Monday, May 11, 2015

Case 25 Anencephalic Newborns (19May)

Collectively, answer the questions at the end of the case.  Tie back to appropriate readings, current events, your professional knowledge, etc.  Respond to at least one of your classmates' postings.

41 comments:

  1. If death is defined by cardiopulmonary arrest or complete brain death then if the infant born is anencephalic it would be considered dead. Organ donation is moral if the deceased had consented prior to death or the legal decision maker consents for the deceased to have organs harvested. If the infant is still breathing, or has a heartbeat, I don't feel like it is justifiable to harvest the organs, ultimately causing cardiopulmonary arrest. I think the only way harvest organs from a anechephalic infant is justifiable is through consent and the infant is stillborn. Resuscitating the infant for organ harvesting is not right. If the infant was dead by cardiopulmonary arrest and brain death, it should not be resuscitated.

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    1. I completely agree Kelli, I can not ever imagine the thought of killing an infant to harvest organs. This sounds insane tome and not in any way moral.

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    2. I don't think resuscitation would or should even be an option. There is no way to tell the demise of the unborn fetus invitro, so there for would the organs even be viable if harvested?

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    3. This makes me think back to the Trolley problem. I could not consent for my infant, with a heartbeat and breathing on their own, to go into surgery knowing that the surgery performed would take their life. That is not my decision to make.

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  2. If an anencephalic newborn has no chance of survival then I do think I would be morally right to harvest organs. If I was a parent of an anencephalic newborn I would consent to this. Many families deal with grief knowing they are helping someone else maintain life. I don't agree with resuscitating for the sake of organ donation because I feel nature has already taken it's course and if the baby has been "dead" too long in the womb they would not be able to use those organs anyway.

    As for an adult in a vegetative state, I have experienced scenarios in ICU where a patient has been on a vent, the family have been told that there is no brain activity and no chance of recovery. I had seen families decide to withdraw the vent and lifecenter is standing by ready to harvest organs. I feel that organ donation is a very personal decision.

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    1. I agree Shelley. I would definitely donate organs to help those families out there waiting and hoping that their child be given a second chance. I can't begin to imagine losing a child, but knowing that I helped another family would give me perspective on the situation.

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    2. I agree resuscitative efforts is morally wrong, and most likely futile in the case of an encephalic newborn. I cannot imagine the trauma and pain this would put a family through and feel it is defiantly never something that should be pursued for the purpose of obtaining organs - we could apply this to any situation in that case - Would we begin reviving overdose victims, MVA victims ? simply for the procurement of organs. I think allowing infant resuscitations it would certainly open up a bigger can of worms.

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    3. I agree also. Reviving the dead only should happen on the movie "Pet Cemetery". Someone might want to resuscitate a dead MVA victim, someday, just for organ procurement. And like you said that would be a big can of worms!

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    4. I agree that organ donation is a very personal decision. I am torn because I don't think I would be able to consent to harvesting the organs if it was my child, but if I was on the receiving end I would hope someone would do it to save my child's life.

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    5. Responding to other replies, I hadn't thought about the parallel of resuscitating other (adults) just to harvest organs:

      "Would we begin reviving overdose victims, MVA victims ? simply for the procurement of organs. I think allowing infant resuscitations it would certainly open up a bigger can of worms"

      Good point!

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    6. organ donation is a personal decision to make.
      I think that parents have the right to make an informed decision about what they want to do. Organ donation is a wonderful gift.

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    7. Agreed Donna, Organ donation is a wonderful gift but I can believe that it is not for ever person. So cultures believe that the whole body needs to be intact so their loved one can make it to the after life. I have talked many times with my family about the fact that I want to be an organ donator.

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  3. If a newborn that was dx with anencephalic and a poor prognosis is expected, the future of the child’s physical presence in the world and organ donation should be the decision of the parents. If the parents decide for the health care providers to provide lifesaving interventions to prolong life, those wishes should be implemented. If the parents decide to provide palliative care for the child or delivered stillborn, the parent should provide specific information/ limitations describing their wishes about organ donation. The moral concept here is that people can live for a long time and be brain dead but what is the wishes of the patient or there family? The health care providers and organ donation center should follow the parents’ wishes.

