The demise of "brain death"

By Paul A. Byrne, M.D.

We are bombarded with propaganda that encourages organ donation. For an organ to be suitable for transplantation it must be taken from a living person.

Recent reports in the literature include:

• Dr. KG Karakatsanis of Greece evaluated current clinical criteria and confirmatory tests for the diagnosis of "brain death" to determine if they satisfied the requirements for the irreversible cessation of all functions of the entire brain including the brain stem. He reviewed medical, philosophical and legal literature on the subject of "brain death." He presented four arguments:
  
  
• First, many clinically 'brain-dead' patients maintain residual vegetative functions that are mediated or coordinated by the brain or the brainstem.
  
  
• Second, it is impossible to test for any cerebral function by clinical bedside exam, because the tracts of passage to and from the cerebrum through the brainstem are destroyed or nonfunctional. Furthermore, since there are limitations of clinical assessment of internal awareness in patients who otherwise lack the motor function to show their awareness, the diagnosis of 'brain death' is based on an unproved hypothesis.
  
  
• Third, many patients maintain several stereotyped movements (the so-called complex spinal cord responses and automatisms) which may originate in the brainstem.
  
  
• Fourth, not one of the current confirmatory tests has the necessary positive predictive value for the reliable pronouncement of human death. Conclusion: According to the above arguments, the assumption that all functions of the entire brain (or those of the brainstem) in 'brain-dead' patients have ceased, is invalidated. Spinal Cord (2008) 46, 396-401.
  
  
• In the New England Journal of Medicine on 8-14-08 it was reported that infants who were not "brain dead" were pronounced dead after life support was discontinued. When there was no detected pulse for only 1.25 minutes, the heart was then excised for transplantation.
  
  
• Dr. David Greer reported in Neurology (Jan 2008) that many highly regarded hospitals in the U.S. routinely diagnose "brain death" without following the guidelines promulgated in 1995 by the American Academy of Neurology (AAN). Researchers at the Massachusetts General Hospital surveyed the top 50 neurology and neurosurgery departments nationwide; 82 percent responded. Results showed that "adherence to the AAN guidelines varied widely, leading to major differences in practice, which may have consequences for the determination of death and initiation of transplant procedures. Apnea testing was omitted by 27 percent; still more distressing is that many fail to even check for spontaneous respirations.
  
  

While the apnea test can only cause a patient with a neurologic problem to get worse, it is commonly done without full and explicit consent. Turning off the ventilator to determine if he can breathe on his own and if he cannot, it is the same as suffocation of this living human being. Yes, medical and legal suffocation, and if the Church approves, it is religious suffocation! The sole purpose of the apnea test is to determine that the patient cannot breathe on his own in order to declare him "brain dead." It is illogical to do this stressful, possibly lethal, apnea test on a patient who has just undergone severe head trauma. To turn off the ventilator for up to 10 minutes as part of the declaration of "brain death" risks further damage and even killing a comatose patient, who might otherwise survive and resume spontaneous breathing if treated properly.

• "In plain, straight talk," writes Dr. Lawrence Huntoon, editor-in-chief of the Journal of American Physicians and Surgeons, "the survey indicates a high likelihood that some patients are being 'harvested' in some hospitals before they are dead! In hospitals with aggressive transplant programs (hospitals make a huge amount of money on transplant cases), making sure a patient is dead before going to the 'harvesting suite' may be viewed as a minor technicality/impediment."
  
  
• In the largest study in the literature known as the Collaborative Study 10 % at autopsy had no pathology in the brain. Only 27% of patients on the ventilator for 1 week had a "respirator brain." From the beginning "brain death" was not based on data that was not sufficient and acceptable scientifically for destruction of the brain much less death of the person..
  
  

Now more than ever, there is great push to kill for organs. It was reported in the news that Zack Dunlap from Oklahoma was declared dead, and a transplant team was ready to take his organs until that young man moved. Instead of a nurse-relative calling it a reflex (as I have been told is commonly done), the transplant team was sent away. http://www.msnbc.msn.com/id/23768436/. This young man did NOT have a destroyed brain. Nevertheless, Zack would have been truly dead had they excised his heart for transplantation. He could hear the doctors discuss his "brain death," but he could not move at that time to tell them he was alive..

"Brain death" never was, and never will be true death. This has been known by neurologists and organ transplanters since the beginning of the multi-billlion industry. So if a declaration of "brain death" is not true death, but organs are taken legally in accord with "accepted medical standards," why not continue to make "acceptable" less stringent criteria? In the 10 years after the ad hoc Committee conjured up the Harvard Criteria, 30 more sets were reported by 1978. Every set became less stringent. Less strict sets were reported until eventually there is a criterion that does not fulfill any of the "brain death" criteria? This is known as donation by cardiac death (DCD). Organs are obtained for transplantation by first getting a DNR order, then taking the patient off life support and wait until the patient is without a pulse (NOT WITHOUT A HEART BEAT!). In the past the waiting time was 10 minutes, then shortened to 5 minutes, then 4, then 2 and now in the NEJM (8-14-08) the waiting time is only 1.25 minutes until they cut out the baby's heart. How shameful can it get! Shame on the medical field for knowing and not protecting these patients! Shame on the transplantation organizations for valuing money over an innocent injured person's life! Shame on the US government, other governments, and clergy for allowing and even encouraging extracting vital organs for transplantation and research! When will doctors informed of the truth stand for life instead of being political creeps?

The transplant world no longer waits for "brain death." Now the goal is to get a DNR. Then they wait until the pulse stops for as short a time as 1.25 minutes. Organs obtained deceptively, yet legally, are called donation by brain death (DBD) and donation by cardiac death (DCD). It is the excision of vital organs that finalizes the death of the donor.

What is going to happen when it becomes better known that "brain death" was a hoax from the beginning? Do doctors and laymen not realize that destroying human life before its natural end is a heinous crime? Do they not realize that excision of an unpaired vital organ for transplantation or research is imposed death, also known as euthanasia? Have they not been reading the papers about all those poor donors about to be sacrificed who suddenly wake up minutes before their organs were going to be extracted? *

No matter how generous one might want to be by donating his own self, or vital organs from someone else to save others, suicide or homicide to save another is not morally acceptable.

* Zack Dunlap from Oklahoma, 'Dead' man recovery after ATV accident,

Doctors said he was dead, and a transplant team was ready to take his organs — until a young man came back to life http://www.msnbc.msn.com/id/23768436/

Val Thomas from West Virginia
WOMAN WAKES AFTER HEART STOPPED, RIGOR MORTIS SET IN
http://www.foxnews.com/story/0,2933,357463,00.html

French man began breathing on own as docs prepared to harvest his organs
http://www.msnbc.msn.com/id/25081786

© Paul A. Byrne, M.D.