Dispute over organ donation brings attention to defining death

The Columbus Dispatch | Misti Crane 
This photo illustration shows an angiogram of a brain at left with blood flow and brain at right without blood flow as it would be seen in a brain dead patient. © Fusionspark Media Inc.

The death of 21-year-old Elijah Smith at Grant Medical Center this month and his family’s dispute with Lifeline of Ohio over his organ donation has brought to the forefront questions about what constitutes death.

Most doctors agree that a person has died when the brain ceases to perform its most essential functions, even if machines and medications keep the heart beating and the lungs delivering oxygen.

Doctors have a list of tests that they perform before declaring death. It’s a process that generally takes several hours. They look for signs of life in a variety of ways, including pouring ice water in the ear, pinching the body, shining light into the pupils and checking for a gag reflex.

They make sure there’s no other explanation, such as a low body temperature, low blood pressure, drugs or poisoning.

In the final step, an apnea test, they turn off the ventilator to see if the person takes a breath, and they take blood to confirm it is acidic and high in carbon dioxide.

If there are no signs of activity in the brain stem, the doctor prepares to share one of the most difficult things a family can hear.

To Pam Smith, Elijah’s mother, death occurs when all of the organs cease to work. She said that seeing that would have given her peace of mind that there was no hope for Elijah, a new father who was hit by a car while riding his bicycle on July 3. He was declared brain dead the next day.

It’s not that she didn’t trust the doctors who ran the tests. They were thorough and explained everything clearly, she said.
______________________________________________________ 
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To register as a donor TODAY
In California: 
www.donateLIFEcalifornia.org | www.doneVIDAcalifornia.org 
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www.organdonor.gov | www.donatelife.net

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