UK health service may harvest organs from babies with lethal defects
by Michael Cook | 13 Mar 2016 |
The UK’s National Health Service is to encourage pregnant women whose children have a fatal birth defect to bring them to term so that their organs can be harvested. This shocking story was reported by the Mail on Sunday, so it must be taken with a grain of salt. However, the newspaper quotes a number of doctors who support the idea and cites plans being studied by the NHS.
The proposal was apparently mooted at the annual conference of the British Transplantation Society in Glasgow.
Transplant surgeon Niaz Ahmad, of St James's University Hospital in Leeds, said: “We are looking at rolling it out as a viable source of organ transplantation nationally. A number of staff in the NHS are not aware that these organs can be used. They need to be aware. These can be transplanted, they work, and they work long-term.”
Apparently anencephalic babies are ideal for this purpose. These are children who are born without a brain, or with very little brain tissue. In today’s UK hospitals 230 are aborted annually and only 12 brought to term. However, more and more women are deciding not to abort the child, according to Dr Joe Brierley, a specialist at Great Ormond Street Hospital for Children in London. Women who have made this decision could be counselled that their child’s organs could benefit other patients. Near the time of birth the child would be pronounced brain-dead and its organs removed.
However, the newspaper reports that NHS Blood and Transplant said: “Under no circumstances would our staff or anybody else within the NHS pressure women to continue with a pregnancy solely for the possibility of organ donation.”
Dr Brierley defended the plans vigorously:
Given that three people a day die waiting for an organ transplant, I welcome anything that improves the number of donors. Helping the families of those dying in intensive care to have the best information to make this decision is vital. With anencephaly, such discussions occur with a woman who has been told her pregnancy may result in stillbirth, or – if the baby is born alive – it will die as a newborn.Bioethicist Dr Trevor Stammers told the Mail on Sunday that the suggestion was “abhorrent”. “It is a ghoulish suggestion that can only undermine public confidence in transplantation – one of the greatest medical advances of my lifetime. The concept reduces the baby to nothing more than a utilitarian means to an end – a collection of spare parts – rather than respecting life for its own sake.”
Whilst provision of such information is the cornerstone of good care, my view is that this should not be used to persuade a woman not to undergo termination. However, if a decision is made to continue the pregnancy for other reasons, then all palliative care options – including donation – ought to be discussed.
I must confess that one of the most difficult things about editing BioEdge is that it is difficult to compose punny headlines. Any editor worth his salt wants to sprinkle a publications with puns. The Economist’s sub-editors are masters of the inobtrusive pun. I recall fondly a story about hallucinogenic mushrooms which was headed “Fungi to be with”.
However, there is such a thing as taste – and ethics -- and puns over most of our stories would be either morbid or ribald. That’s one reason why I am looking forward to more developments with CRISPR. Some day I’ll be able to use “Ethics on gene editing CRISPR but no clearer” or “CRISPR holds promise of abundant fruit”. Sooner or later “Belgian govt’s waffle on euthanasia slated by ethicist” will come true. Or “Cloned baby to be named John-John.” Or “Euthanasia law comes into effect today” – but you need to be Australian to appreciate that one.
This is the kind of thing I think about a lot. So I was dismayed to read that bad puns may be a sign of a degenerative brain disorder. A new paper in the Journal of Neuropsychiatry & Clinical Neurosciences describes two patients afflicted by “intractable joking.” One was dragged along to the doctor by his wife because he kept waking her in the middle of the night to regale her with new puns he had just composed. The other lost his job after asking “Who the hell chose this God-awful place?” Scans showed that both had experienced damage to the right hemisphere of the brain.
I suppose their experience can be summed up in the old joke: “They laughed when I said I was going to be a comedian. Well, they’re not laughing now.” Any ideas from readers about puns for bioethicists?
Michael Cook
Editor
BioEdge
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