Lois Rogers
The Jesus and Mary Chain CD: Psychocandy at WHSmith today
The government is to allow organs to be taken from people before they are officially brain dead in an effort to tackle the shortage of transplant donors.
Guidelines being published in September will allow transplant surgeons to begin removing organs five minutes after a donor’s heart has stopped.
The move has raised concerns about the drive to harvest more organs from dying patients to meet a government target to increase transplant rates by 50% in the next five years.
The new code of practice for diagnosis and confirmation of death, produced on behalf of the health department, is the first set of rules in Britain to provide clinicians with such instructions.
It will give doctors permission to forgo a complex set of tests to establish brain stem death, which can take 20 minutes. The delay means that unless a donor is on life-support, their organs tend to be too badly damaged by oxygen starvation to be used.
Gordon Brown has also called for the introduction of presumed consent, whereby everyone would be treated as a potential donor at death unless they had notified their objection in advance.
The Patients’ Association says it has not been consulted on the issue of diagnosis of death. Vanessa Bourne, its chairwoman, said: “Who is going to advocate for people with no family?”
David Evans, a retired consultant anaesthetist who has long expressed doubts about the methods of defining death for organ donation purposes, said: “No one of scientific mind really believes you can diagnose death in these simplistic ways. By rushing to retrieve organs we are depriving ourselves of the simplest tool to diagnose death, which is the passage of time.”
Doctors in Paris recently reported that a 45-year-old heart attack victim had begun breathing again as surgeons prepared to retrieve his organs.
Last year in Frederick, Oklahoma, Zack Dunlap, 21, was declared dead after a quad-biking accident. Two cousins who were nurses had arrived as a transplant team was landing by helicopter and found he reacted to having his feet and hands touched. He has since made a full recovery.
Peter Simpson, former president of the Royal College of Anaesthetists who led the working party behind the new code, said he was confident such disasters would not occur in the UK.
“We are saying you must wait five minutes [before removing organs],” he said. “Five minutes of lack of circulation inevitably leads to brain damage but not necessarily damage that would meet the brain stem death criteria.”
He said the code was as much to protect people from overzealous resuscitation efforts as to give early signs of when organ retrieval might be appropriate.
“We have not had a lot of disagreement with this guideline, and I am anxious it is not taken the wrong way,” he said. “Diagnosis of death is not well taught.”
The move will increase the number of organs available. Stroke victims could become the biggest donor pool. Up to one in five of the 40,000 people who die annually as a result of strokes have hearts, lungs, livers and kidneys that can be reused.
Some transplant centres have already begun using livers and kidneys from donors whose hearts have stopped.
Steven Tsui, head of the heart transplant programme at Papworth hospital, Cambridge, said extraordinary efforts were made to ensure organs were not taken if there was the slightest hope of recovery. “In surveys more than 90% of the population approve of organ donation, but when they are asked to consent to the use of organs from a family member, only 40% do so. It is time for the public to be made aware of these debates, and that what we are doing is the right thing to do.”
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Organ donation isn't natural, a human being isn't a bag of spare parts for another person. Also it is a slur on the integrity of your body. If it was good why should organs be repelled. And I am afraid the criminals will take over the trade in organs.
Jan Hamer, Didam, The Netherlands
I carry a donor card.
With this new announcement I will cease to do so, until a legally binding version can be produced that says I opt-IN *only* on condition that the original test criteria for my being brain dead have been applied.
Until then, we've just LOST another donor..
Phil, Leeds,
In response to Lois Rogers article I can only say that she hasn't aqainted herself with all the facts before sensationalising, and frankly scaring the public out of organ donation. The practice of retrieving organs from non-heart beating donors is NOT new and the donor is most certainly deceased.
Trish, Newcastle-upon-Tyne,
Look at this from a different viewpoint. There is a shortage of transplant surgeons, specialist nurses and facilities to increase the current levels of transplants. So if you want to reduce the number of operations blame the public for there not being enough organ donors. What you do is scare them!
John, Southampton,
I don't have a problem with organ donation as long as it remains voluntary. What I do have a problem with is "overzealous resuscitation efforts". This reads more as "minimal resuscitation efforts" will be the standard if this law gets through and something I could never agree with.
Lily, London,
If there was ever a way to put people off donating organs it is the assumption by the State that they have the right to take your organs *without* your consent and to not even exercise due diligence to ensure that you are actually dead.
