This transcript has been edited for clarity.
Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at NYU’s Grossman School of Medicine.
I saw a horrible story about a case at Baptist Hospital in Kentucky recently involving organ donation. Apparently, the hospital had a prospective donor who’d been declared dead who was wheeled into the intensive care unit in order to think about the possibility of organ transplant.
As the nurses brought the person’s body into the operating room, a couple of the doctors and nurses realized he wasn’t dead. He was thrashing around and moving, and you could see he was crying, alleged one of the operating room nurses.
Obviously, people were alarmed, the doctors did not go through with the procurement, and we’ll have an investigation, as we should, about how this occurred.
We need many organs in this country for people waiting for transplant. There are at least 100,000 on waiting lists. There probably would be many more waiting if we could get more organs.
We’re pursuing all kinds of ideas, including using pigs as sources of organs. Some people are trying to perfect mechanical organs, to improve dialysis, and to create an artificial pancreas to try to meet the demand for people who are dying of organ failure. There is even talk about bioprinting organs and using various kinds of stem cell transfers to regrow vital cells and organs.
That’s all great, but it’s all distant. Tomorrow, when everybody wakes up, we’ll still be very, very short on organ donors.
That incident that took place in Kentucky is hugely damaging. When we ask people to register as organ donors, they’re fearful that they won’t be dead or that someone will try to hasten their death if they designate themselves as an organ donor. I have that fear expressed to me all the time. The case like the one in Kentucky doesn’t help, although at the end of the day, it’s important to point out that everything stopped as it should have.
When you’re discussing this matter with friends or patients, it is important to point out that the system works 99.999% of the time. We have a dead donor rule. We don’t take vital organs from anyone who isn’t dead.
It is very easy to sign up. Not only can you do it at a motor vehicle agency, but it is now appearing on places like tax forms,voter registration, and many other areas where you can check a box and get on a computer.
It’s important to tell people, too, if they don’t want to continue to be organ donors, they can withdraw their consent. They also can tell their family, as they should, whether they do or don’t want to be donors, and the family can monitor and watch out to make sure that everything goes according to the deceased’s plan.
Even though this case in Kentucky is horrendous and it ultimately has to be condemned as totally unethical — bringing someone in for whatever reason, including misdiagnosis or error, as an organ donor when they’re not — it’s exceedingly rare.
It just doesn’t happen. People know that you have to pronounce brain death in a reliable manner, following the standards of the American Academy of Neurology, and they do.
Encourage organ donation on the part of your patients, your family, and your friends. If they raise cases like the Kentucky one or just the general fear that they worry that someone’s going to rush their death because they’re designated as an organ donor, assure them we have the safeguards. Even the Kentucky case didn’t proceed.
We have every safeguard in place to make sure that the people who pronounce you dead are not involved with procuring organs. That was the group that intercepted this misdiagnosed Kentucky candidate.
I say in good faith that we need to help others. We need to save those lives. For a while now, we’re still going to need cadaver donations.They’re not where they should be. It’s imperative that we not let the outlier case set back our willingness to encourage organ donation when people die.
I’m Art Caplan, at the Division of Medical Ethics at NYU’s Grossman School of Medicine. Thank you for watching.
COMMENTARY
Focus On Safeguards in Promoting Organ Donation, Says Ethicist
DISCLOSURES
| January 15, 2025This transcript has been edited for clarity.
Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at NYU’s Grossman School of Medicine.
I saw a horrible story about a case at Baptist Hospital in Kentucky recently involving organ donation. Apparently, the hospital had a prospective donor who’d been declared dead who was wheeled into the intensive care unit in order to think about the possibility of organ transplant.
As the nurses brought the person’s body into the operating room, a couple of the doctors and nurses realized he wasn’t dead. He was thrashing around and moving, and you could see he was crying, alleged one of the operating room nurses.
Obviously, people were alarmed, the doctors did not go through with the procurement, and we’ll have an investigation, as we should, about how this occurred.
We need many organs in this country for people waiting for transplant. There are at least 100,000 on waiting lists. There probably would be many more waiting if we could get more organs.
We’re pursuing all kinds of ideas, including using pigs as sources of organs. Some people are trying to perfect mechanical organs, to improve dialysis, and to create an artificial pancreas to try to meet the demand for people who are dying of organ failure. There is even talk about bioprinting organs and using various kinds of stem cell transfers to regrow vital cells and organs.
That’s all great, but it’s all distant. Tomorrow, when everybody wakes up, we’ll still be very, very short on organ donors.
That incident that took place in Kentucky is hugely damaging. When we ask people to register as organ donors, they’re fearful that they won’t be dead or that someone will try to hasten their death if they designate themselves as an organ donor. I have that fear expressed to me all the time. The case like the one in Kentucky doesn’t help, although at the end of the day, it’s important to point out that everything stopped as it should have.
When you’re discussing this matter with friends or patients, it is important to point out that the system works 99.999% of the time. We have a dead donor rule. We don’t take vital organs from anyone who isn’t dead.
It is very easy to sign up. Not only can you do it at a motor vehicle agency, but it is now appearing on places like tax forms,voter registration, and many other areas where you can check a box and get on a computer.
It’s important to tell people, too, if they don’t want to continue to be organ donors, they can withdraw their consent. They also can tell their family, as they should, whether they do or don’t want to be donors, and the family can monitor and watch out to make sure that everything goes according to the deceased’s plan.
Even though this case in Kentucky is horrendous and it ultimately has to be condemned as totally unethical — bringing someone in for whatever reason, including misdiagnosis or error, as an organ donor when they’re not — it’s exceedingly rare.
It just doesn’t happen. People know that you have to pronounce brain death in a reliable manner, following the standards of the American Academy of Neurology, and they do.
Encourage organ donation on the part of your patients, your family, and your friends. If they raise cases like the Kentucky one or just the general fear that they worry that someone’s going to rush their death because they’re designated as an organ donor, assure them we have the safeguards. Even the Kentucky case didn’t proceed.
We have every safeguard in place to make sure that the people who pronounce you dead are not involved with procuring organs. That was the group that intercepted this misdiagnosed Kentucky candidate.
I say in good faith that we need to help others. We need to save those lives. For a while now, we’re still going to need cadaver donations.They’re not where they should be. It’s imperative that we not let the outlier case set back our willingness to encourage organ donation when people die.
I’m Art Caplan, at the Division of Medical Ethics at NYU’s Grossman School of Medicine. Thank you for watching.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
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