Should brain dead patients be kept alive for organ donation?

I will add my thanks for your story too, Flickety.

Flickety you have shared a special memory to illustrate the humanity of how this proposal can look and if nothing else has swayed people's opinion, this surely does. So many families are bereft because of the way they have to part with their loved ones and your story is comforting for us to contemplate should we ever find ourselves in this situation

What a wonderful post, FlicketyB. I found it very upsetting when reading Gloria Hunniford's book about her daughter, Caron
Keating, when she related how the nurse said to them that they should let her two small sons kiss her goodbye whilst she was still warm and breathing. The alternative is so horrible to contemplate.
Perhaps every patient could be kept in the semblance of life until the family have all said goodbye, even if there is no permission for organ donation.

When my daughter was close to death my mind refused to contemplate seeing her dead and I would not have wanted her four children to see her either. I know it is believed that some people need to see the finality of death in order to get 'closure' but having seen my FIL laid out in the funeral parlour, I know that he did not look anything like himself and I would have preferred to remember him as he was in life.

I am puzzled by this. Just over 20 years ago my sister was fatally injured in a road accident. Her body was kept on the life support system for 48 hours after she was declared dead before the organs were harvested. This was standard practice then to ensure that there could be no accusations later that the patient was not dead, or their death was expedited by the removal of the organs. I assume systems have changed since then so all that is being proposed is a return to a previous practice.

Joanna, I have been in the circumstance you would find impossible. In a time before mobile phones I was away on a short holiday in France when my sister's accident happened, away for the two desperate days when every attempt was made to save her life, away for her eventual death. I returned home to find a grieving family and a sister who had died in my absence. To go to the hospital and see her still in Intensive Care, still breathing and warm, her skin still rosy, was an immense consolation to me. I knew she was dead but I could hold her warm hand as if she was still living see her chest rising and falling, as if she was breathing naturally and I could say my last goodby. I am so thankful my parents made the decision to donate her organs that resulted in her still being in suspended animation when I returned home. My last memories of my sister are not a of corpse but of someone lying in bed in a hospital room, sleeping, warm, looking her own dear self. I know this was an illusion but one that gave, and still gives infinite comfort.

bagitha, that description would be more apt, I think. It's the word 'someone' that is the problem. When the brain is dead the 'someone' is no longer there. The organs are alive but the person has gone.
My friend's husband received a liver transplant 5 years ago. He had (and still does have) Hepatitis C, which happened because he was given a contaminated blood transfusion 50 years ago after a motorbike accident. He was 'knocking on heaven's door' until the transplant. I think he has given a lot of thought to the person who died, as have his family.

Perhaps the reference to keeping "someone" alive shold be changed to "keeping organs usable" then there is no fuzz about whether the person is dead or not.

This "keeping people alive" subject is so emotionally charged. Total desperation of the NHS has caused this idea to be born.
We should have the opt out system, and then this idea need never have surfaced. I am a nurse and I know that the medical community would never care less for a patient in the hope that they could harvest an organ for someone else.
The organ transplant waiting lists are an unnecessary tragedy that need not happen if we did the sensible thing and opted out. Unfortunately the people who vote against it are not realistic enough to see the benefits.
Brain dead is essentially dead - if you've seen it - you know that.

I don't think my rellies would have a problem about saying goodbye to me if I were brain dead and a machine was keeping my organs usable. However, I will speak to them about it and say that I have donated my organs in such a case and that it would be nice to feel they would respect my wishes. I'll say this even though I don't think they'd have a problem with it. As for funeral arrangements afterwards, that I leave entirely up to them. I have no preferences as to being buried, cremated, or left out for the vultures. (They know this already as well).

Well said, grace and sook.

I will echo gracesmums Yes, yes, yes, yes, yes, yes, yes, yes. My husband recently had his second kidney transplant on February 3rd. A very precious gift from our youngest son.

It is a very emotive issue and would need to be handled with the utmost sensitivity BUT WHY NOT if a person has made his/her wishes clear by signing the organ donor list.

Transplantation does change peoples lives and as jeni said the gift is not just to the recipient but to their whole family. In our case we went on to have two wonderful sons, and very happy normal family life which is now blessed by three beautiful grandchildren.

OK as usual I have spoken first and read the article second and I apologise for my knee jerk reaction. I do not retract a syllable but I realise this was not the original question.
But quite honestly, I do not altogether believe this, I suspect it is an attempt to raise the profile of organ donation. With increased effectiveness of safety features in cars, crash helmets for motor cyclists etc there are fewer young healthy organs available than there are people dying for want of a transplant.
Mnay countries operate a system of opting OUT of organ donation instead of opting in as at present in the UK, where, you may not realise, a potential donor 's signing of a card is entirely non-binding on their relatives and can be overruled by grieving next of kin.
The year after DH's transplant we included donor cards in all our Christmas cards and the girls gave them out to all their friends at school and university, but "scare stories" such as George Best drinking away his transplanted liver do untold damage as people start to have second thoughts.

