Another story of a “miraculous” recovery after declaration of brain death

From the Britain’s The Daily Mail comes another story of a “miraculous” recovery by a patient who was declared brain dead by the attending doctors.  Of course, organ donation has a starring role.

They were told there was no chance of their son surviving after he suffered devastating injuries in a car crash.

But Steven Thorpe’s parents refused to give up hope – despite four specialists declaring that the 17-year-old was brain dead.

Convinced they saw a ‘flicker’ of life as Steven lay in a coma, John and Janet Thorpe rejected advice to switch off his life support machine.

They begged for another opinion – and it was a decision that saved him.

A neurosurgeon found faint signs of brain activity

And of course, the link to organ donation:

‘The doctors were telling my parents that they wanted to take me off the life support. The words they used to my parents were “You need to start thinking about organ donations”.

Yes, of course the doctors wanted the family to be thinking about organ donation.  I guarantee someone of the staff at the hospital started their own thinking about organ donation within minutes of the EMT arrival of a brain injured patient.

This could be a photo of hospital organ donation administrators...or a pair of vultures.

Steven is now 21, a graduate and clerical trainee.  Despite losing use of his left arm and “extensive reconstructive surgery to his face” including having both his nose and eye socket rebuilt, Steven says he considers his survival as “a full recovery” and is very grateful that his parents were adamant to bring in another opinion.

The hospital issued a statement to The Daily Mail,

‘The injury to Steven’s brain was extremely critical and several CT scans of the head showed almost irreversible damage.

‘It is extremely rare that a patient with such extensive trauma to the brain should survive. We were delighted to see Steven recover.’

The article does not state whether the hospital told Steven’s parents, as they urged them to donate ‘dead’ Steven’s organs, that he had “almost irreversible damage.”  When a grieving family is told to start thinking about organ donation, they think their loved one is dead, not almost dead.  But time and again, stories like this show us that to an unfortunate number of medical workers, “almost dead” = “dead dead”.

Dr. Piper, the General Practitioner whose involvement saved Steven’s life notes, “I am astonished with the outcome but one worries that this may happen more often than we know.”

I’m worried too.

h/t to Lifesitenews whose own article on this story includes several references to similar recent “miraculous” recoveries.  Furthermore, they have a dozen similar articles linked at the bottom of their post.  Educate yourself and check it out.

 

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The Catholic way to donate organs

That title is actually be a bit misleading, as it may suggest that I have all the answers for the Church’s stand on organ donation.  I actually do not.  And I cannot speak on behalf of the Church.  But I do have some thoughts and suggestions that might give my faithful brethren and readers a jumping off point for further research.  And this is important because many Catholics have no idea that there is anything possibly wrong with the current state of organ donation.

But there is.

First, let me quote some pieces from a recent editorial commentary in the Wall Street Journal.  The commentary is written by Dick Teresi, author of The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers–How Medicine Is Blurring the Line Between Life and Death.  As he says,

Becoming an organ donor seems like a win-win situation. Some 3.3 people on the transplant waiting list will have their lives extended by your gift (3.3 is the average yield of solid organs per donor). You’re a hero, and at no real cost, apparently.

But what are you giving up when you check the donor box on your license? Your organs, of course—but much more. You’re also giving up your right to informed consent. Doctors don’t have to tell you or your relatives what they will do to your body during an organ harvest operation because you’ll be dead, with no legal rights.

You might ask yourself why you might care that you or your loved one no longer have legal rights, so Mr. Teresi explains why.  You don’t get any say in the tests used to determine your “death.”  As long time readers know, the tests for brain death are sketchy, non-uniform, individualistic and subjective.  He writes:

The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what’s called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead.

Hmmm, by this definition of brain death, I have personally as a lifeguard brought two people back from death.  Because that is what CPR is: breathing for individuals who aren’t breathing for themselves.  Mr. Teresi points out that even though such a person is now considered by organ harvesters as brain dead, they actually have much more in common with the living than the dead.  Their organs still function, they still heal, control their internal temperatures, etc.  And that is not all.

You might also be emitting brainwaves. Most people are surprised [note: shocked and disbelieving is more accurate] to learn that many people who are declared brain dead are never actually tested for higher-brain activity. The 1968 Harvard committee recommended that doctors use electroencephalography (EEG) to make sure the patient has flat brain waves. Today’s tests concentrate on the stalk-like brain stem, in charge of basics such as breathing, sleeping and waking. The EEG would alert doctors if the cortex, the thinking part of your brain, is still active.

