Saturday, March 31, 2007

The March 18 news story "New Trend in Organ Donation Raises Questions; As Alternative Approach Becomes More Frequent, Doctors Worry That It Puts Donors at Risk" may have left readers with a mistaken impression that organ donation after cardiac death compromises or hastens the process of declaring death. One particularly inaccurate quote suggested that the donation process begins before death has been legally declared.

First, organ recovery begins only after the legal definition of death has been met and death declared. Throughout the history of medicine, death has been declared upon the permanent cessation of heartbeat. This is also one of the two legal standards of death (the other is permanent and total loss of brain function). Donation after cardiac death does nothing to alter that standard.

Second, the patient's own physician is responsible for withdrawing life support and pronouncing death. The Uniform Anatomical Gift Act expressly forbids a transplant surgeon from participating in this process.

The Institute of Medicine has twice examined and endorsed donation after cardiac death. Transplant providers and advocates continue to evolve protocols to ensure that the highest ethical and medical standards govern such donations.

-- S.V. McDiarmid

Los Angeles

The writer is president of the United Network for Organ Sharing.