Thursday, February 28, 2008

The Perils of Organ Donation

Organ donation is clearly an area fraught with ethical dilemmas. A recent story has shed more light on the differing incentives various actors face in the organ donation decision. The story concerns a surgeon who has been accused of inappropriately prescribing medications in order to hasten a donor's death so that the organs harvested would be more viable. At first glance, it seems that the surgeon prescribed medications to ease the man's suffering as he was removed from a ventilator. However, the article goes on to note that the transplant surgeon's presence in the room violated protocol, and that while administering the medications...
According to a police interview with Jennifer Endsley, a nurse, the transplant team, including Dr. Roozrokh, stayed in the room during the removal of the ventilator and gave orders for medication, something that would violate donation protocol. Ms. Endsley, who stayed to watch because she had never participated in this type of procedure, also told the police that Dr. Roozrokh asked an intensive care nurse to administer more “candy” — meaning drugs — after Mr. Navarro did not die immediately after his ventilator was removed.
Sadly, I am more inclined to believe the nurse's version of events. It's sometimes sad to think how technology has given us this great power to save human lives, yet somehow, the entire process almost ends up being almost dehumanizing. I remember observing a liver transplant procedure and being in awe that I was seeing the inside of someone's body with this giant cavity where the liver once was, yet simultaneously, somehow detaching this from the person that lay beneath the drapes. Actually, viewing a harvest was more striking. When we first met the donor, she was in the neuro ICU, brain dead, but her heart was still beating. We went into the OR, draped her, prepped, and soon made an incision and began the harvest. Only after about an hour into it did I realize her heart had stopped beating. A necessary step, yet it seems strange that no one really gave much pause to acknowledge this event. I do not claim that all transplant surgeons / staff are like this, but I do recall having this distinct feeling as I watched the procedures and how the transplant team functioned. I think the rigors of being involved in transplant surgery forces one to compartmentalize and focus so narrowly on the harvest and transplant that one may lose sight of the humanity underneath it all.

Think there's a better way? Read about some more views on organ donation.

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