September 12, 2009

The conundrum

I was describing the circumstances, in which I received a kidney transplant. The person I was talking to had a hard time saying the word cadaver. You see, I had a transplant from a cadaver or dead person rather than from a living donor. The person also realized that the persons body may have been kept "alive" until the kidney was removed. My donor did not die an accidental death, but from some disease. I was not told from what. I was also told that the kidney was put on a pump to lengthen it's viability. After I had the transplant, cell death, Necrosis did occur at point the ureter was attached to my bladder. I had to have another surgery ten days later to have it removed and replaced with my own.

I took high school biology in 1959. One of the dissections we had to do was to remove the heart of a gold fish. We had to dissect in such a way that the heart remain beating in order to get a grade. We had discussions about the nervous system, voluntary and involuntary muscle movement. At this time there had not been the first heart transplant, but the fact that you could remove a heart still beating was significant.

The first kidney transplant had been from a live donor and from an identical twin several years before the first heart transplant. The heart transplant patient has no choice but to have a cadaver donor. It still makes many uncomfortable talking about transplants, because for most transplants, someone has to die. Among other reasons, to make transplants possible, there had to be an acceptable point in which the person is living or dead, not if the persons cells are alive and healthy. When death of the brain determined death of the person, rather than when the heart stopped beating and breathing stopped certainly helped in accessing more viable organs for transplantation. The notorious case of Terri Schiavo demonstrated the problems some still have with the definition of life. Cases like this make some of the public fear being transplant donors.

Perhaps it seems that I am presenting slightly disconnected facts, but I think these are relevant to the thinking of what is life and death. Science and technology advances have created new ethical problems that our society has to cope with.

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