One of the more difficult things in life is to admit to having been wrong.
Not just a little bit wrong, but stridently so.
I had the privilege of having dinner yesterday with a distinguished doctor; a Catholic of unimpeachable ethics, and a good chap to boot.
We discussed heart transplants, and he told me that I was wrong.
Given that I have blogged (and as I say, stridently) on this, on more than one occasion, it is important that I correct this error.
He is very clear that brain stem death is an acceptable and reliable indication of death; that the heart may continue to beat beyond death if a patient is on a ventilator, and that the removal of that beating heart is ethically quite acceptable. Indeed, if it is done to save another life, it is clearly a moral good.
Once the brain stem is dead (which is verifiable) there is no prospect of any recovery. The brain is irreversibly damaged, and consciousness is forever gone. This is most common in people with severe trauma to the head (eg as a result of road traffic accidents) and whilst their heart may be kept going by extraordinary technical means, they really are dead.
I raised the query about the need to anaesthetise before removing the beating heart (which I have to confess is the bit that really brings me up short) and he said that is done as there may still be nerve activity from (eg) the spinal cord that might cause movements, which could impede the operation (as well as needlessly distress the medical staff).
The other instances that have caused concern have been where doctors have failed in their duty of diagnosis etc. Clearly that is very wrong, but it does not call into question the practice of heart (or liver etc) transplants per se.
I am now going back over my old posts about this, adding an update, directing people to this post, to minimise any further risk of misleading people.
I should make it clear that we were discussing the situation in the UK. I understand that different and more dangerous ideas and practices may be prevalent elsewhere, including the US.
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