Living patients face organ harvesting

Leo Shanahan

July 9, 2006

AUSTRALIAN organ donors may in future have their bodies prepared for transplantation while they are still alive.

The Australian Health Ethics Committee's working party is seeking to extend the transplant preparations to patients who are certain to die after experiencing "cardiac death" -- when their heart stops beating and their circulation stops.

In the past, transplant preparations have been carried out on brain-dead patients.

The procedure involves taking the patient to an operating theatre for the surgical insertion of tubes into their major arteries to prepare for cleansing of the organs after death, blood tests and drug administration. This helps preserve their organs.

Peter Joseph, chair of the ethics committee's working party on organ donation, said extending the preparation procedures to living patients was necessary to preserve solid organs such as hearts, livers, lungs and kidneys, which deteriorate quickly after circulation stops.

"There is only one state of death, but there are two ways in which a doctor can certify death as having occurred: brain death and cessation of circulation," he said.

Brain death is when doctors conclude through tests that a patient has lost all brain function completely and permanently.

Organs can then be preserved via a ventilator for the purposes of donation.

"In people who are brain dead these preparations are legitimate and present no ethical barrier," Dr Joseph said.

"Brain death is easy. If the brain is dead the person is dead, but the organs are being maintained for the purposes of transplantation.

"If somebody has died by cessation of circulation -- in other words, if the heart has stopped beating -- within a few minutes the organs deteriorate by themselves."

The proposed changes are outlined in the National Health and Medical Research Council's draft consultation paper, which states: "Sometimes the severity of a person's injuries means that they are unable to survive even if there is still some brain function.

"To improve the chances of organs being suitable for transplantation, some treatments are needed before the person dies (e.g. blood tests, surgical insertion of a tube into the main artery of each leg)."

When asked whether it would be possible that somebody could be aware of the fact they were being prepared for organ harvesting, Dr Joseph said: "Yes, it would."

But he said it would not be done without the permission of the donor or the donor's family.

"We do not believe that this is covered by the general permission to donate," he said.

"If ante-mortem [before death] intervention does occur, it requires specific consent."

The committee wants legislation made uniform so the practice is legal in all states and territories.

"There are interstate differences to some of these procedures that may well be . . . actually illegal," Dr Joseph said.

Source: The Sun-Herald

Copyright © 2006 The Sydney Morning Herald.

This article posted August 26, 2006.