The End: The Line Between Life and Death During Organ Donation

Wednesday, August 25, 2010

Organ Donor (Flickr: Mika Marttila)

All this week we’re talking with our friends from Scientific American about endings: in nature, culture and science. For most of human history the clearest, most black and white ending in our lives was death. However, in recent decades, life support technology has made death a gray area, leading to right-to-life debates, as in the case of Terri Schiavo. But the question of when someone is dead becomes especially important when dealing with the process of organ donation.

We asked you, our listeners: If you are are an organ donor, what made you agree to it? If not, what's your reason against it? Let us know in the comments or call 877-8-MY-TAKE and we'll play the responses on the air.

In most donation cases doctors have a clear decision. If a patient is brain-dead, one can ethically harvest their organs after withdrawing life support. But, in the few cases where brain activity still exists, doctors have an agreed-upon set of ethics rules to refer to. Once the patient is taken off the ventilator and the heart stops beating, doctors wait for two minutes before declaring death. It is a situation in which every second counts; the sooner the organs are harvested, the better the chance of the donor recipient surviving. Some doctors are now pushing against that two minute boundary.

Robin Marantz Henig writes about these life and death decisions in her Scientific American article, "When Does Life Belong to the Living?"  She writes that in the midst of this discussion, "the definition of death becomes a matter of giving one diminishing life the possibility of a second chance, by defining another diminishing life as already and irreparably over."

Dr. Bill Pietra faces this decision of when to declare the end of life. He is a pediatric heart transplant surgeon at Denver Children's Hospital. The group with the highest waiting list for new organs is infants, and Pietra understands ethicists' concerns. He says that many people forget that there is also a psychological need for the families of dying children to be able to save someone else's life as they watch their babies pass away.

Guests:

Robin Marantz Henig and Dr. Bill Pietra

Produced by:

Jen Poyant

Comments [21]

Tina Fahrenbrook from Denver Colorado

Dr. Bill Pietra is not " simply" a cardiologist. He makes life and death decisions every day and once the surgeons are done with the transplant it is his leadership, expertise and compassion that give these children a chance at a normal life! Dr. Pietra and his team took a chance on my son, Austin, and I cannot thank him enough for what he has done for my son and our family. Dr. Pietra has given us 8 wonderful years with our son because of his dedication to his profession. Surgeons may put the " heart" in the child but Dr. Pietra makes sure that the child's heart is healthy and strong for the long haul. He has dedicated his life to transplant research and he is a great pioneer in this field.

Oct. 21 2010 02:39 PM
fairequeene

Dr. Bill Pietra is simply a cardiologist, not a pediatric cardiac surgeon---that is a misrepresentation of his duties as a doctor.

Aug. 30 2010 08:23 PM
Pollyanna from Wellington, FL.

In comments, there are remarks about the prices for receiving a donation. It would appear that there is a LOT of money involved. Yet a donor is "giving" up their leftover parts, no longer needed. So with this much money involved, how is it going to be determined that I no longer need those parts that are going to bring in so much money???
In other words, am I dead yet?

Aug. 28 2010 01:09 PM
Susan May from Georgia

Organ donation saves lives. I have a 21 year old son who is alive and attend college today because of a heart transplant. He got it when he was one year old. He isn't just living he is enjoying life. Organ donor are heroes.

Susan May
www.susanCmay.com
Nick's New Heart

Aug. 26 2010 06:16 PM
Neal Beswick from Boston

Our company Transmedics supports the incredible gift of donation. We believe with the use of new technology "The Organ Care System" that keeps hearts beating and lungs breathing during transportation of donor organs and that the current donor utilization rates (Only 4/10 hearts & 2/10 lungs of donated organs are actually accepted) can be significantly improved so that many more patients can get access to transplantation with potentially better outcomes. Our technology is currently under an investigational trial in the US and is not available in the US but we certainly have a goal to revolutionize transplantation with this technology.

