Coroner stands ground on ruling in organ case

Denver Post ^ | October 07, 2004 | Nancy Lofholm

[grassboots.org]

Grand Junction - Montrose County Coroner Mark Young has received threats from angry people waiting for organ donations. He has heard rumors that physicians in Montrose want to start a recall against him. Officials at donor organizations have lambasted him for the potential damage he's done to their programs. And specialists have questioned his findings.

[grassboots.org]

This is the door that organ donation has opened. All donors should be told that they will be alive when most organs are removed and they should be required to personally waive responsibility for their own deaths, in writing. In other words, it should be understood that you are giving your life for a stranger. Perhaps that may be okay, but any other use of the practice is murder by deception.

The possible exceptions are corneas (I think).

I wish that Christian coroners in every part of the country would rule these cases homicide - in every case of removing organs from someone with so-called "brain death". You're dead when you irrevocably stop breathing and your heart stops irrevocably. By then it is too late to donate organs.

[Diddle E. Squat]

Coroner stands ground on ruling in organ case

The official says his intention was "to alert the medical community to differing standards."

By Nancy Lofholm
Denver Post Staff Writer

Grand Junction - Montrose County Coroner Mark Young has received threats from angry people waiting for organ donations. He has heard rumors that physicians in Montrose want to start a recall against him. Officials at donor organizations have lambasted him for the potential damage he's done to their programs. And specialists have questioned his findings.

But Young said Wednesday that he is sticking to his ruling that a man who shot himself in the head actually died from the removal of his organs.

"I'll stand my ground," said Young, who added that he has received encouragement from some physicians "to hang in there because you're doing the right thing."

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In spite of assertions from officials at St. Mary's Hospital in Grand Junction and the Donor Alliance that everything was done properly in the removal of organs from 31-year-old William Rardin, Young still maintains that not enough testing was done at St. Mary's to determine that Rardin was brain- dead before his organs were removed on Sept. 28.

Wednesday afternoon, Young clarified statements he has made since he classified Rardin's death as a homicide on the death certificate.

In a joint statement issued with the Donor Alliance, Young said his intent in raising questions about Rardin's case was not to make the public fearful of organ donations "but to alert the medical community to differing standards."

Young encouraged people to continue donating and revealed that a family member has been a tissue recipient.

And Montrose County District Attorney Thomas Raynes entered the fray Wednesday, saying he has turned over medical files in Rardin's case to a statewide review committee made up of donor officials, physicians, coroners and district attorneys. Raynes said the Colorado District Attorneys Council created that committee five years ago to review any controversies and legal questions that might arise over organ and tissue donations.

Raynes said in his initial review of the records Young turned over to him: "I have nothing in front of me to say that the proper protocol wasn't followed."

Young said he is doing his own consultation with a neurosurgeon and a neurologist and will make their findings known early next week.

Young had been tight-lipped on details of test results that he was questioning, but Wednesday he revealed specifics about that test, intended to determine whether Rardin was brain-dead.

Rardin was given an apnea test at St. Mary's that involved removing him from a ventilator for 10 minutes to see if he would start breathing without the help of the machine. The test showed a brain stem that was no longer capable of responding, St. Mary's Hospital vice president Dan Prinster said.

But Young said that test should have been stopped before it was completed because Rardin's blood pressure had dropped too low to make the test feasible. He said that in order for that test to be conclusive, the patient's blood pressure must be at least 90 so that enough oxygenated blood is flowing to the brain stem to make the test viable.

Young said Donor Alliance guidelines say that the apnea test must be stopped if blood pressure drops too low to maintain that blood flow, and another test used, such as an EEG or an injection of dye into the brain.

Dr. Adair Prall, a Denver- area neurosurgeon and member of the Donor Alliance board, disputes Young's findings.

"There is no such thing as the standard adequate blood pressure, and it's certainly not part of the criteria for evaluating" whether a person is brain- dead, Prall said.

However, Prall said that when the apnea test was done on Rardin, "I know for a fact that, in the flow sheet in those hospital notes, that the blood pressure was over 100."

Young said his investigation of the Rardin case shows there may be a widespread problem with mixed standards for organ donor tests. He said he will continue to pursue what he perceives a problem in those standards.

"People can say I jumped the gun," he said. "They can say what they want. I am starting to find out that while standards may exist, they are not being followed. This needs to be cleared up."

[MineralMan]

"I wish that Christian coroners in every part of the country would rule these cases homicide - in every case of removing organs from someone with so-called "brain death". You're dead when you irrevocably stop breathing and your heart stops irrevocably. By then it is too late to donate organs."

You do? Well, I'm an organ donor. It's right there on my drivers' license, and everyone in my family is aware of my intention to donate any organs that are usable. Are you trying to tell me that you'd prevent that in my case, just because of your own beliefs?

