Bring Out Your Dead

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The Washington Post notes the ethical problems that a pilot program in New York City faces. The city is going to begin using a special ambulance to "save" the organs of people who die suddenly for transplant. Some medical ethicists are outraged.

In the hope of saving the lives of more people waiting for transplants, New York City is working on a plan to deploy a special ambulance to collect the bodies of people who have died suddenly from heart attacks, accidents and other emergencies and try to preserve their organs.

If the "rapid-organ-recovery ambulance" succeeds, officials would like to expand the unique pilot program citywide with a fleet of ambulances and eventually duplicate it in other cities……..

….."I think it's disgusting," said Michael A. Grodin, director of bioethics at Boston University. "People are going to worry when the ambulance comes out to their house whether they are there to care for them or to take their organs."

The plan comes as transplant advocates have come under criticism for increasingly aggressive efforts to boost the organ supply, including advocating the removal of organs before patients are brain-dead. "This is another example of overzealous transplant people trying to retrieve organs any way they can," Grodin said.

The concern that the city of New York may not do quite as much to save a patient if the magic bus is standing by may be misplaced, but it is quite real. Sure, the professional paramedics who man the regular ambulances are going to continue to do their jobs. But the presence of the organ wagon will make people question whether they are really doing enough. There is also the problem of when are people really dead. Even doctors get that wrong in hospital settings.

The other concern is that procedures may be performed – no make that will be performed – on people without their next of kin's consent. Personally, I would be furious if anything were done to my loved ones without my consent. (My wife and I have long had medical power of attorney for one another). Sorry, New York. This is an ethical morass and I predict some serious problems with it.

Besides, there are other things to worry about, aren't there?

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3 Responses to Bring Out Your Dead

  1. They ought to be following around Elliot Spitzer’s State Police connections.  They seem to be suiciding at an increasing rate.  Another one did himself in yesterday evening.

  2. martian says:

    I think the worry extends even farther. Another concern is that doctors or other medical personnel will turn off respirators or other life support equipment prematurely or with undue haste in order to get at those organs. I agree that there are serious ethical concerns here.

  3. Things could be worse, the UK government and some US authors (Cass Sunstein in "Nudge") have suggested that organ donation be opt-out instead of opt-in.  From an older post of mine:The current system errs on the side of caution and I don’t doubt some organs go uncollected. An out-of-state female car accident victim might be taken to the hospital without her purse. An opt-out system will have errors too but in that case some people who have explicitly opted out will have their organs removed against their wishes. The former is unfortunate but the latter is the definition of unacceptable.[longer thing here ]

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