About six years ago on a Thursday morning around 10 o’clock, I got a phone call from Georgette. At the time, I was at my office. She told me that a man we both knew was on life support at one of the local hospitals. He was in his 60s and had gone in for surgery earlier that morning. Something went wrong during the surgery, and he had stopped breathing. The surgical team was able to bring him back to life, but his wife and children were told that he was “brain dead.” The only thing keeping him alive was a ventilator (a breathing machine).
Georgette told me that the man’s family had been advised by his doctor to shut off the ventilator so he could be allowed to die. Although the man’s two daughters were open to the doctor’s advice, his wife was adamantly opposed to shutting off the machine. Georgette asked if I would go to the hospital with her to offer support for the man’s family. I had a hearing and some appointments scheduled for the afternoon, so I told her I would be able to meet her at the hospital after work.
We ended up meeting in the lobby of the hospital at about 6:15 p.m. We took the elevator up to the floor where the man had been admitted. When we got off the elevator, we immediately saw a few dozen of the man’s relatives and friends standing in the hallway and waiting area. We asked how the man was doing and were told that nothing had changed. We then walked to the man’s room. He was lying in bed motionless. The tubes coming out of his mouth and nose were hooked into a large machine. There were also wires attached to his body that hooked into some monitoring equipment.
Inside the room were his wife, one of his daughters, and their parish priest. Georgette asked the priest about the man’s condition and the priest confirmed that there were no vital signs and that the only thing keeping the man alive was the ventilator. He also said the hospital staff was pushing the family to shut off the ventilator.
The man’s wife was numb. She kept leaning down to hug her husband while pleading with God to help him. It was painful to watch.
After about ten minutes, Georgette left the room to find and talk to the man’s other daughter. Shortly after Georgette left, two nurses entered the room. One of the nurses was petite and quiet. The other nurse was built like a tank and was loud and aggressive. The aggressive nurse bellowed: “Have you made a decision yet?” The man’s wife started sobbing and leaned over and clenched onto her husband’s shoulders and arms. The priest responded to the nurse by saying, “They haven’t made a decision yet.”
The nurse wasn’t willing to accept the priest’s answer and said in a loud voice, “This has been going on all day! You heard what the doctor said. We need to get this over with.” The man’s wife continued sobbing while her daughter stood next to her in stunned silence.
The nurse wasn’t going to let up. She again bellowed, “You need to make a decision!” Without thinking, I looked at the nurse and said, “What’s the hurry?” I then looked at the priest and asked, “Father, what’s the hurry?” He responded, “There’s no hurry.” The nurse looked straight at me and yelled, “The doctor made the recommendation this morning that the machine be turned off. There’s no reason to delay it any longer.” I yelled back, “Tell the doctor if he wants them to turn off the machine he needs to come to the room himself and talk to us about it. We already know how you feel, so don’t bother coming back in here again to harass this family. They’re going to take their time making a decision. It’s not up to you to bully them or push them into doing something they’re not ready to do.” She glared at me and then turned around and stormed out of the room. The other nurse followed her out of the room without saying anything.
After the nurses left, the priest prayed out loud over the man. The man’s wife calmed down, and each of us stood around his bed and silently offered up our own prayers. After about forty-five minutes, the man’s breathing became labored, despite the fact that he was hooked up to the ventilator. The priest, sensing that the end was near, looked at me and said, “I don’t think he’s going to last much longer.”
He then started praying out loud, and about five minutes later the man’s heart stopped beating. We all knew his heart had stopped because the heart monitor flat-lined and all we could hear was the solid tone of the monitor, rather than the beeping sound that it had made while his heart was beating. Within a minute or two, a nurse who had been alerted by one of the monitors at the nurses’ station came into the room. By then the man’s wife and daughter were crying.
Prior to leaving the room, I said a silent prayer to God thanking Him for sparing the family the burden of having to make the decision to shut off the ventilator.
Last week I thought about that incident at the hospital when I read about a lawsuit that had been filed in New York by Patrick McMahon, an Air Force combat veteran and nurse practitioner. In the lawsuit, McMahon, who was a transplant coordinator for the New York Organ Donor Network, claimed that he was fired because he questioned several instances where doctors declared individuals to be “brain dead” when the individuals still showed signs of brain activity.
The lawsuit outlined four separate incidents in which McMahon claimed patients who still had a chance for survival were declared brain-dead so their organs could be harvested. One of the cases occurred in September 2011, after a 19-year-old accident victim was admitted to Nassau University Medical Center. McMahon claimed that because of pressure from New York Organ Donor-Network officials, doctors declared the man brain-dead despite the fact that he still showed signs of brain activity and was attempting to breathe on his own. The lawsuit charged that in pushing for a declaration of death, the director of the Organ Donor Network said, “This kid is dead, you got that?”
In an interview after the filing of the lawsuit, McMahon stated, “I have been in Desert Storm, Iraq, and Afghanistan in combat. I worked on massive brain injuries, trauma victims, gunshot wounds, IEDs. I have seen worse cases than this, and the victims recover.” McMahon claims that the Organ Donor Network hired marketing and sales professionals to “coach” workers on how to manipulate and convince family members to submit to requests to shut off life-saving equipment so the organs of their loved ones could be harvested.
Although the Catholic Church has guidelines in place that permit individuals to make end-of-life and organ donation decisions based on a doctor’s declaration that a person is “brain dead,” I am very uneasy about the practice of harvesting organs. In order for certain organs – such as the heart, lungs, liver, kidneys, and pancreas – to remain viable, they must be removed while the donor’s body is still alive and breathing (usually with the assistance of a ventilator). In other words, the organs are good only if they are removed from a living, breathing person.
