“Death is not simply a biological fact,” tweeted Sandeep Jauhar, “but it’s also a social choice.” Death has become a social choice? He continues: “To increase the number of donor organs, we should expand the definition of death.”
Jauhar doesn’t mean death is a choice, as in suicide or doctor killing (“assisted suicide”), he means the definition of death is up for grabs. In an Our Democracy, such things are usually put to vote. Can you imagine the campaigns? I might be for expanding the definition to include those who choose reporting for a living, but then I’d worry they’d soon invent a category for me.
He and two others wrote an op-ed in the NYT, “Donor Organs Are Too Rare. We Need a New Definition of Death.“
This is pure utilitarianism, a case of scientism. This op-ed will, as you will see, show the extreme dangers of putting doctors in charge of non-medical questions, such as what death is and what is allowable in medicine. Memorizing bone names confers no moral or ethical advantage or philosophical or theological insight.
“Medicine”, Jauhar tells us, today declares a death on heart stoppage or when “the brain has ceased to function”. But there have been many cases where “brain dead” people come back to life. Which Jauhar does not mention. The people waking up were not, in fact, dead, because doctors make mistakes.
There are so many examples from which to draw that I am sure you have heard of the phenomenon. Remember George Pickering? Young guy from Texas declared “brain dead” after a “severe” brain injury. His dad had a confrontation with (ahem) authorities and refused to let George be unplugged. George woke up. Became a Christian.
How about Madeleine Gauron? A woman in a coma declared “brain dead”. She woke up before being labeled a candidate for organ donation. T. Scott Marr? Had a stroke, diagnosed with “brain swelling”, hooked to life support, but woke up later after they were removing it. He was only diagnosed with “near brain death”, which I ask you to keep in mind as you continue reading.
My favorite is Anthony Thomas Hoover II, who went into a coma after ODing in 2021. Quoting the best bits of the story:
Hours after a doctor had declared him brain-dead, Hoover awakened to find medical staff preparing to remove his organs. “Even though the man cried, pulled his legs to his chest and shook his head, officials still tried to move forward.” Hospital staff ultimately became “uncomfortable with the amount of reflexes” Hoover showed, and a doctor ultimately refused to remove him from life-support. The man ultimately survived.
These are important because today doctors grab organs from those declared “brain dead”. Now you can argue in each of the cases above “true” “brain death” was not present, and instead mistakes by doctors were made. But then you are arguing doctors can make mistakes in classifying whether somebody is “brain dead.” That isn’t helping Jauhar’s position.
They have to grab organs from those declated “brain dead” because, Jauhar says, “organs from people who die [by heart stopping] are often damaged and unsuited for transplantation.” This is true. Because the persons in these situations are dead-dead, not “brain dead.”
Today they take people who docs declare are in “irreversible coma” etc. and not “brain dead”. They are wheeled “into an operating room” and any life support removed. If the heart stops, they wait five minutes and begin hacking.
Notice this very carefully: “But even a few minutes of a stopped heart often results in damage to the organs. This deprives potential recipients of healthy organs and thwarts the wishes of donors to have their organs used to help others.”
Ah, it’s the patient’s wishes to be cut up. Even if he isn’t dead-dead.
In a relatively new method, Jauhar tells us, the patient is removed from old life support and put on a new form of life support not called life support, but something else, the name somehow changing the device’s moral properties. This new not-life-support life support keeps organs supplied with oxygen so they can be removed profitably. While the patient is still alive.
Yet even this innovation does not bring in enough bodies: “The solution, we believe, is to broaden the definition of brain death to include irreversibly comatose patients on life support…So long as the patient had given informed consent for organ donation, removal would proceed without delay. “
We have already seen cases of people declared “irreversibly comatose” who have woke back up. In those cases of mistaken diagnosis but removed organs, then doctors are purposely killing people. How many of these unfortunate killings are worth one fresh spleen?
As we have already seen with doctor-killings (Canada, The Netherlands in particular), the definitions of eligibility have slipped on down the slippery slope, becoming broader with time. The temptation to make the diagnosis of “irreversibly comatose” in marginal cases will not always be resisted, especially when a prospective donor looks to have a juicy kidney.
We can only speculate which diagnoses will step up when it is found “irreversibly comatose” isn’t supplying the utilitarian need. CHF? Dementia? Alzheimers? “Untreatable” cancer? You guess.
If you doubt that prediction, then see this:
Apart from increased organ availability, there is also a philosophical reason for wanting to broaden the definition of brain death. The brain functions that matter most to life are those such as consciousness, memory, intention and desire. Once those higher brain functions are irreversibly gone, is it not fair to say that a person (as opposed to a body) has ceased to exist?
This is precisely why you cannot trust doctors to do philosophy. Or any scientist in the grip of the Machine Metaphor.
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