National Post

Organ donations

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Re: Dead Heart Patients Eyed For Donations, Sept. 17. As the parent of a young heart recipient, I know that improving the organ donor system starts with awareness. Until someone needs an organ transplant, the average person has no clue as to the importance of giving the gift of life.

As we quietly celebrate our first-year milestone with triumph and gratitude, others — sadly enough — cannot. Organ donation should not be optional if it means saving another life, but that is easier said than done when fear and unawarenes­s are part of the equation. It is a difficult journey for those waiting, but with new frontiers being explored, hope, rather than despair, should prevail. Robin Chadnick, Dollard DesOrmeaux, Que. The Canadian Council for Donation and Transplant­ation’s recommenda­tion that organs be retrieved from patients who have been diagnosed as having undergone “cardiac death” is not new. In 1993, the University of Pittsburgh developed the “Pittsburgh Protocol,” which purported to allow patients or their surrogates to offer organs even though they were not “brain dead.”

In 1997, the Institute of Medicine described the typical candidate for the “cardiac death” diagnosis as five to 55 years old, having suffered a severe head injury, not “brain-dead” and otherwise healthy. Such a patient is unconsciou­s, and receiving life support on a respirator. A physician declares that treatment is futile. The surrogates agree to withdrawal of the respirator. They then agree to organ donation. The respirator is withdrawn. If the heart stops beating within an hour, the organs are retrieved. The Canadian Council proposal enlarges the group of candidates to be designated as potential organ donors to include all patients where the heart has stopped beating after they have been taken off the life support of a respirator.

There are serious moral problems, however. There is no agreement among scientists and physicians either about the criteria for determinin­g “brain death” or if “brain death” is the equivalent of actual death. There is no agreement that “cardiac death,” which is declared even in the absence of “brain death,” is actual death either. No one can truly know that treatment of an unconsciou­s patient on a respirator is futile.

Organ donation at “cardiac death” is not a boon to humanity, but is a further hazard for any critically ill patient who happens to cross the threshold of the emergency rooms, the operating rooms or intensive care units of our hospitals. Those on the hunt for organs have a conflict of interest. They should not be the persons to define death. John B. Shea, MD, Toronto. Expanding the donor pool will not help those patients waiting for a transplant unless there is a simultaneo­us increase in the number of critical care nurses and critical care beds in Canada .

Yes, the list is long and growing longer but some of the proposals by the Canadian Council for Donation and Transplant­ation will make matters worse. Eileen Herbert, critical care nurse, Barrie, Ont. As I huffed and puffed

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