Originally published at: "Brain dead" man wakes up as surgeons prepare to harvest his organs - Boing Boing
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At a presentation for a doctorate thesis in Biochemistry there was a critical distinction drawn between cell death and cell ‘inactivity’ inspiring one of the committee members to ask “How are you defining ‘death’?” To which the super stressed student managed: “Uhh… the absence of any living processes.” (tis a tricky thing to define death when living organs are being sought)
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Cue my reaction when I got to the end of “Never let me go”.
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It would be very interesting to know if there are any statistical tilts that can be found in the occurrence of ‘but not that fresh’ incidents.
Absolutely not trivial to determine whether someone is neurologically irrecoverable without just waiting until all the organs are nonviable, so some level of error is to be expected; but I’d be curious to know if it’s roughly evenly distributed; if certain regions or types of hospitals have higher or lower rates; do vehicle accident cases(and do drivers get handled differently than passengers) get handled differently from ODs; that sort of thing.
I’d assume that nobody is just running a “if he loved drugs so much just sedate him and call it good” operation; but it wouldn’t be totally surprising if people are bad at running what are supposed to be uniform criteria uniformly on both obviously innocent passengers and at-fault drivers if there’s any room for uncertainty or judgement calls.
In this case; it sounds like the ‘supervisor’ might not go over well if that particular call was recorded for quality assurance purposes; seems like a really bad look to be yelling at one of your minions when everyone surgically qualified is noping out hard and you are offsite somewhere without eyes on anything but the numbers.
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Doctors soon told Rhorer and her relatives that Hoover lacked any reflexes or brain activity
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“We were told it was just reflexes – just a normal thing,” she said to the outlet.
umm
Reflexes are a perfectly normal thing - for the living. I can’t imagine any situation that a doctor would say gaze following is a normal reflex for a dead person
wtf
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Yeah, this supervisor is a problem. Mistakes happen, but when you have a doctor saying, “this person is still alive,” the proper response is not, “then find a new doctor.”
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Gaze following seems pretty high level; but would more peripheral twitching be out of the question for someone suitably dead, or is even that something that is coordinated out of parts of the brain that only fail roughly as quickly as the cognitively important ones(outside of situations where mechanical trauma just shears off everything above the brainstem and you can be fairly sure that cortical activity isn’t even on the same table as the patient)?
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Something like a knee-jerk reflex doesn’t involve the brain at all and could persist. The reflex that is usually checked is pupil dilation which involves midbrain circuits. Tracking someone with your gaze uses both midbrain and cortical circuits.
Docosc or another medical professional would know better, but my understanding is that peripheral reflexes alone would not prevent declaring a patient dead, but anything involving the brain like pupillary reflexes would.
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At best it seems like ill-informed micromanagement: I assume that a 'case coordinator’s manager would not be pleased if they thought that they did in fact have a dead patient but coordination of a retrieval team had fallen through, and would want the coordinator to do something about that; but failing to understand that the retrieval team fell through because the patient wasn’t dead would make your management of the situation deeply counterproductive; but more in a ‘professional competence issue’ sort of way, rather than a ‘concerning medical ethics’ or ‘trying to have someone murdered because it makes the paperwork flow easier’ sort of way.
If the supervisor was aware of the circumstances behind the change in plans(surely this can’t be the first time that someone who initially looked pretty dead turned out to be a bit peppier than expected?) then the room for anything but really damning judgement narrows considerably.
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“The prosecution has accused my client of murder, which is an ugly word, ladies and gentlemen. I will show that my client is in no way guilty of the crime of murder, but was in fact merely helping to make these persons ready for organ harvesting, rendering a valuable service to the state of _______, where we currently face a critical shortfall in transplant-ready organs. Where the prosecution would have you see a cold-blooded killer, I see a public benefactor, proactively helping to address the medical needs of the community on his own initiative …”
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For-profit organ harvesting. How could this possibly go badly?
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“So the coordinator calls the supervisor at the time. And she was saying that he was telling her that she needed to ‘find another doctor to do it’.”
WTAF is up with that supervisor?
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In some communities, there are hospitals and healthcare providers that are bending or redefining the rules about consent. Debates and legislation about presumed consent are troubling to read. I’m sure there are members of marginalized communities with historically deep levels of distrust in institutions who would love to see those numbers, too. That we haven’t seen them up to now just reinforces the belief that they won’t look good for the organizations involved.
There’s so much inequality baked into the system:
Stories like this one are going to be circulated for a long time, increasing the distrust that already exists. I mean, look at the man who almost became a victim. 
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Everything in our stupid country is stupid racist.
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It could go here The Jigsaw Man
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It would be hard to believe that this being a drug overdose case didn’t factor into them being too quick to declare him dead, given the terrible medical care drug addicts reportedly get. Doctors are often extremely willing to just let addicts die, not just as a result of unconscious bias, but even consciously withholding care. So maybe nobody decided, “he is alive, but he’s an addict so I don’t care,” but it wouldn’t be entirely surprising if they had.
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Could be worse. Could have woken and found oneself as the GOP VP candidate.
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Could be worser. You might have woken up and realize they still harvested your organs, but attached your head to the GOP VP candidate. More or less the plot of “The Thing with Two Heads.”
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