Do you trust the organ donation process (after recovery of 'brain dead' boy)?

Pippynurseuk · May 14, 2018

As far as I know, no physician who is an expert in brain death has re-tested Jahi McMath. I find it very suspicious that the family is not willing to allow her to be re-tested with every one of the tests which are used legally to determine brain death. The judge has made his "maybe she is" statement based on family testimony and from medical professionals who have not examined her and have relied on family testimony or dubious videos which cannot be verified.
If she has miraculously gone from brain dead to alive, her family should be screaming out for these tests to be done, because as we all know, if she is declared alive and disabled vs. brain dead, their ability to receive financial compensation in a lawsuit and the ability to have her care covered in their home state is significantly different than their current options.

Similarly, I recently read (from an interview by her mum) that she can now move her arms, legs, turn her head and bend at the waist. You would think that theses videos would be all over her Facebook page and the media (being such a miracle) but no, I guess they just haven't gotten round to posting them yet ...

Kratoswife · May 14, 2018

As a black person....I refuse to put myself on the organ donation list. Medicine has a history of giving black people substandard care..I wouldn't be shocked if I come across horror stories of minorities getting poor treatment due to having great organs to harvest. I want them to do everything possible and I am afraid some prejudiced doc wouldn't.

Yikes! I am organ Donor. This makes me want to go back and change my status.

Cat365 · May 14, 2018

The organs are not removed from a person before death. The patient undergoes a terminal wean in the operating room. The patient dies there and then organs are harvested. In fact if the patient lives too long after they are extubated the organs cannot be used.

boquiabierta · May 14, 2018

Yikes! I am organ Donor. This makes me want to go back and change my status.

Nooooo please read the comment above from EllaBella1 for some real information about organ donation, not fear-mongering conspiracy theory.

Black people absolutely do have legitimate reason to mistrust medical authority (Tuskegee et al historically, not to even get into health disparities today such as maternal mortality) but standards of practice around organ and tissue donation is just not like that... the people who harvest the organs/tissues are completely separate from the healthcare providers treating you, and it's just not based in any kind of reality that your care providers might prioritize your organs over saving your life. Please, read EllaBella1's comment.

Here.I.Stand, BSN, RN · May 15, 2018

Yikes! I am organ Donor. This makes me want to go back and change my status.

I'm sure there are docs who are bigots, but the process is not the doc's decision. I've seen countless "my license is on the line!" over issues that are in no way risking a nursimg license... I find it very difficult to believe that a doc would risk his/her license over intentionally providing substandard care in an effort to get organs -- especially before the decision is even made.

Besides, we don't even know that a pt has "good organs" during the course of ICU care. Unless it's a cardiac pt, they have likely not had an echo. The pt hasn't had a liver biopsy. Standard ICU ventilator practices are insufficient for preserving the lungs... the RTs have a very detailed protocol for pre-transplant lungs.

AFTER the decision is made, but prior to allocation, the pt will undergo the above testing to ASSESS the viability for transplant. I've seen several young and outwardly healthy people who you would look at and assume has a strong/healthy heart... only to find significant mitral regurg on the echo. Their heart wasn't used for transplant.

On the OTHER side of the donation decision: over 29% of the people waiting for a transplant are black. The wait list is growing much faster than the lists of donors and donations. Between 1991 and 2015, the number of transplants has roughly doubled. The number of people waiting has roughly QUINTUPLED.

Most people on the list (>80%) are waiting for kidneys.

Unfortunately, black people are at higher risk for diabetes and HTN which can lead to.... renal failure. We absolutely do not want to reduce their chances of getting a kidney!! As it is, 20 people PER DAY die waiting -- trends show this number will likely increase, and certainly will if people choose to withdraw their permission.

Side note: my oldest daughter recently got her learner's permit. It was a VERY proud moment as a mom, when she checked that box without asking for my advice. She made that decision on her own. :inlove:

Here.I.Stand, BSN, RN · May 15, 2018

in case anyone is wondering, those statistics in my last post are from organdonor.gov

Have Nurse, ADN, RN · May 15, 2018

It's odd that this came up. Today while on my way to work, I listened to a physician on the radio, (guest speaker), who is also concerned that organs are being harvested "too soon." He himself is an organ donor and plans to re-visit that when he renews his drivers license. But he did emphasize that he isn't against organ donorship, in fact, it does save lives. But to quote him, "Some physicians are too eager to do something bad to do something good." I must confess it did get my attention.

psu_213, BSN, RN · May 15, 2018

Similarly, I recently read (from an interview by her mum) that she can now move her arms, legs, turn her head and bend at the waist. You would think that theses videos would be all over her Facebook page and the media (being such a miracle) but no, I guess they just haven't gotten round to posting them yet ...

If I remember correctly, at the time we had the original discussion about the unfortunate case on Jahi, a few people mentioned that at some point in the future we would hear from the family that Jahi had made a recovery, which seems to be what is happening.

dbabz · May 16, 2018

I lost my five-year-old son in 2010 in a drowning accident and he was on life support for two days and then we were told nothing further could be done, he wasn't coming back and we opted to donate. Maybe I shouldn't even be reading this, given my situation, but since I am now a nurse, I need to be well-informed.

Maybe this is just the rationalization of a bereaved mother (I will be that for the rest of my life) but here's my logic when this comes up. Wouldn't it be in the best interest of the hospital to do anything and everything to promote the best outcome for the patient? Even from a strictly cold, practical perspective it would seem that a hospital saving a patient would "look" better (in terms of reputation, statistics, etc) than one that procures organs. Two things I should point out; I never really held out much hope--I always felt in my heart that my little boy no longer dwelt in the shell of his body. A mother knows these things. Also, I'd like it to be known that we worked with Gift of Hope, an organization for which I still have the utmost respect. They were absolutely wonderful. Even through my grief, I was in awe of the compassion and kindness that everyone involved showed us. We still donate to them in my son's memory and urge others to do the same when they want to honor him.

I really would like to know what concerns any of you have with the organ procurement process, and again, this is knowledge that I need for future practice so please don't spare my feelings.

allnurses Guide · May 17, 2018

Many, many families discontinue life support on individuals who are not brain dead; that is not the only criteria for doing so.
But feel free to enjoy your conspiracy theory.

Exactly. My son was not brain dead when we made the decision to withdraw futile care.

I hate these sensationalized news stories of so called miraculous recoveries. Patients having this outcome aren't the norm. Far, far from.The stories aren't usually very comprehensive in the coverage of actual facts. They lead to families feeling like they have to continue care at all costs just in case they might be the recipient of their own "miracle" and to lifelong guilt with questioning whether they should have waited longer to withdraw care to give a miracle the chance to happen.

The kid wasnt brain dead. He had not been tested yet. Tests would have shown this and the family would have been facing hard decisions without any news coverage at all.

BSNbeauty, BSN, RN · May 17, 2018

The story I read (and all were from the family's perspective), discussed how the kid started to fail the testing for brain death the day before planned withdrawal of life support. I think that raises my confidence in the process. They were going through the needed exams, and the kid failed, which showed brain activity. Good. And huge skepticism over his eyes changing color because they "saw God".
My guess, the steroids kicked in, reduced brain swelling enough to allow sufficient perfusion, and he never totally lost brain function. Yay science. Not a miracle.

Yay,God, not science. I'm a firm believer that God had everything to do with the process, He created science after all.

allnurses Guide · May 17, 2018

Yay,God, not science. I'm a firm believer that God had everything to do with the process, He created science after all.

They are sure lucky then that their prayers were better than so many other people's who also prayed for God to intervene.