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This has to be one of the most intellectually backwards arguments I have ever heard. It is almost on par with arguments presented by christian fundamentalists.

by hapkins 14y ago

This has to be one of the most intellectually backwards arguments I have ever heard. It is almost on par with arguments presented by christian fundamentalists. Being brain-dead is essentially being dead. Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Being brain-dead, it is also very unlikely that you feel pain. Reflexes can easily still be active even with brain-death, leading to convulsions during surgery. If the author had ever seen a serious car-accident victim in a coma, he wouldn't have second thoughts about organ donation. In his blog post, he is insinuating that you are still a normal, living, conscious human being. You aren't. Having grown up in a family of medical doctors, I find this blog post appalling. EDIT: As thebigshane pointed out, my wording is indeed terrible, I wrote my response in a hurry, and I will not edit it to avoid confusion. I do not have any professional medical education, all I know in this field is derived from in-depth conversations and discussions with my parents, whom are both medical doctors. Brain death is indeed classified by the Harvard criteria, but these also include the patient being non-responsive to external stimuli, such as pain (which contradicts the blog post's claim of convulsions during surgery due to the lack of anesthesia).

batista 14y ago
>Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Except when they can cut corners, because "ok, the guy is badly injured, there's some other patient that needs that organ", etc. It's not like they are gonna be extra thorough each time. Humans are known to do that...
- Symmetry 14y ago
  The people who would be cutting the corners see the people whose lives they're giving up on, but they never meet the people who would be using their organs. Doctors and nurses still make mistakes and get lazy, but I don't think it has anything to do with organ donation.
- bryanlarsen 14y ago
  It's my impression that Doctors are generally very conservative about this, for 2 major reasons: - they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students. - they've seen enough examples of people dying from seemingly minor conditions and others of people recovering from seemingly irrecoverable situations to know that their predictive powers are quite fallible So sure, I expect Doctors to cut corners and make mistakes, after all, they are human. But this is one area where I expect that they're much more likely to err by not declaring death soon enough...
  - batista 14y ago
    >- they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students. The same doctors in bed with big-Pharma, that shove prescriptions around for money and paid-all-expenses trips? The same doctors that perform unnecessary operations for a buck?
  - vadman 14y ago
    Do you go to "Doctors" much? You have an extremely idealistic image of them.
thebigshane 14y ago
While I agree with you overall, I have to nitpick your wording... Being brain-dead, it is also very unlikely that you feel pain Very unlikely? This seems like something that should demand complete[0] confidence. [0]: Ok, ok, maybe not 100% provability, but I want to know more about this surely subjective determination by the doctors. Or is there an automated reading from some machine that can objectively say "Patient is 95% likely to not feel you operating on him alive"? (Also, this is "deeply interesting" according to HN standards but lots of potential for irrational discourse -- my comment probably included)
- robbiep 14y ago
  If you are brain dead you cannot feel pain because your brain is not there to receive the signals. In computer speak, imagine you had a sensor that had external power and continued transmitting input to the CPU- the signals keep coming in, but the CPU is switched off. No processing of pain, no sensation of pain. End of story
  - deleted 14y ago
    [deleted]
  - thebigshane 14y ago
    Let me re-phrase... If I'm brain dead and there is zero chance of me feeling pain, they can take my organs. I just want them to be sure I'm brain dead. How is that determined? (oh and my brain is not an electrical cpu, I understand your analogy but I'm not sure it applies given the complexity of a human brain, for example certain parts of a brain can be "off" while the others are "on")
    - ChuckMcM 14y ago
      When your brain is 'working' it gives off signals, these are measured by an electroencephalograph (EEG). When those signals stop, you know the brain isn't functioning.
griffindy 14y ago
not even a serious car crash, even someone who has had a major heart attack. talking from personal experience, they can look just fine, but if their brain was without oxygen long enough, there's no chance that brain's coming back, even though certain reactions will still be present.

by hapkins 14y ago

batista 14y ago

>Hospitals and surgeons will not operate on you unless you are not expected to recover, or regain consciousness. Except when they can cut corners, because "ok, the guy is badly injured, there's some other patient that needs that organ", etc. It's not like they are gonna be extra thorough each time. Humans are known to do that...

Symmetry 14y ago
The people who would be cutting the corners see the people whose lives they're giving up on, but they never meet the people who would be using their organs. Doctors and nurses still make mistakes and get lazy, but I don't think it has anything to do with organ donation.
bryanlarsen 14y ago
It's my impression that Doctors are generally very conservative about this, for 2 major reasons: - they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students. - they've seen enough examples of people dying from seemingly minor conditions and others of people recovering from seemingly irrecoverable situations to know that their predictive powers are quite fallible So sure, I expect Doctors to cut corners and make mistakes, after all, they are human. But this is one area where I expect that they're much more likely to err by not declaring death soon enough...
- batista 14y ago
  >- they take the Hippocratic oath very seriously. It's a big part of the culture and indoctrination of medical students. The same doctors in bed with big-Pharma, that shove prescriptions around for money and paid-all-expenses trips? The same doctors that perform unnecessary operations for a buck?
- vadman 14y ago
  Do you go to "Doctors" much? You have an extremely idealistic image of them.

thebigshane 14y ago

While I agree with you overall, I have to nitpick your wording... Being brain-dead, it is also very unlikely that you feel pain Very unlikely? This seems like something that should demand complete[0] confidence. [0]: Ok, ok, maybe not 100% provability, but I want to know more about this surely subjective determination by the doctors. Or is there an automated reading from some machine that can objectively say "Patient is 95% likely to not feel you operating on him alive"? (Also, this is "deeply interesting" according to HN standards but lots of potential for irrational discourse -- my comment probably included)

robbiep 14y ago
If you are brain dead you cannot feel pain because your brain is not there to receive the signals. In computer speak, imagine you had a sensor that had external power and continued transmitting input to the CPU- the signals keep coming in, but the CPU is switched off. No processing of pain, no sensation of pain. End of story
- deleted 14y ago
  [deleted]
- thebigshane 14y ago
  Let me re-phrase... If I'm brain dead and there is zero chance of me feeling pain, they can take my organs. I just want them to be sure I'm brain dead. How is that determined? (oh and my brain is not an electrical cpu, I understand your analogy but I'm not sure it applies given the complexity of a human brain, for example certain parts of a brain can be "off" while the others are "on")
  - ChuckMcM 14y ago
    When your brain is 'working' it gives off signals, these are measured by an electroencephalograph (EEG). When those signals stop, you know the brain isn't functioning.

griffindy 14y ago

not even a serious car crash, even someone who has had a major heart attack. talking from personal experience, they can look just fine, but if their brain was without oxygen long enough, there's no chance that brain's coming back, even though certain reactions will still be present.