But various researchers decided that this test was unnecessary, so it was eliminated from the mandatory criteria in 1971. They reasoned that, if the brain stem is dead, the higher centers of the brain are also probably dead.

[emphasis mine]

My thought here is that the harvesting team does not actually want to know if the donor is dead yet.  Nearly dead is close enough for them.

John Shea, M.D. has written for Catholic Insight:

Since 1968, vital organs, necessary for life, have been removed from patients for transplantation. Since then, this has been morally justified by the claim that the donor is “brain dead” or has suffered “cardiac death.” Brain death is defined as complete and irreversible loss of all brain function and cardiac death is declared two to five minutes after cessation of the heartbeat.

The moral problem is that the criteria used to declare that brain death or cardiac death has occurred are arbitrary, and open to continuing serious world-wide debate. They do not necessarily provide moral certainty that real death has occurred, and that such organ retrieval does not actually cause the death of the donor.

Many medical ethicists are concerned with this lack of certainty of an actual death in brain death cases.  Are you comfortable placing the end of your life decision in the hands of these medical professionals?  Is there reason to doubt their commitment to your best interests?  Actually, yes, yes there is.

Organ transplantation—from procurement of organs to transplant to the first year of postoperative care—is a $20 billion per year business. Recipients of single-organ transplants—heart, intestine, kidney, liver, single and double lung and pancreas—are charged an average $470,000, ranging from $288,000 for a kidney transplant to $1.2 million for an intestine transplant, according to consulting firm Milliman. Neither donors nor their families can be paid for organs.

Mr. Teresi does not mention the big gifts which the donor hospital receives in all this exchanging of organs.  But they do.  Providing organs is a very lucrative business for hospitals.

In his WSJ article, Mr. Teresi informs us that the current criteria on brain death were set by a Harvard Medical School committee in 1968.  In 1981, all 50 states adopted the Harvard brain death as a definition of death.  It is enlightening to read a bit from that important Harvard commission (quoting from).

Secular attempts to define death in this regard have not been all that successful.  Indeed, rather than use any sort of consistent biological or philosophical criteria, the concerns which seem to be driving definitions of death in the public sphere today are their relative expediency for procuring successful organ donation.  This trend started decades ago when the now famous Harvard brain death commission moved us toward a neurological (rather than cardio-pulmonary) criteria:

Our primary purpose is to define irreversible coma as a new criterion for death. There are two reasons why there is a need for a definition: (1) Improvements in resuscitative and supportive measures have led to increased efforts to save those who are desperately injured. Sometimes these efforts have only a partial success so that the result is an individual whose heart continues to beat but whose brain is irreversibly damaged. The burden is great on patients who suffer permanent loss of intellect, on their families, on the hospitals, and on those in need of hospital beds already occupied by these comatose patients. (2) Obsolete criteria for the definition of death can lead to controversy in obtaining organs for transplantation.

As Peter Singer, an atheist philosopher at Princeton who rejects brain death as a criterion for bodily death, notes this as a remarkable moment of honesty in bioethics:

[T]he Harvard committee does not even attempt to argue that there is a need for a new definition of death because hospitals have a lot of patients in their wards who are really dead, but are being kept attached to respirators because the law does not recognize them as dead.  Instead, with unusual frankness, the committee said that a new definition was needed because irreversibly comatose patients were a great burden, not only on themselves (why to be in an irreversible coma is a burden on the patient, the committee did not say), but also on their families, hospitals, and patients waiting for beds.           source

A Catholic Moral Theology article drily states that “[t]oday we are still dealing with the incoherence of criteria for death driven by the need for organs.”  Indeed.

So where does this leave faithful Catholics, trying to live our pro-life mandate?  Pope Benedict has said

“The main criterion,” the Pope said, must be “respect for the life of the donor so that the removal of organs is allowed only in the presence of his actual death.”

The Pope is likely to have been referring to the L’Osservatore Romano article when he told the Transplant Conference, “Science, in recent years has made further progress in the determination of the death of a patient.” In the question of determination of death, the Pope cautioned, “there must not be the slightest suspicion of arbitrariness. Where certainty cannot be achieved, the principle of precaution must prevail.”

In the 1995 Encyclical Evangelium vitae (Gospel of Life), Pope John Paul commended organ donation as an unselfish gift of life, but he cautioned that the question of death must be answered by “moral certitude” in order for the gift to be morally legitimate.  The Pope said that organs may only be removed after death – “that is, from the body of someone who is certainly dead.”

