Man wrongly declared brain-dead for organ transplant
The Straits Times, Apr 13, 2007

I came across this article today about a man who was wrongly declared brain-dead by 2 doctors at a hospital in California, after his family agreed to donate his organs for transplant upon his death. This is apparently the second case of its kind in recent months.

The previous case involved a surgeon allegedly trying to hasten a 26 year-old patient’s death by ordering high volumes of pain medication to be administered to him.

These 2 cases have surfaced amid a national organ shortage.

I find such reports very disturbing. I have been collecting news reports like this one for many years (yes, there have been many such reports) because of my research into assisted suicides and medical law during law school. My interest in these particular areas have led to me writing a paper every year on different aspects of these issues.

These 2 reports highlight some major issues which I find are vital and in need of change. I list some of them here in brief (bear in mind these are from memory, I have not the time to check that they are valid today). First, is the fact that 2 doctors’ opinion is usually sufficient to establish an ‘acceptable medical practice’ and therefore is usually sufficient to cover doctors from liability.

Secondly, I believe that the current measure for whether a person is legally dead should be updated. Currently it refers to the patient’s responsiveness to certain stimuli. But medically speaking, it is what is called ‘brain-step’ death. The problem with this definition is that many people in comas would be considered dead, legally. This, unfortunately, is the standard that many doctors use today. I think it should be the law that follows the medical definition rather than allowing doctors to operate on a lower standard than that of currently established by medical science.

Third, this debate typically raises issues such as ‘quality of life’. This then becomes the benchmark to determine whether or not a person should live. Doctors have taken the responsibility to make such assessments. And so they see a patient in a ‘permanent vegetative state’ (PVS) – which incidentally nobody can ever be sure that any particular case is permanent – the doctor makes the decision that if this person is going to be a vegetable for the rest of his life, he will not be able to enjoy a sufficiently good quality of life, and therefore should die.

My contention is that it is something that doctors are not necessarily the best qualified to make – how can they make an assessment on whether the patient would be able to enjoy a ‘sufficiently’ good quality of life (Can they look into the future?). What does ‘sufficiently’ mean anyway? In addition, why should that factor actually determine whether the patient should be kept alive in the first place?

Finally, is the idea of ‘double-effect’ which refers to whether the doctor orders the administering of large dosages of pain killers such as morphine to hasten the death of the patient. This is another way whereby doctors are able to get away with euthanasia through the back door.

I guess the most troubling reality is the majority of us assume that doctors are here to heal us. That they have taken the Hippocratic Oath (apparently they don’t do this nowadays) – the oath to protect life – or that they are driven by altruistic motives. We like to think that they are all noble, always seeking their patients’ best interests.

It is understandably devastating when we hear of doctors trying to kill their patients or hasten their deaths. Something sounds very wrong here. Yet this presumption continues. Only in the rare circumstances when a family member gets suspicious does such dealings ever see the light. This was what happened in the case of Dr Harrold Shipman who killed his patients after forging their wills, adding himself as a beneficiary. In most cases, however, the doctor is able to get away (especially through hospital cover-ups etc - I'm sure it happens quite often) or other legal technicalities.