Back From the Dead?

I think stories like this, about people being brought back from the dead, fuel unease about posthumous organ donation. People quite reasonably worry that, if they register as donors, they will be left for dead, when they could have been saved/revived.

It's worth emphasising that the story here is about cardiac death ("Most people regard cardiac arrest as synonymous with death, he says. But it is not a final threshold"). The definition of death used for organ donation is brain death. As the article goes on to say, "[Dr Jerry] Nolan stops short of saying that Carol was brought back from the dead. Hospitals do not declare death, he says, until they have ruled out all processes that can be reversed."

Nonetheless, this article serves to highlight the ambiguity and confusion surrounding death. Of course, public misunderstanding is somewhat to be expected, given current medical practice - e.g. the family may be informed that, since their relative is [brain] dead, doctors intend to turn off life support, in order to 'let them die'.

In the words of Dr Nolan, as quoted in the article, "We used to think death was a sort of sudden event - we stop the oxygen going to the brain and after a few minutes that was that. But actually, we know that the dying process at the cellular level goes on for a period of time". Our understanding of, and attitudes towards, death and dying are obviously crucial for organ donation (provided, of course, we continue to accept the assumption that it is only permissible to take organs from the dead, except in special circumstances).

Munthe on Harvesting from Living Donors

This new piece by Walter Glannon challenges the almost universally accepted Dead Donor Rule (DDR), arguing that it can be ethically permissible to harvest organs from a donor before their death, provided that this does not harm them. An interesting, and provocative, thesis. I suspect that most of those who would resist harvesting organs from living donors could in fact accept this conditional, but would hold that removing someone's vital organs is always a harm.

Christian Munthe has offered some alternatives reasons to be sceptical of Glannon's conclusions on his blog, here. Munthe accepts that Glannon is right about the ethics - it is morally permissible to remove the person's organs in this case - but points out that we cannot simply conclude, from this, that the Dead Donor Rule is unjustified. The law is a somewhat blunt instrument, so sometimes it must prohibit all actions of a certain kind because not to do so would result in harm, even if some actions of the prohibited kind are morally permissible. Relaxing the Dead Donor Rule, Munthe suggestions, might weaken socially useful prohibitions on killing in other cases, and thus the law justifiably prevents harvesting from living donors, in order to prevent greater evil.

I'm not sure what I think of this particular case - I'm inclined to agree with Munthe, but haven't yet read Glannon's piece (only Munthe's summary of it) - but it's a useful reminder of the general point that law or policy cannot simply be ethics; we need to attend to institutional matters.