Badpuppy Gay Today

Monday, 14 April 1997

In one of the most difficult areas of medical controversy, its now apparent that many in the public refuse to sign organ doner cards, afraid physicians will hasten their deaths. Presently, in Cleveland, a request made by the Cleveland Clinic Hospital, namely, to take the organs of terminally ill patients within minutes of their deaths when they are, perhaps, only functionally but not wholly dead, has caught the attention of Carmen Marino, the first assistant prosecutor of Cuyahoga County. Her comments evoke a horror-movie scenerio: "The ultimate motive for declaring death," says Marino of the request, "comes into play--to harvest organs."

A growing number of medical ethicists now believe that it should be permissible to take the organs of a doner at the moment a heart stops beating, the traditional definition of death. In many cases, however, death may not yet have come to a brain. Under the proposal-request, people who are not yet brain dead, but who are being kept alive on respirators, would be fair game as organ mines in which transplanters would dig for valued parts. To obtain permission to turn off their respirators, doctors would approach family members for permission. After getting that permission, the steps between a patient's death and a raid conducted on his or her kidneys, liver, and pancreas would occur with lightening speed.

Prosecutor Mario calls this request, which to public knowledge has not been carried out, a matter "of grave concern."

There are already nearly 200 hospitals that use organs as soon as their doner's hearts have stopped in addition to those thought brain-dead, according to a study of doner guidelines by Dr. Bethany Spielman, a lawyer and an ethicist at the Southern Illinois University.

The dispute could result in a lower number of kidneys and livers available for transplants. It began when a director of advanced studies in bioethics, Dr. Mary Ellen Waithe, and her student, Peggy Rickard Bishop Bargholt, provided information to Mr. Marino that Ms. Bargholt had discovered while working at the Clinic. The student and her teacher had first attempted to publish their findings in The Journal of the American Medical Association, but that publication rejected the information they provided. The Journal invoked its traditional editorial privacy practices as its reason for refusing to say whether the rejection did or did not occur.

April 13, the dispute erupted into living rooms on the CBS News Program, "60 Minutes." Some of the charges made include the use of two drugs reputedly said to hasten death in the terminally ill, though some medical scholars disagree as to whether these drugs-- especially regitine--can, in fact do that.

"If you scare people about fuzzing the line between life and death," observed Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, "if you frighten people into thinking that doctors kill patients to get organs, you will devastate the system. The whole system depends on altruism, and altruism depends on clear standards that everyone agrees to. You can't innovate in this area, institution by institution, doctor by doctor."