“Certainly dead.”  The problem is that the medical profession which has a well-earned attitude for arrogance and expedience, is not at all interested in being certain of death.  Not all doctors, of course, but enough with plenty of individual latitude in declaring death (and then making it so) to make people of faith and intellect think twice.  And we should think twice.  I never gave this any thought, was never aware of the controversies in organ donation until this very topic affected me personally.  Until it took away someone I loved.  Since then, I have been educating myself and trying to educate others.  I’ve been collecting and sharing stories of supposedly “miraculous recoveries” by medically declared dead patients.  I have a half dozen such stories still to publish.

The National Catholic Bioethics Center states that a properly diagnosed neurological death can only be determined following an evaluation of the entire brain, including the cerebrum, cerebellum, and brain stem in order to determine the complete cessation of all organized neurological activity. Of course, it also calls me “irresponsible” but it goes on to make my point, which is “that the neurological criteria must be rigorously and consistently applied and a judgment made of total brain death before a person is declared dead” — but that unfortunately is just not happening with consistency and assurance.

Therefore, I am going to heed and recommend Mr. Teresi’s advice.  He ends his WSJ commentary by suggesting that prospective donors not sign away their rights, and thereby retain bargaining power.  “If you leave instructions with your next of kin, they can perhaps negotiate a better deal. Instead of just the usual icewater-in-the-ears, why not ask for a blood-flow study to make sure your cortex is truly out of commission?”

To that extent, I encourage my readers to avoid signing donor authorizations that ipso facto sign away legal rights for you and your loved ones.  Require the full tests suggested by the NCBC and do not allow a determination of death if the the cerebrum and cerebellum are not also evaluated.  Determinations by brain stem activity alone are inadequate.

A living will specifying the criteria you wish used to determine your death, the manner and way in which your body both before death and after must be treated and specifying clearly that you are a Catholic who wishes to be treated in accordance with the teachings of the Church are all recommended.  (There used to be a place for Catholics to purchase and download these materials, called Legal Lifeguard but something seems wrong with the site.)

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Socialized medicine => cost-benefit analysis => euthanasia

The increasingly reliable Daily Mail‘s headline tells the tale:

Babies who are born at 23 weeks should be left to die, says NHS chief

The British daily has found the official with Britain’s National Health Service, Dr Daphne Austin being quoted in a BBC documentary saying:

‘We are doing more harm than good by resuscitating 23-weekers. I can’t think of very many interventions that have such poor outcomes.

‘For me the big issue is that we’re spending an awful lot of money on treatments that have very marginal benefit.

‘I would prefer to free up that money to spend on providing support to people who have much more lifelong chronic conditions.’

This official, we are told, advises what treatments and care should be funded in the West Midlands region.  In other words, lives depend on her authorization.  And she would “prefer to free up that money” than treating the babies.

She claimed keeping them alive is only ‘prolonging their agony’, and it would be better to invest the money in care for cancer sufferers or the disabled.

And what might be the ‘prolonged agony’ that would warrant killing these children? Why, “blindness, deafness and cerebral palsy”, of course!  What a horrible drain on society are the blind, deaf and disabled.  Do you think that Annie Sullivan thought much the same of her student, Helen Keller?  That Helen was a drain on the financial resources of her family and her country?  I doubt it.  

Why is this little throwaway article important to us Christians? Because we know intuitively that what this official is suggesting with respect to 23-week preemies is just the latest salvo in the war to drag Western society into a full-blown embrace of euthanasia for the disable, sick and marginalized. 

The Daily Mail helpfully introduces us to the horrible effects of allowing 23-weekers to remain alive. Meet Molly Griffith.

Apparently, The Daily Mail is not fooled by this doctor’s neo-rational argument.  Again surprising and delighting this Catholic blogger, the paper introduces us to Molly Griffith, who would ostensibly be the kind of child that Dr. Austin is looking to kill off.  When she was born prematurely at 23 weeks, she could fit into the palm of a hand.  She is missing a kidney, has epilepsy, and one side is weaker than the other.  But the NHS did not have the sort of cost-cutting twelve years ago, and she endured, growing into a happy, energetic and normal child.  And if the picture of Molly tells us anything, it is that “lifelong chronic conditions” do not deprive human beings of love, joy, intellect, meaning, and above all, life.  Euthanasia does.

 

Notably, the Church of England, bastion of moral relativism that it is, (again) declines to take a stand for life, morality and Christ.  Blessedly, The Daily Mail apparently will.

 

God bless The Daily Mail.

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When ‘brain dead’ is not dead.

….It’s not even “mostly dead.” 