About ten years ago, I personally observed one situation when the parents of a 21-year-old man were pressured to allow their son to die so his organs could be harvested. Georgette and I had stopped at the hospital to visit the parents. Their son had been on a ventilator for three days. The hospital staff was pressuring the parents to allow their son to die so his organs could be donated. The parents gave their consent a few hours after Georgette and I left the hospital.
I’m not saying that the parents made the wrong decision. My heart goes out to any parent or spouse who is forced to make such a decision. By the time they are pushed into making it, they are completely beaten down and exhausted – physically, mentally, emotionally, and spiritually. At that point, they feel as though they have no other choice but to say “yes.”
Is anyone ever ready to make an end-of-life decision? Most of the time the answer is “no”; however, thinking through it ahead of time may ultimately be of some assistance.
3 Comments
Harry,
I have worked as a registered nurse on 2400 – the Nephrology, Urology, and Kidney and Pancreas Transplant Unit at OSF Saint Francis Medical Center since 1993.
I take exception to what you have written in the Perpetual Adoration Letter dated September 29, 2012.
I have cared for hundreds of patients who have received “the gift of life” due to the selfless act of people who have chosen to be organ donors or whose family members made the heart wrenching decision at the end of the patient’s life here on earth.
In Illinois, there is a waiting list of 4,475 people waiting for a kidney. Here in the Peoria area alone, there are 400 people on the waiting list for a kidney.
Words such as yours that were in the Perpetual Adoration letter sets organ donation back considerably. If you were to walk in the shoes of a chronic renal failure patient or a diabetic who are on the waiting lists for these vital organs, you may have a different perspective in your writings. You have planted a very negative seed into the mind of anyone who read your newsletter. A more fair and balanced approach would have been appreciated in regards to all of the positive, loving outcomes that occur with organ donation.
Here are 2 links to help educate you and dispel the myths about organ donation.
http://www.giftofhope.org/about_donation/faqs_about_donation.htm
http://www.giftofhope.org/about_donation/myths_and_misconceptions.htm
The staff with the Gift of Hope have received much training in speaking with family members at a most difficult time in their lives. I have witnessed their caring spirit as they spoke to family about their decision. As a nurse, I do not take part in this discussion. This would be considered a conflict of interest.
A suggestion: Utilize a statement such as the one below in a future newsletter which emphasizes the “self-giving love for others”- that occurs with organ donation – as per Pope John Paul II:
Pope John Paul II summed up the position of the Church in these words:
“[T]he Gospel of life is to be celebrated above all in daily living, which should be filled with self-giving love for others. . . . Over and above such outstanding moments, there is an everyday heroism, made up of gestures of sharing, big or small, which build up an authentic culture of life. A particularly praiseworthy example of such gestures is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope” (Evangelium Vitae, no. 86, original emphasis).
Thank you for your time.
Therese Wille
St. Philomena Parishioner
Therese,
Thank you for your thoughtful comments concerning organ donation.
Neither of the instances that I commented on in my article occurred at OSF St. Francis where I’m sure the staff is well-trained and is better prepared to deal with families who are in distress than the staff of most other hospitals.
I think you would agree with me that OSF St. Francis holds itself and its staff to a higher level of ethics and standards than the other local hospitals. I would expect that this is true of the majority of other Catholic hospitals in the United States.
From my perspective, the opinion of a Catholic doctor at OSF St. Francis would be of greater value than the opinion of non-Catholic doctor at a secular hospital. Also, having gone through the experiences that I wrote about, if I were ever in a situation where I had to make an end-of-life decision, I would want to get a second and/or third opinion as to whether my loved one was brain-dead. In addition, after asking as many people as possible to storm heaven with prayers for a miracle, I would want to take my time in making a decision.
There are clearly two parts to the organ donation equation. The first part is the opinion of one or more doctors that a person is brain-dead and the subsequent decision of one or more family members to end the life of the person. The second part is the actual process that takes place in removing organs and tissues from the person’s body and the transfer of those organs and tissues to one or more people who are in need.
It was not my intention to turn people against the second part of the organ donation equation. After reading about the lawsuit that was referenced in my article, I felt compelled to share my experiences so that people would have an opportunity to consider, ahead of time, what they would have to go through if they were to find themselves in a situation where one of their loved ones was on life support and had been declared by a doctor to be brain-dead.
I would expect that most families that are confronted with an end-of-life decision would want to be given a chance to think the situation through ahead of time so they could at least feel as though they were not being rushed into making a decision.
Prior to final publication of my article, I made several changes to what I had written because I wanted to avoid making anyone feel guilty about already having made a decision to end the life of a loved one. After I published the article, I received an email from a woman who said she had been through the process of having to make end-of-life decisions on three separate occasions for members of her immediate family. She said she appreciated reading my perspective on the topic.
You indicated in your comment that you felt that my article did not provide a fair and balanced view of organ donation. Since your comment provided your perspective and some links to an organ donor website, I’m willing to publish your complete comment (including the links to the website) along with my response in an upcoming Adoration Letter. Let me know if you would like for me to do that.
Thanks for taking the time to share your thoughts with me.
Harry
Harry,
Thank you for responding to my concerns. I apologize for not calling you back. I have been out of town visiting my son.
I was glad to hear that the events did not occur at OSF. OSF’s mission and values in regards to the value of human life is why I chose to work there.
I appreciate that you are willing to have a follow up Perpetual Adoration letter. You have my permission to use my comments and the links. Knowledge is power.
Thank you again for your time and response.
Therese