On a winter night in 2006, a disabled and brain damaged man named Ruben Navarro was wheeled into an operating room at a hospital here. By most accounts, Mr. Navarro, 25, was near death, and doctors hoped that he might sustain other lives by donating his kidneys and liver.
But what happened to Mr. Navarro quickly went from the potentially life-saving to what law enforcement officials say was criminal. In what transplant experts believe is the first such case in the country, prosecutors have charged the surgeon, Dr. Hootan C. Roozrokh, with prescribing excessive and improper doses of drugs, apparently in an attempt to hasten Mr. Navarro’s death to retrieve his organs sooner.
A preliminary hearing begins here on Wednesday, with Dr. Roozrokh facing three felony counts relating to Mr. Navarro’s treatment as a donor. At the heart of the case is whether Dr. Roozrokh, who studied at a transplant fellowship program at the Stanford University School of Medicine, was pursuing organs at any cost or had become entangled in a web of misunderstanding about a lesser-used harvesting technique known as “donation after cardiac death.”
Dr. Roozrokh has pleaded not guilty, and his lawyer said the charges were the result of overzealous prosecutors. But the case has sent a shudder through the tight-knit field of transplant surgeons ”” if convicted on all counts, Dr. Roozrokh could face eight years in prison ”” while also worrying donation advocacy groups that organ donors could be frightened away.
This story is particulary poignant for me and I shuddered as I read it. My brother is awaiting a double lung transplant and I pray that he won’t die on the waiting list. It’s hard enough to know that someone will die so that he can live, but there would be comfort for the donor’s family that some good would come of their loved one’s untimely death. This story is horrific, and if it’s true, fewer people and their families will allow it. The line between natural death and unnatural death is already blurry enough, but to deliberately hasten someone’s death as this physician is accused of doing? God help us!
This lurid allegation may not be true. I have witnessed only one death, and the surprising thing was, the exact moment of death was so hard to determine. Not just for me, but for the other family member present (who is a physician!). We would think, well it’s over now, but then suddenly, here comes another breath! There was at least a 5- or 10-minute period of uncertainty; the “time of death” we listed on the state certificate was in fact just an estimate. I guess it wasn’t too important because no organs were being harvested.
But cases like this are an inherent problem with transplants. You have a surgeon there, hovering about, ready to spring into action, his mind focussed on all the technical details of the procedure. He does not know the dying patient. In fact, it’s better if he doesn’t, as human emotions would interfere with doing his job. In this situation, it’s too easy for him to forget he is dealing with a human being on that table, and not a “commodity”.
[blockquote]David Fleming, the executive director of Donate Life America, a nonprofit group that promotes donations, said the case had “given some support to the myths and misperceptions [i]we spend an inordinate amount of time[/i] telling people won’t happen.†[/blockquote]
Sorry about that David. I know you’re a man in a hurry.
This represents the inherent evil that is entailed in organ transplants. The donor cannot always be definitively dead because his body must be alive enough to keep the organs alive. In many or most cases actual body death is the result of removing the organs. The term “brain death” was created to get around the ugly ethical nature of this fact.
I’m telling my daughters I want them to insist on a brain scan to be sure I’m “brain dead.” Physicians, is this a scientifically valid and verifiable standard? Chris Hathaway, do you know?
If this is true, are we surprised? Humans are sinful. I can easily see how a doctor using a utilitarian ethic could do this.
A CT scan or MRI scan says nothing about brain death.
An EEG (assuming the patient is off sedative/anesthetic drugs) if flat line will at least give information about _cortical_ brain death (you can still have a working brainstem) however recovery to anything other than a vegitative state in the absence of working cortex would be nil.
A SPECT scan would tell you if blood was going to the cortex (which again would tell you about cortical (but not brainstem death).
Thank you, Clueless. So if I am cortical-brain-dead, I am irretrievably gone, and presumably would not feel the surgeon’s knife, either? But sedatives or anesthetics might mess up the EEG.
There doesn’t seem to be the definitive scientific answer I was looking for.
There are no scientific answers. In point of fact, even if your brain was dead, (brainstem and all) and your heart stopped, there would doubtless be cells in your liver or bone that would continue ticking over for a few days or possibly even a week or two, (I don’t know).
The broader question is not when is a person finally and irretrevably gone? but at what point should we stop doing everything possible to maintain life? When both cortex and brainstem are gone? When Brain, Heart and Lungs stop? When the organism is down to a few cells in the liver? Is that when the ventilator should be turned off? Who pays for all this? The family? Should we put the patient’s family’s in debt for this “service” (instead of simply sending the bill to future generations which we are currently doing by our national debt).
What stuns me is the unwillingness of the Boomer generation to “go quietly into that good night” however pitiful their condition and however great the burden they pose to their children and future generations.
For my part, my sister has a durable power of attorney, instructing her to turn off ventilators, and pull feeding tubes, and withold fluids once I am in a condition where I am unlikely to be able to function outside of a hospital bed or nursing home.
I have no intention of directing all family resources to ensure that my last dying cells will be able to continue feeding, while my children and their children’s college education funds are diverted to my maintenance. Nor am I willing to do this to other people’s children (which is what is currently being done).
Enough already. If God calls me, I’m gone.