Thursday, 4 July 2013

Liverpool Care Pathway - Presumptuous And Arrogant

Though our end is nigh, we may not recognise it so to be... Neither may others so judge, for that does not mean we should pre-empt it.

In these times of uncertainty, when death is being redefined and practitioners are being tasked to take life as well as save life, this is presumptuous, arrogant and dangerous.

Welsh assembly members are to vote on a controversial bill under which adults will be deemed to have consented to their organs and tissue being used if they have not stipulated otherwise.

The Welsh government believes the law will increase the number of organs available, save dozens of lives every year and, if successful, could be copied in other parts of the UK.

Opponents claim the move gives the state too much control over people's bodies, could cause extra distress for bereaved families and puts medical staff in a difficult position.

The Human Transplantation Wales Bill was passed by the National Assembly for Wales on July 2nd 2013

The Welsh assembly

The board of directors of the United Network for Organ Sharing will open a two-day meeting at the organization's headquarters in Richmond, Va., to consider new guidelines for donation after cardiac death.

"I'm worried about it," says Dr. Stuart Youngner, a bioethicist at Case Western Reserve University, noting that there's long been a clear line between the decision to discontinue care and to donate organs.

"From the beginning the organ transplantation establishment has recognized that you must keep them separate," Youngner says. "You must keep the people who are taking care of and making decisions about the potential donor separate from those who are trying to get an organ to put it into the recipient." 
The proposal is raising concerns among advocates for the disabled. "Pressure could be brought to bear on people to give up on saving their lives and give away their organs," says Diane Coleman of the group Not Dead Yet, which seeks to protect rights of the disabled.

And Stephen Mikochik, of Temple University's law school, worries about certain situations, such as when parents rush to the hospital and discover a child has suffered severe brain injuries in a car accident.

"You're going to be extremely upset. And if a physician comes in and says, 'Look, the prognosis doesn't look very good.' And then a procurement officer comes in and says, 'Well, look, let's make something meaningful out of this.' You might decide right then to agree to take the person off life-support so some of the organs can be harvested," says Mikochik, who works with the National Catholic Partnership on Disability   NPR

This is presumptuous, arrogant and dangerous.

This is what does happen...

This is Business & Health –

By Jenalyn Villamarin | November 1, 2012 6:08 PM EST

In Denmark, doctors at the Aarhus University Hospital are currently in a predicament after reportedly giving a false diagnosis to a patient.

Carina Melchior was proclaimed brain dead after a tragic car accident. Carina's family had to make the tormenting decision on donating her body organs as well as permitting the doctors to turn the respirator off.

"Those bandits in white coats gave up too quickly because they wanted an organ donor," Carina's father told the Danish newspaper Ekstra Bladet. Adding more negative media hype to the hospital, one Danish tabloid exposed about another unnamed patient who was also mistakenly diagnosed brain dead back in 2002. As Aarhus University Hospital thoroughly investigates both incidents, the hospital firmly confirmed that procedures in the earlier case were accurately followed.

This is Mail Online 

This is presumptuous, arrogant and dangerous.

This is what does happen...

This is New York Post –
The New York Organ Donor Network pressured hospital staffers to declare patients brain dead so their body parts could be harvested — and even hired “coaches” to train staffers how to be more persuasive, a bombshell lawsuit charged yesterday.
The federally funded nonprofit used a “quota” system, and leaned heavily on the next of kin to sign consent forms when patients were not registered as organ donors, the suit charged.
“They’re playing God,” said plaintiff Patrick McMahon, 50, an Air Force combat veteran and nurse practitioner who claims he was fired as a transplant coordinator after just four months for protesting the practice.
The suit, filed in Manhattan Supreme Court, cited four examples of improper organ harvesting.
In September 2011, a 19-year-old man injured in a car wreck was admitted to Nassau University Medical Center. He was still trying to breathe and showed signs of brain activity, the suit charged.
But doctors declared him brain dead under pressure from donor-network officials, including Director Michael Goldstein, who allegedly said during a conference call: “This kid is dead, you got that?” the suit charged.
The patient’s family consented to have the organs harvested.
“I have been in Desert Storm, Iraq and Afghanistan in combat. I worked on massive brain injuries, trauma, gunshot wounds, IEDs. I have seen worse cases than this and the victims recover,” McMahon told The Post.
That same month, a woman was admitted to St. Barnabas Hospital in The Bronx still showing signs of life, the suit said.
She had a kidney transplant earlier in life and network officials used that to pressure her daughter into giving consent.
“They say to her, ‘If you give us permission we will use your mother’s organs and we will help many, many people who need them,’ ” he said.
McMahon’s objections were ignored by a neurologist, who declared her brain dead — and her organs were harvested, according to the suit. McMahon even claims he tried to get a second opinion.
A month later, a man was admitted to Kings County Hospital in Brooklyn, again showing brain activity, the suit said. McMahon claims his protests were again blown off by hospital and donor-network staff, and the man was declared brain dead and his organs harvested.
In November 2011, a woman admitted to Staten Island University Hospital after a drug overdose was declared brain dead and her organs were about to be harvested when McMahon noticed that she was being given “a paralyzing anesthetic” because her body was still jerking.
When he objected, another network employee told hospital personnel McMahon was “an untrained troublemaker with a history of raising frivolous issues and questions,” the suit charged.
“I had a reputation for raising a red flag,” he said.
In order to harvest organs, the network needs a “Note” — an official declaration by a hospital that a patient is brain dead — and consent from next of kin.
The network hired marketing and sales professionals to “coach” workers to tailor their pitches based on the family’s demographics, said the suit, filed by McMahon’s lawyers Michael Borrelli, Alexander Coleman and Bennitta Joseph.
The suit said that on Nov. 4, McMahon told Helen Irving, president and CEO of the network, “one in five patients declared brain dead show signs of brain activity at the time the Note is issued.”
Irving, the suit said, replied: “This is how things are done.”
Network spokeswoman Julia Rivera said she hadn’t seen the suit, but noted that only doctors can declare a patient brain dead.
She called McMahon’s claims of a quota system “ridiculous. There are no quotas.”
A Staten Island University Hospital spokeswoman declined comment. Reps for the other three hospitals could not immediately be reached.
Additional reporting by Bob Fredericks

Redefining Death -

Medical ethics is already beginning to scrape the bottom of the barrel in redefining death.

Further reading -

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