Sorry, but I'll fight you over this one.

[A Real Dan Fan... NOT]

I read this and immediately though of the Monty Python skit in "The Meaning of Life". I must admit that it took me awhile to check Organ Donor on my license.
I kept seeing that husband on the table kicking and screaming while his wife was in the background saying, "I told you to find out more about that!"
I think this is an activist that just wants some publicity. I don't think his heart is really in this.

[grassboots.org]

As the law stands, as long as you know that they are going to kill you to give your organs away, there is nothing I can do to stop it at the moment.

Organ donation is one of the most well-accepted, unexamined practices in our country's history. I would stop all organ donations, if I could, until all donors signed the waiver I mentioned above.

I will work to have coroners declare all such deaths homicide.

[MizSterious]

What's wrong with telling people just what it is they're signing? Let people make up their own minds, once they're informed.

For the record, although rare, so-called "brain-dead" patients have been known to come back and regain most if not all functions. It happens.

[TigersEye]

All donors should be told that they will be alive when most organs are removed and they should be required to personally waive responsibility for their own deaths, in writing. In other words, it should be understood that you are giving your life for a stranger.

That would be committing suicide.

[MineralMan]

"As the law stands, as long as you know that they are going to kill you to give your organs away, there is nothing I can do to stop it at the moment.
"

I see. So you would stop me from donating my organs if you could? Is that what you're saying? Sorry, Charley, but that ain't gonna happen.

Organ transplants don't recognize political parties. I know what organ donation means. I know I would only be "clinically" dead at the time my organs were harvested. Yet, I make that choice myself.

Tell you what: If you or yours need one of my organs to save your life, I'll still be happy to be the donor.

If you disagree with organ donation, then don't be a donor. Leave the rest of us alone, OK?

[grassboots.org]

That would be committing suicide. I haven't completely thought through that yet. Are there cases where you could ethically voluntarily give your life for another and not violate the sixth commandment?

[grassboots.org]

If you disagree with organ donation, then don't be a donor. Leave the rest of us alone, OK? What about the people who don't know that they are still alive when the organ is removed - surely you wouldn't allow that to be done based only upon a card or a family members statement would you? As to your organs, I couldn't guarantee that I would be getting one from an informed volunteer. The law forbids donations to be given to the person of your choice. So accepting for an organ donation is asking that someone be murdered in your name.

[MineralMan]

"Are there cases where you could ethically voluntarily give your life for another and not violate the sixth commandment?"

Sheesh! Of course there are such cases. People do it all the time, to rescue someone. Most parents I know would take a bullet to protect their children.

Think about this a little more. You do what you want, and let others make their own decisions.

[MineralMan]

"As to your organs, I couldn't guarantee that I would be getting one from an informed volunteer. The law forbids donations to be given to the person of your choice. So accepting for an organ donation is asking that someone be murdered in your name. "

So, don't accept an organ donation, OK? Leave others alone. Don't try to legislate my organ donation. I'll make those decisions, not you.

[TigersEye]

Are there cases where you could ethically voluntarily give your life for another and not violate the sixth commandment?

Yes, MineralMan gave some reasonable examples. IMO what you suggest would not. It's one thing to shield someone from a bullet and hope for the best it's quite another to say "even though it will kill me take my organs and help another."

[grassboots.org]

I didn't start this thread to argue that one cannot give thier life for another - I was answering the claim that this is suicide. There are too many aspects to this that resemble cannibalism, rather than risking your life for your children. I don't believe the laws of the land would let you give your only kidney to your own child for a transplant, because it would kill you. The reason the law is hypocritical is because it insists that the donor be dead. That is not a living person giving their life for another. The whole premise is a lie - they are ng donors.

[Diddle E. Squat]

I haven't completely thought through that yet. Are there cases where you could ethically voluntarily give your life for another and not violate the sixth commandment?

According to the Bible, yes. Such as when the Israeli army of the Bible went to war, where they knew that many of them could be killed in advancing the greater good. Or consider the passage, "Greater love hath no man than this, that a man lay down his life for his friends."

Or perhaps google the story of Jesus....

[grassboots.org]

MineralMan - you're not responding to the point. The law is letting people be murdered who do not know that organs will be removed from them while they are still alive. If you understand that, go ahead and off yourself, but that doesn't mean the law should kill people who think they are giving organs after they are dead.

Lord Willing, this will be turned around as people learn the truth. - You're not against informed consent are you? You wouldn't be against a public campaign to inform people that they may be killed if they sign their donor cards, would you?

[grassboots.org]

See Post #14

I think that the best approach to this is to deal with how this is being done fist and later argue whether or not it could be ethical to donate organs in any case.

