October 14, 2014

Bioethics Push Poll to Allow Killing for Organs

Wesley SmithTo donate vital organs, a donor must be dead.

This is known as the “dead donor rule, I have been warning that utilitarian bioethicists and transplant medical professionals want to shatter the DDR to permit killing living, living profoundly cognitively disabled patients for their organs.

Now, we see what appears to me to be a push poll type question in a study measuring popular support for such a change in the law.

A push poll seeks to obtain a desired answer by the way the question is framed. Here is the question from “Abandoning the Dead Donor Rule?” in the Journal of Medical Ethics:

Jason has been in a very bad car accident. He suffered a severe head injury and is now in the hospital. As a result of the injury, Jason is completely unconscious.
He cannot hear or feel anything, cannot remember or think about anything, he is not aware of anything, and his condition is irreversible. Jason will never wake up.

As we have seen in recent stories of awake and aware patients diagnosed in a persistent vegetative state–and perhaps, the Jahi McMath brain death case–this question sets up a false premise. Few, if any, cases are this clear cut, this sure. Indeed, the more we learn about the brain and consciousness, the less we know–as demonstrated by the proven brain interactivity in some patients thought to be completely unaware.

Thus, it seems to me that the question was posed in this unrealistic way to obtain a desired result of allowing the harvest.

Back to the question:

He also cannot breathe without mechanical support, but is on a breathing machine that keeps his lungs working. Without the machine, Jason’s heart and all other organs would stop within minutes. Although he will never wake up and cannot breathe without the support of the machine, Jason is still biologically alive.
In such scenarios, a patient can already be a donor by having life support removed, and IF–it doesn’t always happen as expected–he goes into cardiac arrest, be declared dead a few minutes later and obtain organs.

But that important fact isn’t mentioned in the question posed:

Before the injury, Jason wanted to be an organ donor. The organs will function best if they are removed while Jason’s heart is still beating and while he is still on the breathing machine. If the organs are removed while Jason is still on the machine, he would die from the removal of organs (in other words, the surgery would cause Jason’s biological death).

The question then asks how many people think that would be okay, and based on the push poll nature of the question, obtain a majority support for killing for organs.

Moreover, were the dead donor rule be killed, the patients harvested would not be limited to the relatively few cases such as described above.

Polling is like statistics, you can make them say anything.

By Wesley J. Smith via NRL News Today
Editor’s note. This appeared on Wesley’s great blog.