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Dominic Wilkinson

When the heart stops: harvesting organs from the newly (nearly) dead

In the New England Journal of Medicine yesterday, doctors from Denver reported on three controversial cases of heart transplantation from newborn infants. These cases are striking for several reasons. They were examples of so-called ‘donation after cardiac death’ (DCD), an increasingly frequent source of organs for transplantation, but done very rarely in newborns. They are controversial because the transplanted organs were hearts that were ‘restarted’ in recipients after they had stopped in the donor. Transplant surgeons waited only a relatively short period after the donor’s heart had stopped (75 seconds) before starting the organ retrieval process. These transplants raise serious questions about the diagnosis and definition of death.

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Activists and acts of mercy

In Germany this week, and in Australia recently, there has been public
concern and significant media attention about the actions of euthanasia
activists. A former government official and lawyer, Roger Kusch, went
public in Germany with a video of an elderly woman who he had helped to
die. In Australia, Phillip Nitschke has been criticised for his
involvement and subsequent comments about the death of Graeme Wylie a
man suffering from Alzheimer’s disease whose partner and close friend
have been found guilty of manslaughter.

Opponents of euthanasia have used these cases to argue against liberalisation of laws on assisted suicide or euthanasia.

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When autonomy trumps sense: the costs of refusal to allow withdrawal of life support.

In Canada this week, an 84 year old man died after 9 months of treatment
in an intensive care unit. He had severe brain damage and multi-organ
failure, but his family sought a legal injunction to prevent doctors in
the intensive care unit from withdrawing life-support. Over the course
of his long intensive care stay, intensive care beds at a major trauma
centre were closed so that nurses could used instead to support his
care, and three doctors resigned from the hospital in protest at being
required to provide what they felt was ‘unethical’ treatment.

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A pill-full of sugar helps the medicine go down

A medicine for children that has been shown to be effective in a wide range of conditions is to be released soon in the UK and is already available in the US. It has been exhaustively studied, and has no side effects. It is extremely cheap to produce, and will be readily available. Yet GPs, academics and ethicists are up in arms about the new drug. What is all the fuss about?

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Cloning and animal exploitation

The Daily Mail reports this morning that 8 clone-offspring cows have been born in the UK. Also today, the first survey of public opinion on ‘clone farming’ has been released indicating significant unease and opposition to the idea of meat products or milk from cloned sources.

There are strict prohibitions on reproductive cloning for humans in most countries (for example, the recently debated HFEA bill in the UK, and the Human reproductive Cloning Act 2001). However there are few, if any, constraints on the cloning of animals. Is this the start of a new era of animal exploitation?

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Viability and the abortion debate – what really matters?

MPs in the House of Commons will debate tomorrow whether the cut-off for legal abortions in the UK should be reduced. Currently abortions are permitted up to the 24th week of a pregnancy, and some MPs have argued that this should be reduced to 20 weeks or below. Advocates and opponents of the change have pointed to scientific evidence about the viability of infants born extremely prematurely at 22, 23 and 24 weeks. They seem to believe that if we can answer the scientific question of whether such infants are viable, that will resolve the question about whether or not abortion is permissible at that stage.
That might be the case if there were a consensus on what viability means, and why it is important in questions about abortion time-limits. But, as this article will highlight, there is no such consensus, and it is not straightforward why viability should matter. So far in this public debate there has been little or no mention of the important questions – what is viability, and why is it important in abortion law?

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