COULD KAMIL FROM WROCLAW LIVE?
AGNIESZKA ZUREK
Sad events from the last days which took place in Wroclaw caused a hot discussion in Poland about criteria allowing for stating death of a man. Protests of the mother and friends of 17-year-old Kamil against disconnecting him from a respirator and taking organs from him for transplant oblige us to undertake a good debate about brain death and the merits of applying these criteria in stating death
Very few people in Poland know that the very criteria of brain death, allowing for stating death appeared in medicine in 1968. From the beginning it was arousing doubts among doctors. Some doctors were paying attention to its conventionality and clearly pointed to the role of transplant doctors in accepting a new definition of death. The definition obliging before the year 1968, according to which, in order to state about death of a patient, it is necessary to state about the permanent cessation of breathing and stopped heart beating, was not sufficient for them, as it did not allow for taking organs from the patient in order to do transplants.
An artificial definition of death
With the change of the definition of death in natural way, there appeared questions about whether saving life of patients waiting for transplant would not be the breach of Hippocrates’ Vow towards potential organ donors.
These fears are not unjustified. As Fr. Jacek Norkowski OP, a PhD of Medical Science and the author of books about brain death ‘Medicine on the verge’ and ‘The human being dies only once’ notes that one takes a different way of proceeding only when he is trying to save a patient’s life, while a different way – when the purpose is to keep organs in the best state for using them in transplant. ‘An alive patient cannot be treated as the means (tool) for the good of another patient’ – Fr. Norkowski reminds in the book ‘Medicine on the verge’. In the opinion of the priest this rules was breached in the case of recently deceased Kamil from Wroclaw. The medical examination of the level of hormones of his thyroid gland was neglected and the sensor of intracranial pressure was not installed, which in practice made it impossible to evaluate the factual health state of this boy.
A suitable proceeding to save the patient with the brain damage would have been applying hypothermia and suitable hormone treatment, giving him chances to cure. As dr. Norkowski says, about 60 per cent of patients in whom brain death was stated, undertaking suitable therapy, would give them a possibility to recover. Was such a chance taken away from Kamil? Probably we will never find out about it. Maybe the boy would have died regardless of the undertaken treatment, however, the medical ethics tells us to save a patient’s life till the end. And Kamil’s mother and his friends were fighting till the end, protesting against disconnecting the boy from a respirator and taking his organs for transplant. The fact that not only an illness becomes an enemy of the human being, but…..also doctors, proves that the ‘development’ of medicine takes on dangerous directions. Leading a patient to death through unsuitable treatment or neglecting therapy is contradictory with medical ethics and asks a question if we do not have a kind of euthanasia in Poland – despite its prohibition.
Propaganda instead of information
The lack of good information dooms patients’ families to tragedy, as they hear something different from doctors, and they see and feel something different. Like the mother of Kamil, Agnieszka Wolanska, who was fighting for her son’s life till the end, says that her son squeezed her hand which undoubtedly proves that he was still alive. The despaired woman informed the police about the probability of committed crime.
Similar tragedies happen patients’ families not only in Poland but also all over the world. The issue of extortion of consent by German doctors to take organs from son of Renate Greinert in 1985 was very loud. The woman, similarly as the mother of Kamil, despite the stated brain death of her son, was sure that her child was still alive. Under the blackmail with emotional pressure from doctors, she finally agreed to taking organs from her son but she was still doubting. She stopped doubting after seeing the body of her child just before his funeral. He understood then that her initial intuition was right. Since then she has been engaged in the fight for patients’ rights in whom brain death has been stated, and about the rights of their families. She wrote a book about it, entitled: ‘An issue in dispute – organs donation. Dying in the intact state. Mother’s fight’. Greinert is also an author of an official letter to the chancellor Angela Merkel, in which she demands a debate in Germany about silenced aspects of transplantology. As the German defender of life emphasizes, replacing information with propaganda results in much suffering of not only patients but also their families. Greinert notes that many parents, who agreed to taking organs from their children, later are struggling with pangs of conscience for years, often falling into psychic illnesses.
The discussion on the death of Kamil showed the necessity of undertaking a public debate on issues connected with the statement of the end of the human life also in Poland. A serious analysis is required by the merits of applying the criteria of brain death in medicine. Because there are a lot of examples of recovering to health among patients, in whom brain death was stated before, it means that further using this term is not justified in practice but it can be a serious danger for the human life.
(AA)
"Niedziela" 30/2014