Christian Conservative

I had high hopes when I saw the title of this article, but I was sorely disappointed by the incorrect content. The authors correctly point out the problems with DCD organ harvesting, in which support is withdrawn, the patient becomes pulseless, and after a 2-5 minute wait time organ harvesting begins. The authors correctly cite the recent HHS organ donation study in which 103 cases (29.3 per cent) showed concerning features, including 73 patients who had neurological signs incompatible with organ donation. And at least 28 patients may not have been deceased at the time organ procurement was initiated. They also correctly cite DCD cases in which patients woke up during the organ harvesting process. But unfortunately, the authors propose to fix this by adding brain death testing to the DCD protocol. Their discussion reveals their lack of knowledge about brain death. Take for instance this misleading statement: “Brain death testing started in the 1960s and is the gold standard for the determination of death in patients in a coma on a ventilator.” Yes, in 1968, thirteen men at Harvard Medical School suggested (without tests, studies, or evidence) that we redefine people in a deep coma as being dead enough to become organ donors. But nearly 60 years later, brain death testing continues to be non-evidence based: the most recent (2023) American Academy of Neurology’s brain death guideline was decided by 3 rounds of anonymous voting “because of the lack of high-quality evidence on the subject.” Wouldn’t you think that there would be some high-quality evidence for brain death by now? This statement is also incorrect: “Radionuclide cerebral blood flow assessment has been found to be an accurate brain death determinant” According to the 2023 AAN Guideline, all such ancillary tests have shortcomings, and none are 100% sensitive and specific for a diagnosis of brain death. Brain death as death is unsubstantiated and lacking in scientific validation. This unverified concept cannot prop up DCD. Death is marked by the irreversible cessation of ALL vital functions beyond any possibility of return. Taking organs before this time is homicide. From the article: “The Vatican’s New Charter for Health Care Workers states: ‘In an area such as this, in fact, there cannot be the slightest suspicion of arbitrariness, and where certainty has not been attained, the principle of precaution must prevail.’” Brain dead donors are not dead, and DCD donors are not known to be dead at the time their organs are removed. It’s time that the public was given full transparency about these facts.