Part IV Research on "brain dead" and "almost dead" patients declared "ethical"

by Bill Beckman, Executive Director, Illinois Right to Life Committee

Editor's Note: This is the fourth in a series of columns first posted on the Illinois Right to Life Committee's (IRLC) website [http://www.illinoisrighttolife.org/] written by Bill Beckman, IRLC's executive director. The column discusses research on "brain dead" and "almost dead" patients. This series warns readers about end of life issues and the need to monitor the care given to loved ones. The IRLC director also describes what readers can do to protect themselves from the looming culture of death which permeates the thinking of many medical facilities in our nation.

The following was written by Bill Beckman

Life is precious, and it is certainly fragile for those burdened with a serious disease or injury. In today's health care arena, the certainty of care seems to evaporate when the patient's "quality of life" is deemed too low. This can lead to a battle with hospital ethics committees on whether patient care should be continued [see previous article in this series on RFFM.org, titled "Futile Care--What is it? Knowing May Save Your Life Or The Life Of A Loved One" *]. Ultimately, for some patients, recovery will not be possible--even with the best efforts of relatives to protect the patient's right to care and with the best efforts of medical staffs to provide that care. The right answers on reducing or ending treatment are often difficult and are rarely made with complete confidence.

When hope of recovery is gone, new threats to a natural end to this earthly life now present themselves. If the patient is declared "brain dead", is he/she really dead? Should the patient's organs be donated? If the organs are not usable, should the patient be allowed to have medical research conducted on their bodies--either after declaration of "brain death", or while unconscious, but not yet declared "brain dead"? Relatives are now being asked to make such decisions.

You should be especially concerned if your relative is diagnosed as “brain dead”. “Brain death” is not a definitive means to establish that a person is dead. For this reason, IRLC has already been recommending not to choose organ donation because it could lead to your premature death. IRLC has presented informed concerns from medical doctors about the tentative nature of this diagnosis. For example, see Ethical Dilemmas Defining Death (www.illinoisrighttolife.org/EthicalDilemmasDefiningDeath.htm) and "Brain Death" is Not Death! (http://www.chninternational.com/brain_death_is_not_death_paul_md.html)

For patients who are declared "brain dead", medical personnel might push for approval of organ donations. If the patient’s organs are not considered usable, you may now encounter requests to allow medical research on your dying relative. Some medical researchers have decided it is ethical to perform research on “brain dead” patients. A very outrageous article on this new abuse of disabled patients appeared in the Chicago Sun-Times on January 3, 2006 http://www.illinoisrighttolife.org/EthicalFrontier_ResearchOnTheDead.htm

Researchers can use these "brain dead" patients to test new drugs for effectiveness in stabilizing irregular heartbeats, test new alternatives to respirators, etc.

Of course, as soon as this new utilitarian perspective is put into action, further abuses immediately occur. The Chicago Sun-Times article discussed one patient at M.D. Anderson Cancer Center in Texas who was alive, but unconscious, and so sick due to complications from cancer, his family was about to take him off life support. [Translated, that means the family was going to allow removal of the patient's respirator so death would occur--even though the patient was not declared “brain dead”.] Instead, the family was convinced to leave their relative on the respirator, so medical research could be performed on his body before he died.

According to the Chicago Sun-Times, "M.D. Anderson researcher Dr. Wadih Arap said that in research projects, the soon-to-be-dead can ethically be treated the same way as the recently dead...Arap used (Mr.) Minatra in a study on targeting drugs to specific sites in the body. Arap injected genetically modified viruses that had identification tags and moved through the body like drugs."

Family members allowed this research after receiving assurances their relative would feel no pain. Would you trust such assurances? You should not, given these assurances may be as inaccurate as claims made that no pain is felt during starvation and dehydration after feeding tube removals, or ridiculous assertions which state unborn babies feel no pain during abortions. However, whether there is pain or no pain, allowing medical research on unconscious patients continues to expand morally unacceptable "quality of life" criteria used in making decisions that can deny care to patients and, ultimately, justify euthanasia. Do not allow the dignity of your dying relative to be violated by agreeing to medical research that may cause pain on even hasten the death of your still living relative.

Apparently, hospital ethics committees will allow the continued use of the respirator for patients on whom research will be performed, but have no problem removing the respirator from non-research patients deemed to have a low "quality of life", even when relatives consider that step premature. Early in 2006, I was informed a physician at a California hospital, contrary to the expressed request of family members, removed a respirator from a heart attack victim, who then died. The doctor took this action when no family members were present, even though they indicated they would be back shortly. The victim’s son lives in Chicago. He mentioned his family's distress over the incident to a friend who is a Chicago policeman. The officer said removing respirators happens at hospitals in Chicago all the time.

A family member called a supervisor at St. Mary of Nazareth Hospital in Chicago inquiring about their policy in such cases. The caller was informed the hospital would remove the respirator in similar cases. The supervisor emphasized the point by adding the hospital is not concerned about lawsuits from family members because the hospital always wins in court. If you have a relative placed on a respirator, be aware that someone must remain with the patient constantly to protect them from overzealous medical personnel who find their quality of life too low even to give them a fair chance to recover.

This column was first posted on RFFM.org in August of 2006.

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Comments

[Joseph Schlessinger]

I do a lot of medical research and I really enjoyed this post - keep it coming!