Organ Transplant Program Removes Babies' Hearts

[ScareCrow]

I'm gonna have to think about this one for a little myself. I can see both sides of this issue and certainly see a need for regulations of some sort.



Surgeons in Denver have begun removing the hearts of severely brain-damaged newborns less than two minutes after the babies are disconnected from life support and their hearts stop beating so the organs can be transplanted into infants who would otherwise die.
A detailed description of the transplants in tomorrow's issue of The New England Journal of Medicine immediately ignited an intense debate about whether the first-of-their-kind procedures were pushing an already controversial organ retrieval strategy beyond acceptable legal, moral and ethical bounds.
The doctors who performed the operations as part of a federally funded research project defended the practice, and some advocates for organ donation praised the operations as offering the first clear evidence that the procedures could provide desperately needed hearts for terminally ill babies.
Critics, however, are questioning the propriety of removing hearts from patients, especially babies, who are not brain dead and asking whether the Denver doctors waited long enough to make sure the infants met either of the long-accepted definitions of death -- complete, irreversible cesssation of brain function or of heart and lung function. Some even said the operations were tantamount to murder.
"This bold experiment is pushing the boundaries and raising many questions," said James L. Bernat, a widely respected Dartmouth Medical School professor who wrote one of four commentaries the journal published with the report -- an unusual step that anticipated the firestorm of reaction the procedures would ignite. The journal posted them on its website (http://content.nejm.org/cgi/content/full/359/7/669/DC1) with a videotaped debated among three prominent bioethicists.
"This clearly shows the feasibility of doing this," Bernat said. "The question is: 'Should this be done?'"
The operations comes as transplant advocates have become increasingly aggressive in trying to bridge the gap between the number of available livers, kidneys, hearts and other organs and the number of Americans on the waiting list for transplants. Continued at link below.



http://www.washingtonpost.com/wp-dyn/content/article/2008/08/13/AR2008081303362.html

[lily]

I can see why you would have to think about this for a little while and let it digest, Scarecrow.......I did the same when I read an article about translpant vehicles being allowed to follow ambulances to what was being called in as fatal accidents.


Critics, however, are questioning the propriety of removing hearts from patients, especially babies, who are not brain dead and asking whether the Denver doctors waited long enough to make sure the infants met either of the long-accepted definitions of death -- complete, irreversible cesssation of brain function or of heart and lung function. Some even said the operations were tantamount to murder.

This is a legitimate concern.........but doctors are the ones that make the decision every day whether a child is born brain dead or not, so I don't understand the concern. If it could help another infant who was born with no chance of surviving without a heart transplant and the parents are willing to donate......shouldn't that be left up to them and their doctor?

[Alonzo]

So we take a heart out of an infant that, with or without a heart, will die. We then take that heart and place it in an infant that, without the heart, will die but, with the heart, will live.

So people prefer 2 dead babies to 1 dead baby. Only in America.

[ScareCrow]

I can see why you would have to think about this for a little while and let it digest, Scarecrow.......I did the same when I read an article about translpant vehicles being allowed to follow ambulances to what was being called in as fatal accidents.


.

This is a legitimate concern.........but doctors are the ones that make the decision every day whether a child is born brain dead or not, so I don't understand the concern. If it could help another infant who was born with no chance of surviving without a heart transplant and the parents are willing to donate......shouldn't that be left up to them and their doctor?

Honestly I think my biggest issue with this is because of one of my nieces. My oldest niece was born on new years day in 1999. On the night she was born the doctor on call didn't want to come in and asked that the nurses postpone the delivery causing my niece to be a dry birth. She survived but has severe cerebral palsy and other health conditions as a result of the incident. Of course the lawyers did their thing and lawsuits were filed but no amount of money changes the fact that this child will be affected by this doctors choices for the rest of her life, she was 9 before she took her first steps and doctors don't expect her to live past 16.