Neal Beswick
www.Transmedics.com

Aug. 26 2010 04:42 PM
Neal Beswick

Our company Transmedics supports the incredible gift of donation. We believe with the use of new technology "The Organ Care System" that keeps hearts beating and lungs breathing during transportation of donor organs and that the current donor utilization rates (Only 4/10 hearts & 2/10 lungs of donated organs are actually accepted) can be significantly improved so that many more patients can get access to transplantation with potentially better outcomes. Our technology is currently under an investigational trial in the US and is not available in the US but we certainly have a goal to revolutionize transplantation with this technology.

Neal Beswick
www.Transmedics.com

Aug. 26 2010 04:41 PM
wiesia from florida

i located the price of a "donated heart" from - Transplantliving.com. 90,000 usd for the heart alone. very expensive. does anyone know how that money is distributed. someone is making money here and for the life of me i am finding my it almost impossible to find information about these procurement organizations, just a lot of feel good language to encourage donation. personally, it would make donation a heck of a lot easier if it was actually donated and not sold and resold. is organ donation a for profit or not for profit machine?

Aug. 25 2010 12:44 PM
Melissa Wetzel from South Florida

On my 16th birthday I stood before the DMV rep awaiting my official driver's license when she asked "Do you want to be an organ donor?" Without hesitation I said "yes" thinking, when I'm gone I won't need them.

It wasn't until 2 years later that I understood the gravity of my decision when my family found out that my 6-month old nephew would need a liver transplant. He was born with a faulty liver and only a transplant could save him. We were playing against the clock and every phone call brought a level of anxiety while we considered “is this it?”

Thankfully, he did receive his liver transplant at 10-months of age. Lightening struck twice when we learned that my infant niece would also need a liver transplant—she received her gift of life at 12-months old. This brother and sister duo, 10 and 7 respectively, are the light of our lives. Their organ donors saved their lives and changed the scope of my family forever. I find solace in knowing that one day I will be an organ donor and give other families the same chance mine did to overcome sickness and enjoy renewed life because of transplantation.

In Florida there is an online donor registry, www.donatelifeflorida.org, so you don’t have to wait to renew your driver’s license to make your wishes known. Be an organ donor…pass it on!

Aug. 25 2010 12:23 PM
Eli Compton

I know the impact of transplantation and organ donation—personally and professionally. I am the mother of Erik Compton, who has received 2 heart transplants and lives a productive life as a professional golfer. I also serve as the Executive Director of Transplant Foundation Inc, a non-profit charitable organization dedicated to funding patient services, public education to increase organ donation and lifesaving transplant research. Since inception in 1987, we have awarded over $3 million in support of transplant patients and their families and served 60,000 individuals globally.

Simply stated organ donation is about life—my son is alive today because two separate families made the difficult decision to donate their child’s organs. My heart goes out to both families that despite tragedy, chose to donate their loved ones organs to give others a chance of renewed life.

Be an organ donor…pass it on.

Eli V. Compton
Executive Director
Transplant Foundation, Inc.
www.transplantfoundation.org

Aug. 25 2010 11:49 AM
Carmen from OKC

I am an organ donor. First: because I won't be needing my organs once I am dead. And second becuase I can give the "gift of life" to someone else.
No need to be greedy. If your body will be cremated it is worthless, if your body will be buried then it will decompose, again it is worthless. Wy not donate what someone else needs?

Aug. 25 2010 11:13 AM
wiesia from florida

i am an organ donor but i may reconsider if i find out that someone is lining their pockets while those who receive, or to be more correct, buy my organs and go into debt to stay alive. how much does a heart cost if a ligament is 19,000.00?

Aug. 25 2010 10:44 AM
wiesia from florida

how much is a donors body worth? i just had acl surgery and had a cadaver ligament screwed into my knee. i almost fell over when i received the insurance statement and the ligament alone cost 19,000.00. total cost of surgery 64,000.00. how much is a body worth and what is the money trail?

Aug. 25 2010 10:35 AM
Liz Porter from Ft Lauderdale, FL

If I agreed to accept the gift of an organ for myself or my loved ones, how could I possibly and in good conscience refuse to be a donor ?

Since some people do not do the right thing, I do support that to receive an organ you must be an organ donor first.

Aug. 25 2010 10:15 AM
Liz Porter from Ft Lauderdale, FL

If I agreed to accept the gift of an organ for myself or my loved ones, how could I possibly and in good conscience refuse to be a donor ?