From Seattle (via Houston) comes another story of a patient misdiagnosed as brain dead.  Unlike previous stories I’ve posted, this one has the organ harvesters as the heroes.

Karen Arbogast was a wife, mother and grandmother who volunteered as an EMT in the Tri-Cities area.On Tuesday, she was dead.

On Wednesday, she was alive.

Arbogast, 51, was involved in a three-vehicle crash early Tuesday evening at Highway 395 and Hildebrand Road in the Tri-Cities area.

The Washington State Patrol said a FedEx delivery truck struck a Toyota Camry after running a red light on Highway 395. The truck then slammed into the driver’s side of the Mercury Monterey van.

Arbogast was unconscious but breathing and taken to Kennewick General Hospital, said investigators.

“We couldn’t believe that this just happened,” said her daughter Candice Duncan, who rushed with other family to be by her mother’s side. “She’s always, always, thought of other people first.”

But relatives said doctors in Kennewick told them the crash had left her brain-dead, or at least, with no brain activity.

“[It was] sad to see Mom being in that kind of state,” said her son, Scott Magnuson.

Because Karen is registered as an organ donor, her husband, Carl, signed release forms. Doctors left her on life support so they could fly her to Harborview Medical Center in Seattle for the organ harvesting procedure.

“My dad took off her wedding rings and all that stuff, and we all said goodbye,” said Duncan.

“And it was hard,” said Magnuson. “I didn’t really say goodbye because I still had hope, you know. I just kind of got down next to her and kissed her forehead and said, ‘I hope you recover.'”

Little did he know his words would be prophetic. The first word from Harborview came early Wednesday morning, said Carl’s brother Perry Arbogast.

“He’s there sitting at his chair at 2:30 in the morning,” said Perry, “and the doctor calls and says … ‘we have signs of life.'”

Ten hours after the crash, Harborview had found brain activity. They were calling, asking if they could perform surgery, said Perry.

“From being to the depths of losing your wife after 31 years, and then to find hope that she’s still alive?” he said.

As shocked family members drove to Seattle from Hermiston and Umatilla, Oregon, doctors removed a blood clot from Karen’s brain and cut into her skull to relieve pressure, said relatives.

And it appears to be working. As of Thursday night, Karen Arbogast’s condition has been upgraded to serious, said a hospital spokesperson. Though unconscious, she’s even moving.

“Today, she moved her upper shoulder and she wiggled her toes on her right side and her irises are responding to light,” said Duncan. He said Karen was even able to breathe on her own for 45 minutes.

Perry said a neurologist told them it is actually not unusual for victims to have no detectable brain activity for several hours after major trauma, but he’s calling it something akin to a miracle, though she’s not out of the woods yet.

“Had they not sent her here to harvest the organs they would not have found out she was alive,” said Perry Arbogast. “I think that’s remarkable.”

Family members said doctors are still giving Karen just a 25 percent chance of regaining consciousness. But for now, Duncan said she’s not worried about her mother dying anymore.

“My mom has just always been there for me and been a pillar of strength for me,” said Candice, who said people around the country have been praying for Karen’s recovery. “Mom taught me to hold on to that and never let go.”

http://www.khou.com/news/Woman-makes-miraculous-comeback-from-brain-death-diagnosis-105533163.html

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Imagine a society where people live in constant fear for their lives…

A new video of young Lia Mills’ speech on euthanasia.  13 years old, she is more articulate and wiser than I.

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Catholic bioethicist weighs in on paralyzed man thought to be unconscious for 23 years

A Catholic bioethics expert weighs in on the case of Rom Houben, which is quickly becoming one of my all-time most read posts.  In an interview with Catholic News Agency,  John Haas, President of the Philadelphia-based National Catholic Bioethics Center suggests the case shows the wisdom of Catholic teaching on the duty to provide sustenance for those believed to be comatose.

Houben’s mistaken diagnosis was a “perfect example” of why artificial nutrition and hydration should be continued, Haas said.

He reported that the U.S. Catholic bishops last week passed a modified version of Directive 58 of the Ethical and Religious Directives (ERDs) for Catholic healthcare. This directive spoke of “the moral obligation to continue to provide hydration and nutrition to patients in a compromised state,” Haas said.

“This obligation extends to patients in chronic conditions (e.g. the ‘persistent vegetative state’) who can reasonably be expected to live indefinitely if given such care,” the ERD read.

“The bishops have always held to that position,” Haas explained, but some other Catholic voices have not.

