Should You Place Restrictions on the Organ Donation Process (in Case Pain Can Still Be Felt)?

A Massachusetts resident can become an organ donor by simply signing a donor card or having a donor symbol affixed to the person’s driver’s license.  Many citizens sign up to be an organ donor in this way without placing restrictions on the process of removing the organs (which is known as “harvesting”).  More details about the organ donation process in Massachusetts can be found in Massachusetts General Laws, Chapter 113A, the Uniform Anatomical Gift Act, which was signed into law by Massachusetts Governor Deval Patrick on February 22, 2012.

Is it possible that, without anesthesia or other restrictions, you could feel pain during the harvesting process?  A recent article in the Wall Street Journal, entitled What You Lose When You Sign That Organ Donor Card, raises this concern.  Once you are considered to be brain dead, you no longer have any legal rights, and the medical doctrine of informed consent no longer applies.  At that point, the Health Care Agent named in your Massachusetts Health Care Proxy would no longer have any say about the organ donation process.

What is troubling is that the organ harvesting process, where you would be known as a beating-heart cadaver, can sometimes result in an increase in the “deceased” person’s blood pressure, which could possibly mean that the organ donor feels pain during the process (although many doctors dismiss this possibility).  Some doctors use a local anesthetic, which doesn’t affect the organs, but others do not use any anesthetic at all.

To allow more control over how the organ donor will be treated during the harvesting process, it may be better not to sign a donor card or have anything affixed to your driver’s license, but rather to give your Health Care Agent complete authority to make decisions regarding all organ donation issues.  The Health Care Agent could then insist that the organ donations be conditioned on proof that pain cannot be felt or conditioned on local anesthetics being used during the organ harvesting process.

The author of a new book entitled The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers — How Medicine Is Blurring the Line Between Life and Death and an organ transplant surgeon were interviewed on March 19, 2012 on National Public Radio; a recording and transcript of the interviews can be found at http://www.npr.org/2012/03/19/148296627/blurring-the-line-between-life-and-death.  Although the surgeon stated definitively that there is no pain when there is no upper-level brain function, the interviewer did not seem to delve very deeply into the issue, and unfortunately did not ask about why there have been reports of increases in blood pressure during the organ harvesting process.