Bioethics Blogs

Dead yet? Science, scaremongering and organ donation

Tont-Filippini’s claims could arose fears in the community and prompt people to reject organ donation. Melvin Es

In his new book, Catholic bioethicist Nicholas Tonti-Filippini attempts to portray the surgeons involved in organ donation as modern-day grave robbers.

As described in a recent article in The Age, Professor Tonti-Filippini poses that some patients who are diagnosed as “brain dead” are not really dead because there is some mid-brain function. Further, he argues that brain blood flow testing should be performed to ensure these patients are not prematurely declared dead and inappropriately have their organs donated.

So what is brain death and how is it diagnosed?

According to the Australian and New Zealand Intensive Care Society, whole brain death is required for the legal determination of death in Australia and New Zealand. A patient must be declared dead by a physician in order for deceased organ donation to be permitted.

Brain death occurs following a severe brain injury associated with significant elevation of pressure in the skull (called intracranial pressure). As the brain swells, exposure to oxygen reduces and intracranial pressure increases. Eventually brain blood flow ceases and the entire brain, including the brainstem, permanently dies. There is no recovery from brain death.

Neither myself nor Tonti-Filippini are neurologists and it’s important to note that those clinicians are the genuine experts in the field and undertake ongoing research. In fact, the Quality Standards Subcommittee of the American Academy of Neurology updated its practice parameters for determining brain death in 2010.

The Academy also created a brochure which clearly explains the key features of brain death diagnosis to families:

  1. the person is in a permanent coma, and the cause of the coma is known;

  2. all brainstem reflexes have permanently stopped working; and

  3. breathing has permanently stopped.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.