Organs of Coercion

Dear Stan,

Here is a fascinating and depressing article by Melanie Phillips. It echoes concerns about organ transplantation which have been discussed on Catholic websites for the past few years, i.e. are the moribund donors really "deceased" when the transplant team move in?. As Melanie is from a traditional Jewish background, her cogent comment shows that it is not an exclusively Catholic area of moral anxiety. The immediate cause of her article was the recent proposal by the Reverend Blair's sinister successor Gordon Brown that you have to opt out of donating your organs rather than opting in. As one contributer to another website noted, it is not bad enough that the Government plunders our wallets while we are alive, it now wants to asset strip our corpses. And it could be a fantastically lucrative business, selling everything from kidneys and hearts to bone to the private medical trade.

At least Phoney Tony only squandered our money.

Bill

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January 14, 2008
Organs of Coercion
Daily Mail, 14 January 2008

The news that Gordon Brown has thrown his weight behind a move to register everyone automatically as an organ donor unless they opt out has all the hallmarks of a major spin operation.

The Sunday newspapers ran prominent stories about the proposal, which is piggy-backing on tomorrow’s government review aimed at boosting the number of organs donated for transplant. Mr. Brown himself penned an article arguing that voluntary organ donation should be replaced by an opt-out system. Similarly, the BBC had clearly been primed with information to promote the story to pride of place.

If this is supposed to assist Mr Brown’s new year campaign to restore his waning political fortunes, it’s a pretty rum way of going about it. To begin with, the idea is not even new. England’s Chief Medical Officer, Sir Liam Donaldson, first proposed such an opt-out system last summer. Maybe Mr Brown thinks he can humanise his image by capitalising on the distress of people suffering or dying for want of a transplantable organ.

Undoubtedly, the impulse to give people the gift of life after one’s own death is a noble one. But if Mr Brown really imagines that he will win popular acclaim by saying that the state will whip out people’s hearts or kidneys without their consent, his advisers undoubtedly need a brain transplant.

For the implications are truly terrifying. There is no more fundamental human right than control over our own bodies and what is done to them, both in life and death.

The inescapable implication of a donor opt-out is that we no longer possess such control. The presumption instead is that the state controls our bodies and can do what it likes with them after it declares us to be dead.

If the medical profession alone were to suggest this — as its leadership most lamentably is doing — it would be alarmingly coercive. For the Government to be backing it, however, deepens coercion into something even more threatening.

Volunteering to donate your organs is one thing. Making it compulsory unless you opt out transforms an act of altruism into state oppression.

Sir Liam attempts to defuse public hostility by saying soothingly that opting out would be an ‘inalienable right’. On the contrary - being forced to opt out of automatic donation destroys our inalienable right to control what happens to us.

It is a weaselly, back-door means of trapping people into having something done to them when they are declared to be dead which may be unacceptable to them in life. Opting out requires an effort. Many will simply forget to do so. That is the cynical calculation behind the scheme. In addition, what will happen - as inevitably as night follows day —is that people will be put under great pressure not to opt out.

Patients who have done so may well be discriminated against. Chillingly, hospitals are to be rated according to the number of dead patients they ‘convert’ into donors. It is hard to imagine a more sinister incentive for the wholesale abuse of vulnerable patients.

There is, however, a yet more fundamental objection to the opt-out proposal. This is the serious doubt whether people whose organs are harvested are indeed dead.

All the evidence suggests that organs are harvested not from the dead but from the dying. In other words, at the time the organs are removed the patients are still alive.

This is because, in these cases, the criterion doctors use to decide that someone has died is the death of the brain stem. This is said to be ‘brain death’, and thus death itself.

However, it does not follow at all that the rest of the brain has also ceased to function. Yet no tests are carried out on other parts of the brain to establish whether all activity there has actually ceased or not.

As a result, people are declared dead while their heart is still beating unassisted and blood is still circulating round the body. Most of us would think such patients are not dead but very much alive.

Indeed former transplant doctors, who became so horrified by the implications of what they were doing that they abandoned the practice, say that organs for transplant are only viable if the donor is still alive — since when the body is really dead the organs become useless to anyone else, as they die too.

Brain stem death is in fact merely a convenient definition that allows surgeons to remove organs from a living body while they are still being nourished by its blood supply.

Such observations provoke outrage in transplant doctors who claim there is no basis for such ‘scaremongering’, which will cause more people to die because potential organ donors will be unreasonably frightened off. But among such doctors, their own behaviour gives the game away.

Some give ‘brain stem dead’ patients a general anaesthetic before removing their organs. But whoever heard of anaesthetising a corpse? The reason they do it is because of a sharp rise in blood pressure during the organ removal. Some doctors claim they administer the anaesthetic simply because it stops the excessive bleeding caused by this blood pressure rise. But a rise in blood pressure during any surgical procedure is an indication that the body is experiencing physical distress.

Dr David Hill, a retired anaesthetist who has long expressed deep concern about organ donation, has written that if patients react in similar fashion when their organs are being removed, the most logical conclusion is that they are not in fact dead.

In recent years, ‘brain stem death’ has been increasingly questioned as we realise how little we know about the brain. Doctors are discovering that, among patients in a persistent vegetative state whose brains are presumed to have stopped functioning, there is in fact a large amount of brain activity. The implications for what patients presumed to be ‘brain dead’ might be experiencing are simply unknowable.

More and more experts have been expressing increasing concern about brain stem death and organ donation. Three doctors wrote in a medical journal last year that declaring patients dead for the purposes of harvesting their organs was in effect a fiction, and that prospective organ donors were not being told the truth.

And a professor of philosophy and expert in medical ethics, Michael Potts, has drawn the horrifying conclusion: ‘Since the patient is not truly dead until his or her organs are removed, it is the process of organ donation itself that causes the donor’s death.’

In Britain, however, the medical establishment backs organ donation and the proposed opt-out scheme. This is because the British Medical Association and the medical royal colleges long ago lost their own ethical plot.

Renouncing the core medical precept, ‘First do no harm’, they have come to believe instead in the amoral doctrine that the end justifies the means.

As a result, from abortion, embryo research and cloning to starving and dehydrating ‘dispensable’ patients to death, respect for human life has been replaced by the belief that individual lives are merely instrumental to the creation of the happiness of the greatest number.

This way lies the most alarming infringement of human rights and a descent into tyranny.
A system the public believes embodies the highest form of altruism rests instead on deception and unlawful killing. Far from being forced into an automatic/opt- out donation system, people should finally be told the truth.