This Government has lost all contact with reality!
Graham Marsden, Portsmouth, UK
"He said the code was as much to protect people from overzealous resuscitation efforts.."
I learn something new every day! Now I have found out that there can be "overzealous resuscitation efforts".
If I am in an accident, I WANT there to be "overzealous resuscitation efforts" on my behalf...
Dodgy Geezer, Gloucester, UK
I used to think organ donation was a good idea, but now I have suddenly changed my mind. How do I register my wish to opt out? Perhaps The Times could publish an address or telephone number for doing this.
Martin, Newmarket, Suffolk
There will soon be bonus payments for all those involved in the collection and re-use of human organs, except of course the donar. God help us all when money starts changing hands.
jaques de montreal, Leeds,
Yet more madness from the morally bankrupt, tick-box,target-setting government.
RB, Aberdeen,
After reading this I think I will get a tattoo as well.
Ray Harvey, Hitchin, UK
Look at this from a different viewpoint. There is a shortage of transplant surgeons, specialist nurses and facilities to increase the current levels of transplants. So if you want to reduce the number of operations blame the public for there not being enough organ donors. What you do is scare them!
John, Southampton, uk
Surely taking organs from people who have not been fully assessed as dead and hence declared dead is murder. This is a very gruesome and legally questionable step. And as a life-long donor card carrier, if presumed consent becomes law I will be opting out.
Alex, York,
I only managed to read half of this article as i became too infuriated to read further on.
WATS A PATHETIC IDEA!
im speechless!
assiya khan, walsall,
If this ill conceived idea goes ahead then I too shall withdraw my consent . Nothing short of independantly verified brainstem death should be a licence to remove, and will be an even greater problem if extended to include child 'donors' when the body temperature is a factor in determining death.
Tony, Stonegate,
You might not be dead "after 5 minutes"
Future of the UK, paramedics will wait till the deadline with a timer so they can organ harvest rather than save lives.
How long till underworld gangs invest into this new "market" too?
Brundi, Ho Chi Minh City, Vietnam
Yet again another move from the most bizarre Government known to man. This has changed my mind and I will now NOT donate.
Roger, Surrey.,
Hello. Uhh, can we have your liver?
-- My what?
Your liver. It's a large, ehh, glandular organ in your abdomen.
You know, it's, uh,-- it's reddish-brown. It's sort of, uhh,--
--- Yeah,yeah, I know what it is, but... I'm using it.
William McIlhagga, Ilkley,
forces one to carry an "i do not wish to be a donor"card- another half-baked idea from this incompetent government
peter c, Devizes, Wessex
My 4 yr old nephews brain died at the time of his fall. His body was kept alive on a life support machine FOR his organs to be harvested. His parents had to make the decsion to turn off the machine - they thought it WAS their decision but it was because the transplant was arranged. I will opt OUT.
Liz, East Anglia, UK
Next step in not so distand future will be a random hunt for living donors in the streets...
Daddy, wARSAW,
How horribly gruesome. I definitley won't donate now. Does it get any worse? Soon they'll be knocking people over the head and dragging them into hospitals to harvest their organs. I didn't trust the medical profession in this matter before but I especially don't now.
judy, Liverpool, England
I am registered as a donor and carry a donor card. I am happy to do this after my death BUT under these rules I will withdraw consent. This will lead to less donors rather than more.
barbara, north east,
This is another ill-considered idea from this deranged Government that will surely once again demonstrate the Law of Unintended Consequences. The concept of 'presumed consent' is fine, but people want reassurances that the donor body is really dead. This will do nothing to allay their fears.
John (transplant recipient), Yorkshire,
I feel that a person presumed dead may only be in a deep coma and may be able to feel pain but not respond to it. I would not want my organs taken without anaesthetic. People have been known to unexpectedly recover from deep comas and some have reported an awareness of things while unconscious.
Veronica Wood, Coventry, UK
Just this week a child was declared dead after a drowning accident only to have a heartbeat discovered after some time. According to these new rules her organs could have been harvested at the initial declaration...
I plan to have a tattoo on my chest that says "NO- I will NOT be an organ donor
Eileen, Gloucester,
This is very very scary. So now when we go into hospital in the UK we have to worry about (a) getting MRSA (b) getting C-Diff (c) having our organs taken whilst we are still alive (d) not being allowed the best drugs because we were naughty enough to spend out own money on some drugs . Nice.
John, Woking, Surrey