The conscience clause in anesthesia: organ donation
Posted by Backspin on February 20, 2013, 5:43 pm
Hi everyone, just another pre-AA here, wondering:
Over the last year or so, I've read about the controversy surrounding organ donation (think hearts, not kidneys). Is it possible to avoid these procedures altogether as an anesthetist? e.g. negotiating with employers up front about procedures you would not do.
IMO, it's a must-have conversation for future anesthetists.
There's controversy surrounding the usage of "brain death" as the medical definition of death (see NHBD/DCD). From what I've read, organs harvested from procedures based on this definition may essentially kill the patient prior to and in anticipation of his/her imminent, actual death. The death is at some point, planned, in order to preserve maximum organ freshness.
This raises a grave moral objection in my mind. However hopeless or close to death someone may be, the end (killing someone by harvest, even moments before death) simply does not justify the means (best case: prolonging or saving a life). Not to mention, an anesthetist, by facilitating transplant of an organ harvested this way, is implicated in benefiting from murder or consenting to its ill-gotten gains.
Any thoughts? Can an anesthetist be transplant-free (maybe excepting kidneys and non-vital organs)?
Note: I'm not trying to spread propaganda. I realize this is a very complicated, highly sensitive issue undergoing vigorous debate and inquiry (it should). My purpose isn't to solve the matter conclusively for anyone, but to ask how it might affect someone going into anesthesia.
Re: The conscience clause in anesthesia: organ donation
I've been in the field for a few years and I've never heard anyone mention this topic - so doesn't seem like much of a controversial subject to me. Essentially all organ donor patients are being kept alive artificially - they are intubated with a ventilator breathing for them, receiving nutrition via an iv, many are on vasopressors keeping their blood pressure at a life sustaining level. It's hard to understand how a person could have an issue with taking part in a organ harvest that takes vital life saving organs from a person who no longer needs them (and who has consented to donating these organs) to give to someone in crucial need. Although the process of an organ procurement is a sad thing because someone had to lose their life it warms my heart knowing that I took an active part in saving/extending another's life. It's all in your perspective.