This is clearly an emotive issue, and I do not believe for one minute in a sort of Dr Strangelove scenario where "people" would be "kept alive" for long periods of time.
If you die in a RTA, you are dead. Full stop. And organs start to deteriorate from that moment. I believe the "window" is 45 minutes for potential donation. The ideal donor will already be in hospital unable to survive the trauma which has occurred, he/she will be on a life support system while at least 2 independent senior doctors will have to agree brain death. Organs must be in the best possible condition for transplantation so at this stage time will be taken to register their availability to transplant coordinators in the various fields, and no action is taken until after relatives have said their goodbyes . I am sorry johanna feels she would not be able to say goodbye to someone on a life support system but clinically "dead". All I can say is that I would rather do that than see a parent/wife/son/daughter say goodbye to a CONSCIOUS person dying for want of an organ.
Like Jeni and perhaps others I do not know about, our daughters have a father who would otherwise have been dead within 6 months, DH has led one daughter up the aisle and beome a proud grandfather twice over. I do not know who his donor was, but I am profoundly grateful to him/her and his/her/relatives for agreeing to organ donation.How many people will die because of sentiment? At the moment of bereavement it must be an impossible decision to take which is why I believe that donor cards should be binding and next of kin should not be able to overrule that commitment.

He as lucky he only waited a year. But that was a year I don't rally want to look back on!

I'm really not sure, Jeni where I stand with this, in view of time-lines. I honestly don't think the nitty-gritty of it all has been addressed sufficiently by those who are promoting this suggestion, and I have no personal experience upon which I'd be able to base my decisions.
If I were pushed to make a stance today, then I would support maintenance of organ health for no longer than 6 months.

May I ask how long Peter waited? To have been given another 14 years was clearly wonderful, and I wonder if he may have had more, if an organ was available through this discussed method?

Would there be a limit to how much of a person could be used, though? I'm thinking of an era where we have things like hand and face transplants. If a body can be kept alive for a considerable time, then it would be possible to find matches for so much of it, and that I find quite disturbing. Even a funeral of some kind would not bring any peace to the people mourning a loved one; I would imagine that, even though no one ever totally gets over losing someone a funeral is at least a time to move on in whichever way one can. Has anyone seen the rather beautiful but terribly disturbing film 'Never let Me Go'?

This is a difficult one. I could not possibly say goodbye to ANYBODY who is still breathing. Life support machine, or not.

I would presume that in fact we are only talking about a matter of hours, perhaps a couple of days at most?

I think somewhere along the line with this there tends to be a polarisation of views.
Would it be possible, for those who find it difficult to address the concept of maintaining organ health, for however long (although I would support a time-limit, and quite what that might be I'm not sure), to be able to have a ceremony of their choice in which the family are able to say their goodbyes.

I think the sticking point is not whether organs can be used in the here and now or at a later date, but in the family being able to honour the death of a loved one with compassion and togetherness. Maybe a contentious view, but why not a funeral, an act of saying goodbye, be possible before actual organs are available for use.

Quite correct. The longer the perfusion time the better.
I remember when Peter was waiting for a match, they flew a kidney down from Glasgow to Bristol. Unfortunately it did not match with any of the three potential recipients.
The story went round the ward that the only possible match would have been a bottle of whisky!
It was St Andrews night after all!
This is absolutely true. Medics have a strange soh!

Brain cells die very very quickly once oxygen deprived. (in the case of a brain dead person then many of these are dead anyway)
Other cells die much more slowly. And they do, I think, put kidneys in cool boxes and drive them from one hospital to another. But obviously the longer they are unhooked from a supply of oxygenated blood the less good the condition is going to be. Does that sound right jeni ?

My husband too was the recipient of an organ donation. The kidney gave him an extra 14years of active healthy life that otherwise we would not have been able to share.
The gift of an organ is a gift not just to the recipient, but to their whole family.
In my husbands case this included 2 young children.
It made an enormous difference to all our lives!
So yes I do support this idea!

Am I right in thinking that although the person is brain dead, the heart is still beating and alive and has to be for the organs to be fit for transplant? I'm trying to clarify this as I recently read an emotive argument against transplant on the grounds that the person was in one respect alive. I like the idea of donating my organs, but in the event that they are not much use to anyone, I would like a natural burial with a tree planted over me. Not too soon hopefully!

I agree. It will help the people organising transplants if they have a few more hours to contact suitable recipient, transport them nearer to donor etc etc
Once the donor dies the organs are going to start to deteriorate and the transplant less likely to be a success. Anything that can be done to improve the chances of the transplant succeeding. Yes.

Thank you, Gracesmum, for such a touching post.

Yes, yes, yes,yes, yes,yes,yes,yes..
I don't think we are talking about "Keeping people alive" specifically for organs. Once a person has been pronounced dead there ia a relatively short "window" for the harvesting of organs/skin/retinas etc. So once a family have said their goodbyes, the life supprt system can be turned off and the first steps taken to saving 4 or more lives and vastly improving the quality of life of others. Why is this "spooky"?
Of course the patient is not conscious and at least 2 doctors have to certify the patient brain dead. Organ donors and recipients cannot be in the same hospital so there is absolutely no possibility of "dodgy" dealing. People leave their material goods to their loved ones when they die - is there no greater gift than to save other lives by organ donation? Forgive me for sounding so emphatic, but I would not have had my dear husband for the last 15 years of someone somewhere had not signed their donor card. I have also spoken with the parents of a young woman who died of a brain haemmorrhage and who, when they met my daughters and me (in the relatives' room of that same ITU I refer to below) who said that having seen the "other side" of organ donation, were more certain than ever that it was what their daughter wanted.
Despite the lack of consciousness, the patient is treated with the utmost care and respect - I have seen this, I have seen a patient being washed and dried, have her hair combed, be spoken to in loving and caring terms by the ITU staff.