Wednesday, May 09, 2018

the boy who came back

Stories like this one will give you a clue why the pro lifers got so hysterical against the UK doctors in the Alfie case awhile back:

from the BBC (video at link).

more here from WFSA:

MOBILE COUNTY, AL (CNN/RNN) – A boy was left brain dead after an accident while playing at a friend's house. After his parents accepted his condition and made the decision to donate his organs, the boy woke up. Trenton McKinley, 13, suffered severe brain trauma two months ago from a dune buggy accident. "I hit the concrete, and the trailer landed on top of my head. After that, I don't remember anything," Trenton told FOX10 News.
For the next several days, Trenton was brain dead and barely breathing, according to reports. "Five kids needed organs that matched him,” said his mother, Jennifer Reindl. “It was unfair to keep bringing him back because it was just damaging his organs even more."
Reindl said Trenton was dead for 15 minutes, and doctors said he would be a vegetable if he survived. Then a day before doctors were scheduled to remove him from life support, Trenton began to show signs of cognition.
Trenton said he believes he was in heaven while he was unconscious. "I was in an open field walking straight,” he said. "There's no other explanation but God. There's no other way. Even doctors said it."

several medical problems with this: was he just in a deep coma, or brain dead? The family understood he was brain dead, but then they say the doctors said he had no chance of recovery so they wanted to pull the plug: which is not the same as being brain dead.

Removing the respirator as "extraordinary" treatment is ethically permitted by the Catholic church, but he was not brain dead.

And if he wasn't brain dead, how could they remove his organs?

The dirty little secret: doctors are now allowed to do "living" donations of organs from the dying who don't meet the criteria for brain death. It is called "non brain dead" organ donation, and that is what seemed to be happening here.

The problem? the lay public doesn't know the difference, so that as more of these cases hit the news, the story of people awakening while their organs are being removed will go from an "urban legend" to reality.


In brain death, the entire brain is dead, including the brain stem. Remove the machines and you die.

But in this case (and in Alfie's case), there was no brain death: either the family misunderstood, or the doctors were just trying to remove the extraordinary treatment of a respirator because

a) it's expensive,
b) the family will suffer
c)even if the patient recovers he will be handicapped (aka a "vegetable")

ah, but then you have
d) look at all those wonderful organs that can save the lives of other folks.

and I left out the "but he's dying" argument, which is what these bozos argue: Sorry guys: No, he wasn't dying, but he was in danger of living and that is what the newfangled masters of the universe hate: all those with a poor quality of life becoming a burden on society.

For the elderly, there is a good argument that their many medical problems and low chance of recovery might cause them and the family not to push extraordinary care, but that is not the same as calling someone brain dead so you can harvest their organs:

In effect, this will make people less likely to not sign an organ donor card.

(and the powers that be will then change the law to mandate organ donation if you didn't have a paper saying no).

Many years ago, when bioethicist Arthur Caplan moved from Mn to PA, and he signed up for a local driver's license, he was going to check the "organ donor" box, but the clerk warned him not to do it "because then they'll let you die".

And every move to increase organ donations by moving the criteria to include more people will just make more people suspicious of doctors. (The bioethicists now want to move the diagnosis of brain dead to include "higher brain dead", i.e. you can breathe on your own and live a long time but they can declare you dead because after all you don't meet the criteria for personhood, and if they take your organs, hey, a lot of strong healthy people will live.)

I support organ donation, but because of this last trend I never had an organ donation card on my driver's license.

But since I live in the Philippines, no problem: They often have to pull the respirator after a few days because the families can't afford the bill, but they don't do "body runs" to take the patient to Manila to get the organs out.

and don't give me that argument about "but with modern medicine, many of these people who would have died now live and fill up nursing homes".

Uh no: that argument goes back to the time of Plato, guys, and many of those who thanks to modern medicine nowadays are able to hold jobs in the past would have been kept in a back room and cared for by family (or dropped off at the local monastery).

Long nuanced discussion from the BMJ here. 
The ethicists who question if brain death means dead aren't doing it to question if we went too far by using the criteria for brain death to obtain organs, but to push the line further and use less dead people as organ donors.


By the way: Joy's cousin who was in a coma and on a respirator for two weeks after a cardiac arrhythmia is now off the respirator and in a private room with his family.

The next step is a feeding tube and rehab: but since their insurance doesn't cover this, the rehab will probably be in the home, by the extended family and friends, as is done here.

Today the family is applying for a government grant to get him rehab.

Keep him and the family in your prayers.

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