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    1. I agree that the the decisions need to be with the family. organs are harvested everyday on patients who's hearts are still beating but are declared brain dead. but we get the okay from family to do what they wish

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  4. If I were in this situation and I had an infant with anencephaly and I knew the baby would not survive, I do think it is morally okay to harvest the organs with proper consent. On the other hand I do not think it is morally okay to harvest the organs while the infant has a heartbeat and is breathing. I also do not agree with at all with resuscitating an infant just for the purposes to harvest the organs. Lastly I only think it is morally okay to harvest organs from a patient in a vegetative state if that patient dies. It is not moral to kill someone to harvest any organ in my opinion.

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    1. I agree Andrea, even though the patient is in a vegetative state it is immoral to kill them for any purpose. I know this can/is a huge controversy but, to me, it is still killing someone. I think the movie "Coma" was about this exact idea. They put people in that permanent vegetative state and made money harvesting their organs.

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  5. I think it is justifiable to harvest the organs of the anencephalic newborn if there is no chance of survival and the parents give consent. I think adopting a social permit would be a positive policy to implement because it may give the family that lost a child peace knowing that they helped save a child. I do not agree with harvesting organs by means of resuscitation, I don't feel this is morally correct. The process of death has already taken place and medical technology should not intervene. I don't agree with harvesting organs from someone that is in a vegetative state either. That I think would be considered murder, since you are essentially killing that person.

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    1. When I think of someone in a vegetative state I think of someone one being kept alive usually with a ventilator and with no brain activity. I would not want to be kept alive like that and hope that my family would honor my wishes and remove the vent and allow me to die. With that being said I agree with organ donation from that standpoint.

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    2. I can understand your point Trisha but if that patient was in a vegetated state with no hope to live without medical technology, no quality of life, and the patients and or family wishes are granted, I think of what a blessing an organ recipient can have. This maybe a since of closure for the loved ones of the patient that may save another one's live.

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  6. I think it is justifiable to harvest organs on the anencephalic newborn. I think that that the parents need as much time with the child that they can have to say their good byes before they take the child for the procedure. I think developing a social policy would be a great thing to implement but you would always need the consent of the parents. I do not think that if the baby is stillborn we should resucitate the infant.I think the decisions no matter what is for the parents to decide.

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    1. Sounds like the class is split about harvesting organs of an anencephalic newborn. I agree with you 100%. It's such a personal decision, but I don't see anything morally wrong. I would find comfort in knowing I was able to save the life of someone else's baby that probably would have died without my babies organs.

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    2. Yes it is a personal decision and one I pray I never have to make, but I am an organ donor and my family knows my wishes. The key to all of this is discussing these issues ahead of time and getting all of the credible information available.

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    3. yes I agree shelley i would give my babies organs also and i would find comfort in knowing I was able to save someone from having to go through what i was going through.

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  7. I think in the case if an anencephalic newborn it is completely justifiable to harvest the organs, so long as the parent have been educated properly and are willing to consent . However, I do NOT feel it is acceptable to resuscitate a stillborn infant for the sole purpose of organ harvest, This to me would cause undue suffering for both the infant and parents, and I think the success rate of doing such would be very low. Creating a social policy on the harvesting of organs would not be very beneficial in my opinion as it would create a great deal of controversy as well as intrude on an intensely personal decision made by the parents with the input of experts. Harvesting the organs of an individual in a completely vegetative state is acceptable in my opinion as the " person " is no longer there, the autonomic functions of the brain simply allow the body to exist.

