Wesley Smith writes an important post concerning organ donation after cardiac death, a protocol driven practice that begins with removing ICU-type life support and ends with Organ procurement:
... the Journal of Intensive Care Medicine calls into question the entire concept of DCD. For example, withdrawing life support often doesn't lead to immediate cardiac arrest, and some patients don't die at all.Some patients are managed as potential donors rather than as dying patients and some suggest that organ procurement should be more aggressive:
Beware: Rather than use this information to more carefully manage organ procurement protocols--and we still need nationally uniform rules--some bioethicists and organ professionals will instead use it it as a club to destroy the dead donor rule itself. As I have noted often, there is a drive underway to open the door to explicit killing for organs.
This is good. There is a serious shortage of vital organs. If the patient has no realistic chance of regaining consciousness, why not put their parts to good use in saving the lives of others?
Such instrumentalization of human life is exactly what we are criticizing in this post. Further, from the J. Int. Care cited above:
There is little evidence to support the position that the
criteria for organ procurement adopted from the UPMC
protocol complies with the dead donor rule. A high falsepositive
rate of the UW evaluation tool can expose many
dying patients to unnecessary perimortem interventions
because of donation failure. The medications and/or
interventions for the sole purpose of maintaining organ
viability can have unintended negative consequences on
the timing and quality of end-of-life care offered to organ
donors. It is essential to address and manage the evolving
conflict between optimal end-of-life care and the necessary
sacrifices for the procurement of transplantable
organs from the terminally ill. The recipients of marginal
organs recovered from DCD can also suffer higher mortality
and morbidity than recipients of other types of
donated organs. Finally, transparent disclosure to the
public of the risks involved to both organ donors and
recipients may contribute to open societal debate on the
ethical acceptability of DCD.