Use of Regitine During Transplants

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Use of Regitine During Transplants

As of February 2000 there were in the United States 67,340 people waiting for organ transplants.8 In 1998, 4,855 Americans on that list died waiting.8 Against this backdrop of critical need, physicians in Wisconsin are using a controversial drug, Regitine, to preserve organs from patients on life support who still have brain activity, but who are not expected to survive their injury or illness.4 These donors, who typically die of cardiac arrest following the removal of life-sustaining technologies, are called non-heart-beating donors (NHBDs) and differ from traditional "brain-dead" donors in that the cessation of heart beat is sufficient to declare death and begin organ removal.3

According to the non-heart-beating donor (NHBD) protocol, transplant surgeons turn off a patient's respirator in an operating room. The patient is then injected with Regitine, which does not benefit him, but helps preserve his organs by increasing oxygen flow to them. This increased flow to the major organs results in a large general drop in blood pressure. Two minutes after the patient's heart ceases to beat, he is declared dead and organ removal begins.9 Critics, including Wisconsin prosecutor Carmen Marino, contend that the temporary loss in blood pressure caused by Regitine hastens death and that therefore transplant surgeons are killing patients to get their organs.4

While I agree that upholding strict transplant ethics is important, I here argue that the fully informed use of Regitine is acceptable, even if Regitine hastens death several minutes. If a patient (or immediate family members) has consented to organ donation, understands the effects of Regitine, and gives consent f...

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6. Rothman, D. 1996. "Bodily Integrity and the Socially Disadvantaged: The traffic in Organs for Transplantation." In Organ and Tissue Donation; Ethical, legal, and policy issues. Speilman, B. (ed.).

7. Spielman, B. (ed.) 1996. Organ and Tissue Donation; Ethical, legal, and policy issues. Carbondale: Southern Illinois University Press.

8. Veatch, R. 2000. Transplantation Ethics. Washington, D.C.: Georgetown University Press

9. Weiss, R. "Demand for Organs Fosters Aggressive Collection Methods." The Washington Post, November 24, 1997.

10. Youngner, S., and Fox, R. 1996. Organ Transplantation Meanings and Realities. Madison: The University of Wisconsin Press.

11. Youngner, S. and Arnold, R. "Ethical, psychosocial, and public policy implications of procuring organs from non-heart-beating donors. JAMA, 1993; 269(21): 2769-2774.

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