Amend organ donation laws with caution

Consent from relatives vital

I refer to “Organ donors’ pledges to be upheld by law” (Star,October 9)

The whole nation watched with awe-inspiring excitement a dramatic mission well executed – the successful double heart transplant on the young girl, Tee Hui Yu. Malaysians of all walks of life are proud of this remarkable feat by our very own medical team.

However the euphoria created by the success of the cardiac transplant should not be allowed to be carried too far as to rashly amend the various legislations governing the pledge to give away one’s organ. There should be an elaborate and careful study into its ramifications before embarking on such amendments.

Taking the organs from a brain dead patient may be just a physical maneuver for the doctors and the medical staff but an emotion - wrecking experience for the members of the family especially when the death is sudden as in an accident. It is of utmost importance that the emotions and feelings of the loved ones to be taken into consideration before harvesting their organs.

The braid dead patient may have given the consent when he was alive but it is the close relatives who have to endure the torments of a brain dead member of the family.They would keep hoping against all odds that their loved one would miraculously recover in due course. Until they are convinced beyond doubt, it would be unfair to remove any vital organs from them.

Brain death is the cessation and irreversibility of all brain functions, including the brain stem. It is the irreversible end of all brain activity. A brain-dead individual has no clinical evidence of brain function upon physical examination. This includes no response to pain no cranial nerve reflexes.

These reflexes include pupillary response (fixed pupils), oculocephalic reflex, corneal reflex, no response to the caloric reflex test and no spontaneous respirations. These signs must be diligently looked for before certifying a person is brain death.

It is important to distinguish between brain death and states that mimic brain death (e.g., barbiturate intoxication, alcohol intoxication, sedative overdose, hypothermia, hypoglycemia, coma or chronic vegetative states).

The diagnosis of brain death needs to be rigorous to determine whether the condition is irreversible as it can be misleading in some cases. It needs a certain degree of competence and experience by the physician who examines the patient. Although it needs two qualified physicians to certify brain death, in a society where medicine is so commercialized, how can the next of kin be convinced to accept the decision of these physicians without the slightest doubt?

Organ donation may an unselfish act on the part of the donor but it should have the willingly consent of the close relatives out of respect for the deceased and a passionate love to sustain another fellow human life. Kindness should be instilled by education and example; it cannot be compelled by laws and legislation.

Dr.Chris Anthony