it’s dead.” This paragraph in itself is a good opinion, but really it is up to the parents to give their consent on the issue. We should watch how we use our technologies of today.
I don’t understand why people are calling this murder. These doctors aren’t taking babies that have a good chance to live and killing them so as to save another baby. No. They’re taking brain-dead babies that basically have no chance to live, and giving life to another baby that would have died otherwise. These babies that they’re using for donation are brain-dead, meaning that there is absolutely no activity inside their brains. Sure you’d be able to keep them alive on life support, but that is it. They would never know who their parents were. They would never know anything, because they have no brain activity. I know that I personally would rather have my child die, and have their heart give life to another child then just see them lying there with tubes all over their body. Then there’s the whole debate about whether or not 75 seconds is enough time. The way I see it, I think that 75 seconds is enough. The parents decided to take their children off of life support, and to donate the heart to another dying baby. If a heart hasn’t restarted after 75 seconds, I really don’t see it restarting at all. I’m sure that the parents weren’t pressured into donating. If they were, then that is bad of the doctors. No one should be pressured into doing something. They need to decide for themselves if they want to or not. And these doctors didn’t even come up with the 75 second time. It was a board of people who were there to make ethical decisions that decided that 75 seconds was sufficient. Don’t blame the doctors if you feel that 75 seconds is too short of a time. There were 3 babies that were given life. I believe that is great. It is horrible that 3 other babies died, but can you really consider it life when the only thing that is keeping you alive is a machine?
In response to claire,
i completely agree with you. If a baby is in a vegetative state… zero brain function… i just dont see the point. they should not be kept alive through machines if there is no chance in their living. It would only be smart to take lemons and turn them into life. Let babies who have a chance to live have their organs. Give others a chance to live. It would almost be selfish of the parents to not let these kinds of procedures happen. I think its wonderful that we are able to do these kinds of things.