The group that manages organ donations in the United States has proposed new rules, setting off a fiery debate among doctors and medical ethicists. The United Network for Organ Sharing (UNOS) — a nonprofit group that coordinates organ donations through a contract with the federal government — wants to let doctors immediately retrieve organs from a patient whose heart has stopped beating, rather than waiting a customary two minutes to see if it starts beating again. UNOS also wants to remove a ban on using organs from a patient until after doctors and family members have agreed to stop all life support. Here, a guide to this controversy:
What's the point of these new guidelines?
Roughly 6,000 Americans die each year waiting for donated organs. These proposed changes are meant to reduce the number of cases in which organ donation is compromised by delays. "The ultimate goal is to facilitate the dying wishes of patients who wish to be donors and save the lives of the 112,000-plus patients who are in need," Charles Alexander, past president of UNOS, tells The Washington Post.
What do critics say?
They worry that the new rules would promote a "ghoulish" culture of vulture-like doctors eager to harvest organs. "This is another step towards this idea of hovering, hovering, hovering to get more organs," said Michael A. Grodin, a professor of health law at Boston University.
Will these rule changes muscle families out of the decision-making process?
Not according to some observers. Some families "push extremely hard to have their loved one donate organs," Dr. Jeffrey Punch of the University of Michigan’s Department of Surgery tells ABC News. "They desperately want their loved one's last function on earth to be saving others' lives." But sometimes, delays in withdrawing life support make it impossible to harvest organs. "This is tragic for that family, as well as to the recipients that do not benefit." These changes merely seek to prevent such situations.
So why all the controversy?
The definition of "death," and who gets to determine when a patient is dead is at the center of it. If these rules take effect, "every hospital in America can now develop its own definition of 'dead,'" says bioethicist Gail Van Norman. "And that is profoundly disturbing." Others find such criticisms groundless. Punch, for instance, labels them "a hysterical and inappropriate reaction to a very minor change in some standards. There is zero threat to the public well-being."