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  8. After finding out you, as parents, are giving birth to an infant with anencephaly, it is up to the parents to decide whether they want to donate the infant's organs. I do not think it is disrespectful, unfair or otherwise immoral to their decision. No matter which way they choose to go.
    I don't think we need a social policy that would allow harvesting the organs of this type of infant. I think the organs should be harvested after the infant has died, therefore it is not up to society to be concerned with the parent's decision with regards to the organs of the infant.
    If the anencephalic infant is stillborn it is not morally justifiable to attempt resuscitation at all no matter what the reason is for, even if it is for organ harvesting and helping another family. The death and dying process is personal for the parents and is a process that doesn't need interrupted by resuscitation, life, and death again.
    Harvesting organs of someone in a permanent vegetative state is not the same as harvesting organs of an anencephalic infant. There is a developmental process that got interrupted with the birth of the infant and after birth, it's death being eminent. This is not the same with someone in a vegetative state.

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    1. The problem is that the organs can not be harvested after the infant has died. They must be taken while the baby is "alive" thus the reason why brain dead patients are used for organ donation. If they were usable after death, I would feel differently too about using the organs to save another baby. I am definitely for organ donation, and intend to be a donor myself, but think this is not the right way to go about it.

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    2. I think we all would agree with saving someone's life with organ donation. It is hard to agree to when the procedure and parameters have to be met. After resuscitation are the organs always deemed denotable?

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  9. Even though the organ donation could possibly save many lives, I feel that it would be immoral to harvest organs from an anencephalic newborn who is still alive. Attempting resuscitation of an infant just to harvest organs is barbaric and immoral as well. I have never been in this situation but If I had a child who needed an organ transplant I may feel differently on the matter.

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    1. I feel the same way you do about resuscitation it would be immoral to do so.

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  10. 1. I believe it is immoral to transplant the organs of an anencephalic infant, especially given the criteria that the infants' organs must be taken before being declared brain dead or otherwise. If this were not the case, I would agree that it would be acceptable for those who would choose to donate. I think it would be unfair to ask parents who are already suffering loss, or waiting for loss, to terminate sooner their own child for the sake of saving another who might suffer the same fate without intervention. In my opinion, both infants need a miracle and it's not justified to kill one to save another.
    2.Therefore, I do not think it is acceptable to adopt a social policy permitting the harvesting of organs for these infants.
    3. I also do not feel it is justifiable to resuscitate a still born infant for the purpose of harvesting organs. If that were the case, we would be resuscitating everyone for organ harvesting. Not all organs are usable, it takes a lot of testing to see if organs can even be used or not. So some babies would suffer needlessly for organs that potentially could not be used or resuscitated and have the same result as well. This creates more trauma for the infant and increases the suffering the parents go through as well.
    4. I believe in a vegetative state, the same ideas apply. Unless the patient is declared brain dead, I do not believe harvesting organs is moral or appropriate. There have been a few cases of vegetative patients miraculously waking up. This is a great story that miracles do happen! http://www.foxnews.com/health/2015/02/07/man-in-vegetative-state-for-12-years-wakes-up-to-tell-remarkable-story/

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  11. Thank you Carla for sharing that website for that story! It is an eye opener!

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  13. It is my opinion that it is not disrespectful, unfair or immoral to transplant the organs of a anencephalic infant. With that being said you then have to look at the condition and reason behind the possible harvesting of the organs. There absolutely should be a policy developed and put in place for such an event to occur. With parental consent once they have been completely informed of the infants condition, prognosis and all possibilities that could happen I believe it is moral for parents to make the decision to give life to another. I do not feel like it is moral to resuscitate a still born baby to harvest organs. There would be more at stake for a family emotionally to have this done. The possibility of resuscitation can cause further organ damage. It can also give false hope to the family. If resuscitation is possible at the birth why couldn't it continue to be done? Harvesting the organs of someone in a permanent vegetative state is not justifiable. Someone in a permanent vegetative state may not require artificial means of life support to maintain life. For these infants their prognosis is hours, days or at best weeks. I think that if a parent knows that their unborn baby has this condition and they have made the decision to be an organ donor they have given a lot of thought to this process compared to someone that may be in a permanent vegetative state.

