Letter: Transplant consent
Your support helps us to tell the story
From reproductive rights to climate change to Big Tech, The Independent is on the ground when the story is developing. Whether it's investigating the financials of Elon Musk's pro-Trump PAC or producing our latest documentary, 'The A Word', which shines a light on the American women fighting for reproductive rights, we know how important it is to parse out the facts from the messaging.
At such a critical moment in US history, we need reporters on the ground. Your donation allows us to keep sending journalists to speak to both sides of the story.
The Independent is trusted by Americans across the entire political spectrum. And unlike many other quality news outlets, we choose not to lock Americans out of our reporting and analysis with paywalls. We believe quality journalism should be available to everyone, paid for by those who can afford it.
Your support makes all the difference.Sir: The issue is about the consent that an individual gives when he or she signs a donor card, or that Professor John Harris proposes should be enacted in legislation. That consent must be informed, and for this to be the case the individual must be told what is going to take place at the time their organs are removed.
The British criteria for brain-stem death test for lack of function in the part of the brain which regulates body function. Where the brain stem is irreparably damaged, Dr Andrew Robinson (letter, 24 February) is quite correct in asserting that survival is impossible; but this highlights the very point at the centre of the argument. This is the distinction between the situation where death is certain (circulation has stopped and the body is cold) and where death is inevitable, when the brain stem is dead but cardiac and respiratory function is supported.
The brain-stem death criteria test nothing about function above the brain stem. People who decline to sign a donation card do so because they do not want to have their organs removed while any possibility, however remote, remains that they might have an awareness of this taking place.
The procedure frequently involves an incision from the pubis to the throat, so as to expose all the organs in the abdominal and chest cavities. The breastbone is broken and the ribs spread apart. It is carried out with the lungs ventilated and heartbeat sustained. Certain transplant surgeons have indicated reluctance to allow anaesthesia for the unfounded reason that it might damage the organs. Once the organs have been removed, the ventilator is disconnected. It is only at this point that death is certain in the form accepted by the laity: breathing ceases, the heartbeat stops and the body cools, although death has been declared on the basis of cessation of brain-stem activity some hours before.
These are some of the facts which need consideration before collective public consent to donation is enacted in the form of legislation.
Dr JOHN URQUHART
Consultant Anaesthetist
West Suffolk Hospital
Bury St Edmunds
Join our commenting forum
Join thought-provoking conversations, follow other Independent readers and see their replies
Comments