Friday, May 1, 2015

How Dead Do You Have to Be?

As technology advances, we are faced with multiple ethical challenges that were unthinkable in the past.  In 1962 a new era of lifesaving began.  The first outpatient kidney dialysis clinic was started by Dr. Belding Scribner in Seattle.  Suddenly there was a lot of demand for treatment but very limited facilities.  Ethics Committees were formed to struggle with allocation of scarce resources - labeled "God Squads" by residents.

Dialysis wasn't an ideal long-term solution.  Subsequently, organ transplantation became available - but again there is a shortage of kidney, hearts, lungs, livers, etc.  Many folks die while on the waiting list.  Living donors are sometimes available but the number of organs for transplant still falls far short.

A recent article about brain death and imminent death was published, where a patient with ALS wanted to donate organs when he was at the point of imminent death - not waiting until brain death when organs are less viable.  It's an interesting, difficult, and sad dilemma to know the right answer.  Is it "do no harm"?  Or respect a patient's autonomy when dying?  Or protecting a hospital's statistics?  Hopefully, there will be a way to address the needs - and to focus on saving lives.

1 comment:

  1. Is it impossible to be an organ donor while anticipating a peaceful home death? I'd like both in my future but is it feasible?