Quote from nurselizarddp
I want to clarify, I don't think he would be a living donor, as they discussed removing all vents, tubes etc.. and it could be minutes to several days of survivial without feeding etc... My question is once this is done and it everything is stopped can they reattached.
In otherwords, I don't understand how he can get to point B "death" to donate organs if the options are right now.
a) Live in vegatative state
b) Let nature take it course naturally when removing equipement.
If B was the choice I feel the organs would not be viable because they just underwent a slow death, which would be sad as he would want to donate.
Unfortunately, that is an issue that cannot ethically be gotten around.
The hospital cannot "hasten" death to preserve organs, even in a pt in a PVS state. Once tubes are removed, nature takes what time it may. And, yes, this will cause some problems with the organs.
And once physiological/cardiac, respiratory death have occurred, to my knowledge - no reintubation occurs, no vent, vasopressors can restart. The heart has stopped, no circulation occurs and natural deterioration begins. If one were to "code" the pt and in the remote chance the heart restarted, the pt would still be considered "live" because the status as a PVS pt, they are still "live", just as they were before the cessation of pulse/respirations and unable to donate.
I suppose technically at that point, a EEG might determine brain death, changing the scenario. HOWEVER, you probably will not see that occur, for legal/ethically reasons.
Given the current public sentiment, quite a few legal cases, public perception, HCP liability, regs regarding UNOS (central donation agency), politics, religious pressures and HCP ethics - that would not be an acceptable solution. Please review the Terri Schiavo case. No matter whether every family member agrees to such a decision, there will be at least one person, staff member, concerned citizen, etc. that will come out and say that the organs were obtained unethically and this tars the whole system.
UNOS has determined that there are specific rules guiding donation, so that the public does not have objections and that someone will not be inappropriately/immorally harvested and especially that death is not hastened The integrity HAS to be preserved or the public will lose faith in the system and/or be very reluctant to donate.
This does mean that many organs will not be suitable for donation because of "letting nature take its course". But it preserves the integrity, and ensures that the public will not have cause to believe that they may be "killed" for their organs.
Please be aware, as in my first post, some organs do not necessarily deteriorate like the heart or lungs do. Bone can be harvested and used to repair bones in recipient pts. So usually some harvesting may occur, even if other organs have deteriorated.