The University of Nebraska Medical Center (UNMC) in Omaha may be skirting laws governing the procurement of human organs for transplant by harvesting organs from individuals who may not yet be dead.
UNMC surgeons have developed a protocol for “normothermic regional perfusion with controlled donation after circulatory death,” a practice fraught with ethical concerns.
Under UNMC’s protocol, published at clinicaltrials.gov, the donor is removed from life support, and once the heart has stopped (circulatory death) the surgeons wait five minutes – as required by Nebraska law – to see if the heart restarts on its own.
If it does not, surgeons cut open the chest cavity to begin organ harvest, then sever blood flow to the brain – ensuring brain death – before artificially reanimating the circulatory system with an external pump. The resumption of blood circulation restarts the beating of the heart, keeping the organs functioning and viable for harvest.
In 1981, the Uniform Determination of Death Act (UDDA) became law, establishing the parameters by which an individual may be considered “dead.” As per the law, a person may be declared legally dead after the “irreversible cessation of circulatory and respiratory functions, or the irreversible cessation of all functions of the brain, including the brainstem.”
UNMC’s restarting of the circulatory process within minutes of declared death proves the circulatory and respiratory functions have not “irreversibly” ceased. Proponents of UNMC’s organ harvest protocol dismiss this apparent contravention of the UDDA by claiming the donor is “brain-dead” by the time circulation is resumed.
What isn’t acknowledged is the harvester’s role in bringing about that brain death, caused by their own interruption of the brain’s blood supply, as described in the second step of UNMC’s protocol:
2) Ligation of all the blood vessels that supply blood to the brain to ensure that blood flow to the brain is not reestablished once circulation is restarted as described below.
If the brain is already “dead” as claimed, resuming blood flow would not bring it back, making this step unnecessary. The fact the step is included reveals the brain may indeed still be functioning at some level, and the organ harvesting surgeons know it.
The intent of this macabre procedure is to preserve the body’s organs as close to living form as possible.