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sysadmin April 30th, 1995 22:00

AMA: Using Organs From Live Anencephalics Ethically Justified
An AMA committee in 5/95 decided that the organs of anencephalics could be used before the anencephalic is dead.

CHICAGO (AP) -- Babies born with most of their brains missing should be allowed to be used as organ donors before they're dead, a policy-setting committee of the American Medical Association says. The proposal to change state laws to allow such transplants has created dissent within the AMA and renewed a debate among ethicists. Critics charge it's killing one patient to save another. "It is," acknowledged Dr. John Glasson,chairman of the AMA Council on Ethical and Judicial Affairs, a nine-member committee whose opinions are considered AMA policy. But anencephalic newborns, as they are known,are doomed and ``don't have any consciousness,''said Glasson, a retired North Carolina orthopedic surgeon. Donating their organs would help ease a serious shortage for children needing transplants and help the parents of the anencephalic newborns deal with their grief, Glasson said. But George Annas, a Boston University professor of health law, said, ``You can't kill babies to take their organs no matter how many lives could be saved.'' The committee proposal appears in Wednesday's edition of the Journal of the American Medical Association. About 1,000 to 2,000 U.S. infants are born each year with anencephaly, in which most of the brain,skull and scalp are missing. Such infants have brain stems that allow them to maintain some body functions, such as breathing, sucking and crying. Fewer than half survive more than a day; more than 90 percent are dead within a week. Their vital organs deteriorate as they slip toward death,rendering the organs useless for transplants unless removed soon after birth, the AMA committee said. In 1988, the committee declared that it is ethical to use anencephalic infants as organ donors only after they have died. But the Baby Theresa case in Florida helped change minds on the committee. In that 1992 case, the baby's parents learned they had an anencephalic fetus but instead of an abortion wanted to offer her organs for transplant after birth. But the Florida Supreme Court denied the parents' request because of a state law requiring organ donors to be dead. The baby died nine days after birth, and none of her organs was suitable for transplant. All states have similar laws that should be revised to allow for such transplants, Glasson said. The committee said anencephalic newborns can be used as live organ donors only if the diagnosis of anencephaly is made by two experts and the parents request the organ donation. Last year, members of the AMA's 435-person House of Delegates had expressed concern that infants might be falsely diagnosed with anencephaly. Annas, at Boston University, called it ``very surprising'' for the AMA ``to say that it's OK for doctors to actually kill patients themselves.'' The AMA opinion is not in line ``with good ethical thinking,'' agreed Alex Capron, a medical ethicist at the University of Southern California. ``At first blush, a lot of people think, `Yeah,it makes sense,''' Capron said. But he said he firmly supports ``dead donor'' laws, which reflect the belief that ``you don't take the lives of living people to serve the greater good.'' [PRODIGY 05/27/95]

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