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  14. I believe if a parent wants to donate the baby's organs it would be moral and fair as long as the parents receive informed consent. I feel that is no different than an organ donor being kept on life support until organs can be procured. There should be a policy in place for such situations. I feel resuscitation could be performed if parents consent but that would likely be difficult to obtain given the nature of the situation; meaning if the parents were unaware of this defect in the infant before birth so this could be discussed and considered ahead of the birth. A person in a vegetative state could be considered if they are an organ donor or they have a designated medical POA that decides it.

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    1. I agree with you Cindy that if the parents want to save another life with their loss they should be able to sign consent and it be granted their choice

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  15. I do believe it is immoral to transplant organs from an anencephalic newborn. When a couple is expecting, there is worry and fear, but there is the ultimate expectation that in the end they will have a healthy child. I think the only way to approach a parent who has or will give birth to an anencephalic infant about harvesting organs is to state the benefit to another child. At that point, I do not feel most parents would have time to grasp the magnitude of what they means for their infant.
    I think to attempt resuscitation of a stillborn neonate with anencephaly would be wrong as well. I am not sure I can put into words my reasons. I think there are some things that just feel wrong to the core of my beliefs. I believe there is a reason for everything and although I believe in organ donation, this feels wrong. Maybe because of where I think it can lead. Would people conceive to harvest organs for other children or adults without regard to the infant? I have what many may see as an antiquated point of view, but I believe life begins at conception and we should not take that life, no matter how short. I know this seems in contrast to some of my other opinions and again, I have no explanation.

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  16. I believe it is moral to transplant organs from an anencephalic newborn. Almost all pregnant women will have blood work and ultra sounds done to detect for this defect. If it is determined that the unborn child has this defect I believe that the parents needs to be aware of this and talked to about possible organ donation after birth if the baby is stillborn. I do not believe that any newborn, child or adult should have to go through resuscitation just for the sake of organ donations.

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  17. Harvesting organs from an anencephalic infant is such a hard thing for me to process. The sadness of an infant dying with an hours of birth or being stillborn is very over whelming. I think this should be totally up to the parents if they want to use their child’s organs to save another life. But the pain they would Indore to make such a choice I think would be the hardest thing in the world to go though. I personal could not make that choice. I also think it would not be justifiable to resuscitation a baby purely for the purpose of harvesting organs.

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  18. Harvesting organs of an anencephalic infant is not immoral. This is always a fatal abnormality. If parents are educated on the organ harvesting and they consent then it should be performed. Resuscitation purely for organ harvesting should never happen. Any person should only be resuscitated to allow life to continue. If the POA/next of kin decides that organ harvesting from someone in a vegetative state is right for them then they should be allowed to make that decision. Yes, rarely miracles happen, but to make that decision would give multiple people the chance at a quality life.

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  19. Personally I feel it is immoral to harvest organs from anyone that is legally alive. I feel that taking of any life to sustain another is wrong. Resuscitation to only harvest organs and then let the child die again is wrong as well. That is my choice. I do believe that is a choice and should be made with education and thought by the parents. I have not lived their lives and cannot make that decision for them or their child.

    My concern is that if we develop an across the board policy, where will it stop? Will there be other conditions that medicine decides are deemed acceptable to harvest organs?

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  20. I believe that it is morally wrong to harvest the organs of an anencephalic infant. The only way to have viable organs from an anencephalic infant is to remove the organs before brain death occurs. We are called to not do harm. Removing the organs of someone who is not brain dead is causing harm. I also believe that resuscitating an anencephalic infant who was stillborn for the purpose of keeping organs viable is morally wrong. It is terrible to think about learning you were having an anencephalic child. There has recently been a case where an anencephalic infant has lived to celebrate her 1st birthday despite the prediction of physicians. The article can be found at http://abc7chicago.com/family/miracle-baby-predicted-to-die-during-birth-celebrates-first-birthday/638688/.

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