The reason I bring this story up is because it brings to my mind a question of how much power a doctor really has. At the time my niece was being born the nurses didn't say, "well the doctor is out celebrating the new year so we are going to put your child at risk by making you wait". Instead they gave a BS excuse as to why they were postponing delivery. Now say one of these doctors is offered a bribe for a heart, or even worse yet have a member of their own family needing this heart. What is there preventing this doctor from deliberately causing problems with one child to save another. I know that this is an unlikely scenario but is the main reason I would really like to see some strict regulations on this practice. I have no problems with a child being an organ donor, I just realize that doctors are human too and capable of succumbing to the same temptations as the rest of our population.

[Alonzo]

scare, think of the odds of that happening vs. the odds of saving the life of another baby.

[ScareCrow]

scare, think of the odds of that happening vs. the odds of saving the life of another baby.

I am thinking of those odds, but it happening just once is too many for me. After thinking about the story some, I really have no issue with the transplants I would just like to see some oversight of the doctors and clear regulations defining how long these doctors must wait. I don't really think it's asking to much to have something that could become so dangerous to be at least moderately scrutinized.

[lily]

Honestly I think my biggest issue with this is because of one of my nieces. My oldest niece was born on new years day in 1999. On the night she was born the doctor on call didn't want to come in and asked that the nurses postpone the delivery causing my niece to be a dry birth. She survived but has severe cerebral palsy and other health conditions as a result of the incident. Of course the lawyers did their thing and lawsuits were filed but no amount of money changes the fact that this child will be affected by this doctors choices for the rest of her life, she was 9 before she took her first steps and doctors don't expect her to live past 16.

I'm so sorry to hear that......but don't let it sour you on infant transplants....that was a case of doctor negligence.....that isn't what happens %99 of the time.



The reason I bring this story up is because it brings to my mind a question of how much power a doctor really has. At the time my niece was being born the nurses didn't say, "well the doctor is out celebrating the new year so we are going to put your child at risk by making you wait". Instead they gave a BS excuse as to why they were postponing delivery. Now say one of these doctors is offered a bribe for a heart, or even worse yet have a member of their own family needing this heart. What is there preventing this doctor from deliberately causing problems with one child to save another. I know that this is an unlikely scenario but is the main reason I would really like to see some strict regulations on this practice. I have no problems with a child being an organ donor, I just realize that doctors are human too and capable of succumbing to the same temptations as the rest of our population.

Would not happen........the transplant list is "gold". Unless he had an entire staff, complete with blood work on the patient needing the transplant, which would be another entire staff.....he'd never get away with it and be able to practice medicine again.

[Trish]

Honestly I think my biggest issue with this is because of one of my nieces. My oldest niece was born on new years day in 1999. On the night she was born the doctor on call didn't want to come in and asked that the nurses postpone the delivery causing my niece to be a dry birth. She survived but has severe cerebral palsy and other health conditions as a result of the incident. Of course the lawyers did their thing and lawsuits were filed but no amount of money changes the fact that this child will be affected by this doctors choices for the rest of her life, she was 9 before she took her first steps and doctors don't expect her to live past 16.

The reason I bring this story up is because it brings to my mind a question of how much power a doctor really has. At the time my niece was being born the nurses didn't say, "well the doctor is out celebrating the new year so we are going to put your child at risk by making you wait". Instead they gave a BS excuse as to why they were postponing delivery. Now say one of these doctors is offered a bribe for a heart, or even worse yet have a member of their own family needing this heart. What is there preventing this doctor from deliberately causing problems with one child to save another. I know that this is an unlikely scenario but is the main reason I would really like to see some strict regulations on this practice. I have no problems with a child being an organ donor, I just realize that doctors are human too and capable of succumbing to the same temptations as the rest of our population.

My heart goes out to you and your family. I can understand that from your personal experiences you would want there to be safeguards in place to at least try and prevent any of the same type of thing that happened to your neice from happening to another baby. Hopefully, there are already safeguards in place.

[Tarja Turunen]

Provided the child in question is dead, I see no problem with it. I doubt there will be a doctor who would remove a heart from a person who is still alive - whether they are on life support or not. If there was such a doctor, I would expect him/her to be punished to the full extent of the law.