The truth about organ donation • Hacker News Board

Re: The truth about organ donation

#11

Post by bryanlarsen » Wed, Sep 12, 2012, 7:51 PM UTC

batista wrote: post #5

hapkins wrote: post #3

This has to be one of the most intellectually backwards arguments I have ever heard. It is almost on par with arguments presented by christian fundamentalists. Being brain-dead is essentially being dead. Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Being brain-dead, it is also very unlikely that you feel pain. Reflexes can easily still be active even…

> Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Except when they can cut corners, because "ok, the guy is badly injured, there's some other patient that needs that organ", etc. It's not like they are gonna be extra thorough each time. Humans are known to do that...

It's my impression that Doctors are generally very conservative about this, for 2 major reasons:

- they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students.

- they've seen enough examples of people dying from seemingly minor conditions and others of people recovering from seemingly irrecoverable situations to know that their predictive powers are quite fallible

So sure, I expect Doctors to cut corners and make mistakes, after all, they are human. But this is one area where I expect that they're much more likely to err by not declaring death soon enough...

Re: The truth about organ donation

#12

Post by griffindy » Wed, Sep 12, 2012, 7:51 PM UTC

hapkins wrote: post #3

This has to be one of the most intellectually backwards arguments I have ever heard. It is almost on par with arguments presented by christian fundamentalists. Being brain-dead is essentially being dead. Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Being brain-dead, it is also very unlikely that you feel pain. Reflexes can easily still be active even…

not even a serious car crash, even someone who has had a major heart attack. talking from personal experience, they can look just fine, but if their brain was without oxygen long enough, there's no chance that brain's coming back, even though certain reactions will still be present.

Re: The truth about organ donation

#13

Post by numeral_two » Wed, Sep 12, 2012, 7:52 PM UTC

Not that I agree with this, but a book written on the subject recently was a fascinating read - "The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers--How Medicine Is Blurring the Line Between Life and Death by" Dick Teresi. Check out this NPR story about it too: http://www.npr.org/2012/03/19/148296627/blurring-the-line-be...

Re: The truth about organ donation

#14

Post by skizm » Wed, Sep 12, 2012, 7:54 PM UTC

I'm not an organ donor mostly because I think that some Doctor somewhere might give me up for dead since there are 3 people waiting for organs even though there is a slim chance I will live. That might not even be a bad decision on the part of the doctor (1 cripple vs 3 healthy people) but I don't want him to make that choice for me. If I'm alive and explained the situation for myself there is a good chance I would say "sure go for it, I'll be a brain dead cripple anyways" but I don't want that choice taken from me and given to some doctor with a few seconds to make a decision while he holds a knife over my still breathing body.

Re: The truth about organ donation

#15

Post by SpikeGronim » Wed, Sep 12, 2012, 7:54 PM UTC

My wife is an operating room nurse. She sometimes participates in organ transplants. She tells me that there is an anesthesiologist present and giving anesthesia drugs, contradicting the article. The way she describes it they open you up and cut your abdominal aorta, at which point the anesthesiologist leaves the room because you are fully dead. Then they harvest organs and tissues as fast as they can. The people being harvested are clearly, permanently beyond help. The harvests are scheduled to coincide with major surgeries for the recipients. They usually take place in the very early morning as preparation for the transplant later that day.

If I am on a respirator, and will be for the rest of my life, go ahead and harvest me.

I disagree with the conclusion and implications of this article. I also dislike how it implies that organ harvesting doctors have evil motives without coming out and saying it. The factual error that I saw, just as a husband of a transplant worker, also detract from the validity of the article.

Re: The truth about organ donation

#16

Post by robbiep » Wed, Sep 12, 2012, 7:55 PM UTC

In my opinion this takes an ethical grey area that a very small number of donors would fall into, blows it up, and pretends nothing else exists.

Pain in brain death? Ascending pathways still work but your brain lacks the capacity to feel it. Heart rate spike? Autonomic nervous system releases adrenaline, again, automatic; a physiological reaction.

Is the authour hoping that this will lead to a change in brain death definitions? Is he suggesting that the donor is capable of recovery, of a mormal life given time and our modern miracles? Not going to happen.

If this blog is influential enough to lead to people declining organ donation, or withdrawing from the registry, then I believe he is responsible for the impaired lives of potential recipients

And yes, I read the articles.

Re: The truth about organ donation

#17

Post by batista » Wed, Sep 12, 2012, 7:56 PM UTC

bryanlarsen wrote: post #11

batista wrote: post #5

Earlier quoted context omitted.

> Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Except when they can cut corners, because "ok, the guy is badly injured, there's some other patient that needs that organ", etc. It's not like they are gonna be extra thorough each time. Humans are known to do that...

It's my impression that Doctors are generally very conservative about this, for 2 major reasons: - they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students. - they've seen enough examples of people dying from seemingly minor conditions and others of people recovering from seemingly irrecoverable situations to know that their predictive powers are quite falli…

>- they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students.

The same doctors in bed with big-Pharma, that shove prescriptions around for money and paid-all-expenses trips?

The same doctors that perform unnecessary operations for a buck?

Re: The truth about organ donation

#18

Post by vannevar » Wed, Sep 12, 2012, 7:56 PM UTC

alimoeeny wrote: post #4

There are quite a lot of misguided statements in this article, like you are "alive" because your heart is beating, or you feel pain if they don't give you pain killers. You should be "brain dead" to be an organ donor. And brain dead means dead, no chance or recovery, I am sure there are cases that mistakes happen but that is a mistake, you need to be confirmed brain dead by quite a lot of doctors to get harvested!

And brain dead means dead, no chance or recovery...

The key point of the article is that the test allegedly used to determine brain death isn't a very good one. I'd be curious to know whether the test described (pulling the patient off a respirator for two minutes) is indeed the actual criterion used. It sounds suspiciously simplistic.

Re: The truth about organ donation

#19

Post by alimoeeny » Wed, Sep 12, 2012, 7:57 PM UTC

cobrausn wrote: post #8

alimoeeny wrote: post #4

There are quite a lot of misguided statements in this article, like you are "alive" because your heart is beating, or you feel pain if they don't give you pain killers. You should be "brain dead" to be an organ donor. And brain dead means dead, no chance or recovery, I am sure there are cases that mistakes happen but that is a mistake, you need to be confirmed brain dead by quite a lot of doctors to get harvested!

Yeah, I would like to see some actual numbers before coming to any conclusion. Something along the lines of the number of people that have recovered from the state wherein they could legally take your organs. Not sure if those numbers would be easy to come by.

I don't know if it is easy to come up with these numbers (legal and policy maters aside from a purely medical stand point). Still as someone who have been around transplant teams, I can say at least in the state of Maryland, things are very well under control and I for one would not worry too much about been taken advantage of. But definitely there are places that things are not handled as they should.

Re: The truth about organ donation

#20

Post by jd » Wed, Sep 12, 2012, 7:59 PM UTC

The bottom line is still that many lives are saved by organ donors. From a moral point of view it's also pretty clear cut. If you want to accept an organ when you fall ill then you should also be willing to donate your organs.

The concept of organ donation is a little freaky, and the idea admittedly makes me a bit uncomfortable. Especially as I visualize it. But surely selfishly hanging on to something I don't need anymore (being dead and all) isn't the right solution.

I think this article is essentially some elaborate rationalization. The author can't reconcile being against organ donation knowing it saves lives. Hence the absurd stuff about doctors cackling evilly as they chop up their live patients to harvest the organs for fun and profit. Right.