The Dark Side of Being an Organ DonorS

Becoming an organ donor is widely considered a good thing. If you die and offer up your body to medicine, you can extend the life of others with zero inconvenience—after all, you're dead. But it turns out that the reality of organ donation isn't quite so crystal clear, and that it's something you might want to lend a little more thought to.

Becoming an organ donor is easy; just tick a box on your driving license, or fill in a simple form. You may not know that you waive your rights to informed consent at that stage: doctors don't have to tell your relatives where your organs go, or what they do to your body to extract them. You have few legal rights; you're dead, remember.

That's not too bad, though. I can live with that. But writing for the Wall Street Journal, Dick Teresi raises a more interesting point: the majority of organ donors are victims of head trauma, who end up being ruled dead based on brain-death criteria. And brain-death diagnosis isn't really an exact science:

The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what's called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)

Here's the weird part. If you fail the apnea test, your respirator is reconnected. You will begin to breathe again, your heart pumping blood, keeping the organs fresh. Doctors like to say that, at this point, the "person" has departed the body. You will now be called a BHC, or beating-heart cadaver.

The problem is, plenty of BHCs still have brain waves. A bigger problem is that—very, very occasionally— BHC's even start breathing again by themselves. Whether they're actually dead or not, well, that's up for debate. It's that uncertainty that many people are, quite rightly, starting to worry about. For a deeper insight, you should read Teresi's article; it's really quite thought-provoking. In the meantime, I'm remaining a donor but hoping for a lack of imminent head trauma. [Wall Street Journal; Image: Spirit-Fire]