[lsee]

Yahoo NewsPress Release

Source: Donor Alliance

Donor Alliance and Coroner Mark Young Release Statement Regarding Grand Junction Organ Recovery Case Wednesday October 6, 7:59 pm ET

DENVER--(BUSINESS WIRE)--Oct. 6, 2004--Coroner Mark Young said today: "I want to clarify statements made with respect to the case of Mr. William Rardin. Donor Alliance, the organ recovery agency on this case, acted in good faith when recovering Mr. Rardin's organs. Mr. Rardin was severely wounded by a self-inflicted gun-shot wound to the head, and was not expected to recover due to the severity of his wounds.

"The intent of my original statement was to alert the medical community to my perception of differing standards. The intent was not to concern the public about organ donation or the risk of donating organs. What I want to come out of this is a defined standard. I plan to work with the right people to make that happen.

"I will be examining the case with a neurosurgeon and a neurologist to discuss this case, and we will comment on the findings early next week.

"A member of my family has been a tissue recipient. I fully support the organ and tissue donation program and would encourage others to participate in this program that saves lives. The public should be confident that any issues that have risen as a result of this case will be properly addressed."

Sue Dunn, Donor Alliance vice president of Organ Operations, said: "We appreciate that Mark Young, coroner of Montrose County, has taken the time to clarify some of the misinformation in this case. Organ donation is a critical issue in America. With 86,000 people today waiting for transplants, we hope this helps to quell people's fears and we can put this behind us."

Contact:

Donor Alliance
Today's Contact:
D. Nikki Wheeler, 303-370-2709
or
After Wednesday, October 6, 2004:
BRW LeGrand for Donor Alliance
Jennifer Tramontana, 303-298-8470

____________________________________

I think I understand what you mean, but I believe "murder by deception" is an opinion based on a belief of when "life" actually ends.

At what point does my human body cease to be "me"?:

As an organ donor (and a Christian), I understand that my body will be kept "alive" to permit my organs to be taken. After these organs are removed, naturally my body will finally and in fact "die". But if my brain is no longer functioning to keep my body alive, "I" am already "dead", by my understanding of "life". Keeping my physical body "alive" long enough to harvest my organs does not mean "I" am alive while this is taking place. "I" will already be elsewhere. I can only trust that everything possible will be done to make sure "I" am, in fact, brain-dead before this procedure is performed, but afterwards, all I hope is that good use will be made of the body "I" no longer need.

Can doctors make mistakes? Certainly. I am willing to take my chances based on current medical science, although I can see the need for clearer medical standards and explanations in this regard. I have made what I feel is an educated choice with the information currently available and I am willing to accept the risks. I am not against "informed consent", but I also do not believe I was misled when I signed my donor form. If a form existed for me to "take responsibility for my own death", I would sign it, if for no other reason than to relieve the minds of the surgeons and families impacted by my departure.

Matthew 10:28 "And fear not them which kill the body, but are not able to kill the soul: but rather fear him which is able to destroy both soul and body in hell."

[grassboots.org]

At what point does my human body cease to be "me"?:I think I understand what you mean, but I believe "murder by deception" is an opinion based on a belief of when "life" actually ends. Can you tell me when life ends? (It is interesting that prolifers also have to fight on the other end as to when it begins!) As a Christian, I believe the Bible addresses the when life ends: The Life is in the Blood (circulation) and he breathed his last (Breathing) Current medical definitions are all fraught with difficulty as the article suggests. There are scores of definitions of "brain death", with most transplant-associated doctors choosing which ever one will allow them to get on with it. But if my brain is no longer functioning to keep my body alive, "I" am already "dead", by my understanding of "life". If your brain isn't functioning there will be no transplant. Breathing and the heartbeat are regulated by the brain (even when aided by machinery) You can't make a corpse taken from the cemetery to breath. Remove the brain and other functions will cease no matter what other machines you might use. Note in the article that blood pressure must be "normal" in order to determine that you are really dead. How Ironic! Read up on brain death and you will find out that same kind of gobbledygook. When this new definition was started back in the 60s studies showed that a large percentage of those who were "hypothetically" branded "brain dead" would later recover. I believe you are among the misled. You are not dead when someone arbitrarily declares you such. Believe me, it was quite arbitrary. Your noble sacrifice would be better accepted if you actually undersood the situation. I am not impressed with the sacrifice of a person already dead. I can only trust that everything possible will be done to make sure "I" am, in fact, brain-dead before this procedure is performed, Why do we have to create a new term "brain dead"? Why not just say make sure I am dead? The reason is that language and common sense won't allow us to say they are "really" dead. Would you accept that the form said: "Understand that by signing this form, doctors will take organs from you which will in fact hasten your death"

[lsee]

You present some interesting questions about a complex issue.