Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
A case study published in the American Journal of Case Reports titled: Pronounced dead twice: What should an attending physician do in between? concerns a homicide death of a 39-year-old woman that was caused by Acute Fentanyl toxicity due to a Fentanyl injection in the hospital.
The woman was being prepared as an organ donor. She was pronounced dead based on cardiac death. A minute after being pronounced dead the doctors noticed that her aortic and renal arteries were pumping and pulsing. The organ procurement surgery was stopped. The person was then given additional doses of Fentanyl and Lorazepam leading to the woman being pronounced dead again 18 minutes after being pronounced dead the first time.
The case study reports that the autopsy concluded:
A postmortem sub-clavian blood toxicology study found 6.3 ng/mL of Fentanyl, 17 ng/mL of Lorazepam, 15 mcg/mL of Levetiracetam, and 29 ng/mL of Ziprasidone. The cause of death was determined to be acute Fentanyl toxicity due to a Fentanyl injection in the hospital. Another significant condition contributing to death was a ruptured berry aneurysm of the Circle of Willis. The manner of death was determined to be homicide. It is our opinion that the additional dose of Fentanyl given between 3: 00 A.M. and 3: 17 A.M. was the direct cause of death.
The case study does not indicate if the physician was charged with homicide or punished by the hospital or the body that oversees physicians. The case study does state that in similar circumstances the first organ procurement team should leave the room immediately and withdraw from the case and the attending physician should let nature run its course and refrain from excessive medical intervention.
Excessive medical intervention is not the right phrase considering that the person was given an injection that was intentionally lethal.
The rest of the case study analysis discusses the problems with autooresuscitation and the dead donor rule.
I fear that the outcome of this case is not as uncommon as presumed. It is likely that this case became known because one of the medical professionals who was involved with this case was aghast by the reality that the patient was intentionally killed. Since these acts and decisions are made in private settings, it is likely that this occurrance happens somewhat regularly without any notice or commentary by others. Further to that, the administration of a lethal dose of fentanyl is unlikely to have been done unless it had been in the past.
In countries that have legalized euthanasia, linking organ donation to euthanasia not only provides a source of healthy organs for transplant but it also turns euthanasia into a "social good."
The new question is: why kill the person by lethal injection first if they have agreed to be an organ donor? It is far more effective to kill the person by organ donation rather than procuring the organs after euthanasia.
Several years ago, bioethicist Wesley Smith wrote that the dead donor rule was important for maintaining the integrity of the organ donor procedure. I agree, but the change in medical ethics might have made this comment a moot point.
More articles on this topic:
I managed, somehow, to survive the events of 2011-2012. It is also of note that I have never consented to organ harvesting yet I was identified as an ideal "donor". My blog site shows my hospital records at the end of every part as well as appendices, my proof. I am legally allowed to share my records with the public. If i had died, Ontario's Quality of Care Information Protection Act would have ensured that no one would ever have seen my records, even the courts and coroner.
ReplyDeleteI don't quite follow. Why was she originally in the hospital? A fentanyl overdose - because they say that the dose given at the hospital was a SECOND dose?
ReplyDeleteIt is an open article so you can read it.
ReplyDeleteThe case says that she was being prepared for organ donation, she died, but then when they started to open her up they noticed that she was not only living but her heart rate, etc was nearly normal, so the doctor gave her another shot of fentanyl, enough to cause her to die.
"...the attending physician should let nature run its course and refrain from excessive medical intervention."
ReplyDeleteWhat does that mean - that if the person is NOT dead (but thought so previously - even by a few seconds) that the attending physician should not do everything in his power to SAVE him - keep him alive?