In 2004, Haas noted, Pope John Paul II delivered an allocution in which he again said it is necessary to provide hydration and nutrition as long as it is “achieving its end” of nurturing the body.

Houben’s recovery, he said, would seem to be “a case where the Church’s position was actually ahead of the curve.”

Asked about Dr. Laureys’ comments about the difficulty of a patient permanently labeled as “unconscious,” Haas said he hoped health care providers would not have negative attitudes towards such patients.

However, he noted that Pope John Paul II described how “regrettable” it was that the medical term for such patients was “persistent vegetative state.”

Some doctors’ comments and medical terminologies “do tend to devalue and demean these people, which is really unfortunate.”

He said the case could help confirm the position of those who oppose physician-assisted suicide, but where the practice is legalized the patients are generally required to be conscious and responsive.

However, Houben’s case would be relevant to those with advanced medical directives who say they want artificial hydration and nutrition removed if they are unconscious and unlikely ever to wake.

The Catholic tradition holds that hydration and nutrition cannot be removed if a person will die of dehydration and starvation, Haas reiterated.

I’m not sure that CNA should have let this last statement stand.  I think what the Church is teaching goes beyond small “t” tradition–I’m not sure where JPII’s ‘allocution’ falls.  I’m sure one of you will correct me on that, if I’m wrong.  I’d also go one further than Mr. Haas to say that–as we have seen time and again (contraceptives, artificial insemination, stem cell research)–the Church is always ahead of the curve.  And over at The American Catholic blog, in an article with a  wonderfully complete title, Dave Hartline agrees with me.

Catholic bioethicist weighs in on paralyzed man thought to be unconscious for 23 years.

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Parents Remove “Baby RB” From Life Support

I hate to follow the happy posts with some sad news.  Very sad news indeed.

A severely ill toddler at the center of a legal battle between his parents has died days after his father agreed to switch off his ventilator.

The 13-month-old boy, known as Baby RB, suffered from congenital myasthenic syndrome, a rare genetic condition that means he cannot breathe on his own.

The father had been fighting the mother (now separated) over this issue, with the father arguing that the child could “play and recognize his parents.”  This is very tragic, for this youngster to have his life taken away, and his father robbed of the joy of his companionship.  Again, everyone is guilt-tripped into accepting the moral relativism in a twisted version of a virtue; in this case, Compassion. 

Please pray for this child’s soul, and for the parents involved, especially the father who has been battling all along to save his son.  They all need our prayers.

Parents Remove “Baby RB” From Life Support.

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Suffer the people in vegetative states to come unto me.

Last year, a young man I knew suffered an undiagnosed brain aneurysm which burst on his way to work.  He was driving down the interstate at the time and wandered across the median where he hit an oncoming car head-on.   Thanks to the testimony of a witness traveling behind him, the paramedics and emergency staff immediately diagnosed him as possibly suffering an aneurysm.  They got him into treatment right away but unfortunately on the second day in the ICU, he had a brain-stem stroke:  basically, the worst kind.  By this time, mutual friends had let me know what happened, and I was making emergency arrangements to travel to his city.

At this point, I should tell you that Andy was a phenomenal human being, just really the kind of son that every parent would want to raise.  He was considerate, respectful, fun-loving, loyal, adventurous, faithful, and joyous.  His MySpace listed his father as his hero and his concerns were always his family, both his parents and especially his younger sister.  To my knowledge, he never went through a period of rebellion, and never was ’embarrassed’ by his parents, as so many kids feel at least temporarily.   His family had raised Andy in a very evangelical church and though he had a lot of fun in college and afterward, he never strayed very far and I must say again, that he was one of the most thoughtful, kind, and generous people I’ve ever met. 

As I was getting ready to travel to see him, a team of doctors were testing Andy’s brain responses.  Though he had some functioning, and could breathe on his own, they determined that he was “brain-dead” and recommended to his devastated family that they sign-off on harvesting his organs.  Now, absolutely, Andy would have wanted to help others through donations of his working organs.  His parents clearly knew this too.  They sadly agreed, having spent several days in shock in the hospital.  However, when I heard about this decision, I was stunned.  I am by no means a medical expert but I know a little about medical issues.  I kept asking  our mutual friends if they were explaining the story correctly.  How could the doctors declare Andy ‘brain dead’ when he passed the functioning test and could breathe on his own?  This really made no sense to me.  I asked them over and over to explain the details to me.

The declaration of ‘brain dead’ was made on a Monday and on Tuesday morning, a team of specialists collected his vital organs and Andy died.  He was 27.

I never made it in time to say goodbye.     

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