From this week, people in Wales will be presumed to have offered their organs for donation, unless they specifically opt out. The rights and wrongs of assuming that someone who dies is willing to have their organs “harvested” are bad enough, and raise a number of ethical and cultural questions.
However, what is more concerning is that yet again, the presumption is that the individual will be dead when the organs are taken.
Of course, for those in need of an organ transplant, I cannot imagine there is anything worse than waiting and waiting, and wondering.
But the fact, that is completely ignored, is that the individual giving the organ will not actually be completely dead. By now, you must imagine that I’ve slightly lost it – of course the person is dead. And in some ways – they sort of are. Doctors are simply asked to determine whether the individual is (in the UK) brain stem dead.
This is not based on supposition or hearsay. A Journal of Medical Ethics article – “Does it matter than organ donors are not dead?” sums up some of the intricacies of the debate. In their abstract, they state: “We dispute [the] claim that the removal of vital organs is morally equivalent to “letting nature take its course”, arguing that, unlike “allowing to die”, it is the removal of vital organs that kills the patient, not his or her disease or injury. Then, we argue that removing vital organs from living patients is immoral and contrary to the nature of medical practice.”
Clinicians use a range of techniques to determine whether they feel that a patient is “dead enough” to warrant removal of those vital organs – but none are necessarily perfect. Another article, from Medical News Today, talks about a case where a patient was about to have their organs removed, before waking up on the operating table.
And it is known that donors can likely feel pain.
For organs to remain alive and appropriate for transfer, they must be taken to avoid any damage caused by lack of circulation. And by no means would anyone want to negate the benefits of organ transplantation.
But the question is, why isn’t this more widely known? Is it really right to ask people – or tell people – that they will donate their organs, when they don’t realise they will still be alive when the organs they can’t live without are removed? Many people may be comfortable with this – but surely we live in a society where the facts should be open, and people aren’t misled.