So a patient isn’t sawed open until they’re declared clinically brain dead, but they are ripped open and pillaged while they’re still breathing/pumping blood, etc. Is there even the remotest possibility that, somewhere deep inside the person’s mind, they’re feeling this intense pain and screaming but unable to communicate it to the outside world?
As someone who has volunteered for organ donation, this possibility scares me.
Cecil mentioned those “who stand to benefit financially from your demise.” I have heard of the mythical “organ thieves” who leave you, well, for dead in an icebath–except you then wake up and discover slits in your abdomen and realize your kidneys have been stolen. (They are mythical, right?) Well, in any case, I guess that the transplant business is big business.
Is this ethical?
I’m not saying it’s unethical to charge lots of money for a rare item that holds the potential for life. If organs were cheap, there’d be even more of a shortage than there is now. But is it ethical to charge hundreds of thousands (or whatever it is) for something that a grieving family gives up for free? Should they be compensated in some way? It’s hard to support a transplant corporation making big bucks on the backs of dead people.
(Of course, compensating the families of organ donors brings up the unethicality of paying people to OK the killing of their loved ones…hey, it’s cheap life insurance!)
The ‘remotest possibility’? Let’s think about this: There is the ‘remotest possibility’ that the person is going to leap off the table and campaign for governorship while his EEG is flat as a slightly bumpy road. Science, medical science included, offers no absolute certainties; that’s a job for math and theology.
But both that scenario and yours would entail massive, fundamental rethinkings of how the brain works and how that function affects consciousness. If someone were functional with a flat EEG, maybe the Greeks were right and the mind really does reside in the liver. But we have absolutely no evidence of that, since we’ve never once seen it.
So, to answer your question as it was posed, I can’t honestly say that it is fundamentally impossible. I can say that it is so improbable even talking about it is absurd: If a person with a flat EEG were capable of consciousness, why not a Jell-O mold? (Hook electrodes up to Jell-O and you’ll get something that superficially resembles what you get from hooking them up to a braindead person, unless my memory is scrambled.)
While we’ve never seen the mind, as it is an epiphenomenon of neural function (most likely), that isn’t what I meant to say: I meant that we’ve never seen someone remain conscious or at all responsive with a flat EEG.
Dead people don’t breathe - it’s the ventilator breathing for them. In fact, one of the tests of brain death is an “apnea test”.
The cost of organ transplants does not include “purchasing” the donated organ. It’s the cost of the massive amounts of supplies, equipment and personnel that go into organ transplantation that drives up the cost. Are you proposing this should all be given away for free?
First, a good many (though not all) “transplant corporations,” as you call them, are run out of state-funded medical centers. Different parts of the country have different rules on which transplants will be performed and which may not. One region may choose not to give a chronic alcoholic a new liver unless he lays off the bottle, or a three-pack-a-day smoker a new set of lungs unless he goes cold turkey. So for some, it isn’t exclusively a cash cow.
Other regions may do the transplant for whoever can afford it. The last statistic I heard quoted was that the waiting list for a liver in New Jersey was 9 months; in New York the wait is over a year. No cite on this information, other than the transplant coordinator at UWMC told me this. Whether hospitals should make these kinds of decisions would be a Great Debate, I’d think; on the one hand you have to tell a patient, “Cirrhosis of the liver from chronic alcoholism? Sucks to be you.” On the other hand, you have to tell a patient’s family “Sorry, we couldn’t find a liver for your husband because we gave one to the heroin junkie on 44th street.”
When you hear that organ transplants are big business, you’re right, but it is so because insurance companies cover it. While the rest of a hospital may run in the red doing expensive MRIs for charity patients or trying to collect thousands of dollars from a patient due to die in 3 weeks with terminal cancer, the transplant departments run in the black.
Most of that cost of a transplant, which could run $150,000 or much more, is not the cost of the organ but in the preconsultation fees, hospital stay, prescription medication (possibly $1000/week), 3-day-a-week follow up care for 2 months, blood tests, and other stuff that the donor family really didn’t have anything to do with (that is, if the person has end stage renal disease he’d be seeing the doctor anyway to the tune of $30,000/week on dialysis or other medical visits). I can’t justify giving the donor family a chunk of that change. The patient isn’t suddenly incurring medical costs out of the blue; he’s simply exchanged one medical condition for another, slightly better one.
Here’s snopes on kidney thieves. Evidently the legend stems from one incident in Britain where four Turks sold their kidneys, but one later tried to get the organ broker in trouble by blowing the whistle and claiming it had been stolen from him.
The whole idea of mugging some random schmoe and taking his kidney is completely asinine, anyway; you don’t know Random Schmoe’s blood type, and you’d have to get the kidney tissue antigen-matched in order to sell it to the proper receipient, and you can’t tell by looking at somebody that he has healthy kidneys. Your Random Schmoe may be diabetic, have cancer or AIDS or hepatitis or some other blood-borne infection. There are so many things that could go wrong that… well, I’d put it outside the bounds of probability that it’d happen randomly in some bar.
There is organ donation and tissue donation. Many people are hesitant about tissue donation and that is understandable. Please dont rule out donation as a whole just because you are worried about organs and if your still alive or not. You can opt to be a tissue donor. There are NO chances of needing your tissue when you donate because you are dead at that point! (Need to be dead to do tissue donation) Different tissues that can be donated are your skin for many people who need various types of skin grafts (they take it off your back so people wont be able to notice its gone if you have a funeral), and your bones in your legs for transplant or made into other devices for people in need. Prostetics are put back in so your leg looks close to normal when done.
Tissue transplant is just as important as organs and if you are just too worried about being alive still… donation tissues.
Give it some thought!! If not organ, at least tissues!!
OK, that answers my question. It’s not that the organs themselves are costing the bucks–it’s the medical issues surrounding the transplant. In that case, yes, I agree that the donor’s family shouldn’t be compensated.
I was under the mistaken impression that some corporation (whether privately or publicly owned) was charging a premium for the organ that it received for free (well, minus the medical costs), in which case I thought it was unethical for them to be making money.
A nitpick: Blood and bone marrow are both tissues, and both are routinely donated by folks who are still alive (and stay alive afterwards, and walk away from the donation facility).
It is also possible to be a living skin donor, although it is much rarer.
Know those super-obese people who get 10 or 20 lbs of “excess skin and flesh” taken off after massive weight loss? In some cases the skin has been donated. I know of one case where the donor even went to visit the recipient (a young boy severely burned in a house fire) after their respective operations.