Since some people do not do the right thing, I do support that to receive an organ you must be an organ donor first.

Aug. 25 2010 10:12 AM
Liz from Ft Lauderdale FL

If I agreed to accept the gift of an organ for myself or my loved ones, how could I possibly and in good conciense refuse to be a donor ?

Since some people do not do the right thing, I do support that to receive an organ you must be an organ donor first.

Aug. 25 2010 10:12 AM
Florence McClain from Hell's Kitchen, NYC

Lat year I donated a kidney to my brother; it was the single most important thing I've ever done in my life. How often to we get to knowingly save another person, to give them the chance at another 20 years of life? It is so easy to save another life, by simply letting them use that which we no longer need after death. The decision to be an organ donor, whether a living donor, or after your death, should be a joyous one. At some point, your generosity is going to give another human being the chance to continue grabbing onto this precious life, and what could be a greater gift to give than that? We have to get over our societal queasiness about organ donation; as far as I am concerned, any religion that says you cannot donate a life-saving organ, whether you are living or dead, does not deserve to be called a religion.

Aug. 25 2010 12:09 AM
Dave Undis from Nashville, TN

About 50% of the organs transplanted in America go to people who haven't agreed to donate their own organs when they die. As long as we let non-donors jump to the front of the waiting list if they need a transplant we'll always have an organ shortage.

There is a simple way to put a big dent in the organ shortage -- give organs first to people who have agreed to donate their own organs when they die.

Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren't willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.

Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. LifeSharers has over 13,000 members.

David J. Undis
Executive Director
LifeSharers
www.lifesharers.org

Aug. 24 2010 06:45 PM
alyman

I used to be an organ donor yet read of a number of cases in which people who received organs from people who had had melanoma then also developed the disease. Since I've had melanoma I reluctantly removed the organ donor 'spot' from my driver's license. I think it's a wonderful program yet also something that people need to be thoughtful about as it would be such a shame for someone to receive what they thought was a healthy organ only to be felled by a hidden disease brought with that donation.

Aug. 24 2010 06:26 PM
alyman

I used signed up to be an organ donor yet read of a number of cases in which people who received organ's from people who had had melanoma then also developed the disease. Since I've had melanoma I reluctantly removed the organ donor 'spot' from my driver's license. I think it's a wonderful program yet also something that people need to be thoughtful about as it would be such a shame for someone to receive what they thought was a healthy organ only to be felled by a hidden disease brought with that donation.

Aug. 24 2010 06:22 PM
Amy from New York, NY

My decision to be an organ donor came the day I was stopped in my tracks by a speeding blue van with a siren and flashing yellow lights. This didn't look to me like any of the other emergency vehicles I'd seen in the city, but as the van passed, I realized it was an Emergency Organ Transport van. The tears that came to my eyes standing on that New York sidewalk caught me off guard; I suppose I was moved by what this bittersweet moment represented. As millions of people around the city were having just another day, something really powerful had just happened: somewhere a heartbroken family had just seen past their pain to make a generous and selfless decision, and another family in another place had just received the happy news that their loved one's life may be saved. And furthermore, the fact that this blue van had the privilege to speed through Manhattan and break all the traffic laws was showed just how precious human life is! The whole scene took my breath away.

I don't see any reason not to donate your organs. You're gone; you don't need them, they won't do any good six feet under, and they could potentially do a world of good if given to someone else!

And as a side note, I do agree with a previous comment that the policy should be reversed from the current practice (as it is in some European countries) - the default decision should be that a patient's organs will be donated. The patient and/or family must specifically opt out.

Aug. 24 2010 01:58 PM
Susan Kim from New York, NY

I am an organ donor and the main reason I am is that it would be completely insane not to be. It's not like I'll be using any of my organs after I am dead.

I am sure there will be some people that claim for religious reasons they need to keep their body in tact for the afterlife. Really? How devout are you going to be when you or an immediate family member needs a transplant to live?

I think organ donation should be something you opt out of when you get your license. And if you do opt out, you will never be eligible for an organ transplant.

Aug. 24 2010 12:27 PM

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