New rules would widen scope of organ donation

In the future doctors could remove organs following cardiac death

The government and opposition parties Venstre, Dansk Folkeparti, SF and Enhedslisten have agreed on an action plan for organ donation that would open for the possibility of doctors being able to remove organs from a donor declared dead on the basis of cardiac death instead of brain death, Jyllands-Posten reports.

Donation from those who have suffered cardiac death would require doctors to connect the donor to a heart-lung machine some minutes after death in order that the organs don’t suffer damage from lack of blood or oxygen.

Ethical questions
Jakob Birkler, the chairman of the council of ethics Det Etiske Råd, told the paper that this raised a number of ethical questions.“It’s not in the hope of saving the patient,” he said.

“You know that you can’t, but solely to ensure the quality of the organs so another person can use them.”

Finn Gustafsson, a consultant doctor responsible for Rigshospitalet’s heart transplant program and chairman of the transplantation society Dansk Transplantationsselskab, told the paper that cardiac death was less conclusive than brain death. “We doctors are not at all in doubt that a brain-dead patient is conclusively dead and will never be brought back to life again. Brain death is a very sure death diagnosis,” he said.

“But it’s a more complicated affair to declare a person dead on the basis of cardiac death so you can begin to remove organs.”

One of the problems with using cardiac death as the measure of whether a patient is dead is that it is sometimes possible to revive a patient many minutes after his heart stops but if too much time elapses and the patient does not recover, the organs can be damaged from lack of oxygen and blood.

No-touch time
Helle Haubro, a manager at the organ donation organisation Dansk Center for Organdonation, said that this can be seen from differing rules in countries that already use cardiac death as the death criterion. “In some countries they wait just two minutes. In other countries the no-touch-period is 5 minutes, 8 minutes or 10 minutes,” she said.

“There are a few countries where they wait 20 minutes.”

Denmark has one of the lowest rates of organ donation in the EU, according to Politiken. There were just 10.4 donors per one million inhabitants in 2013.