Execution by organ procurement: Breaching the dead donor rule in China
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The complete list of these 71 papers and excerpts with problematic BDD are in Appendix 2. Examples include:
“The heart donor was a brain trauma patient. By the time of heart procurement, breathing had ceased. Endotracheal intubation was performed and artificial respiration [established]. The heart beat well. The donor heart was procured …”43
“The donor was intravenously injected with heparin 3mg/kg 1h before the operation… The heartbeat was weak and the myocardium was purple. After assisted ventilation through tracheal intubation, the myocardium turned red and the heartbeat turned strong… The donor heart was extracted with an incision from the 4th intercostal sternum… This incision is a good choice for field operation where the sternum cannot be sawed open without power.”44
“After donor brain death, tracheal intubation was performed as soon as possible for artificial ventilation. The chest was opened quickly, and the ascending aorta and pulmonary artery were infused with cold cardioplegia…”45
“After the donor was confirmed brain dead the trachea was intubated, artificial respiration was established, rapid median sternal incision…”46
“2.1 Obtaining and protecting the donor organs. After the donor's whole body is heparinized, donor is supine, endotracheal intubation is performed through the mouth, and the anesthesiologist intermittently gives oxygen to the lungs by manual balloon pressure. Split the breastbone in the middle.…”47Can anyone explain to me in what sense these excerpts indicate that the donor was killed for the sake of the organ transplant?
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@Klaus I thought the same thing. The main complaint is that being sure they were brain dead was problematic in 71 cases.
Now, of course, I could certainly see the Chinese "adjust the sentence" of a particular prisoner if a need for an organ arises, because China is an asshole.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@George-K said in Execution by organ procurement: Breaching the dead donor rule in China:
Now, of course, I could certainly see the Chinese "adjust the sentence" of a particular prisoner if a need for an organ arises, because China is an asshole.
Oh, I wouldn't be surprised at all if this is happening in China either.
But the methodology of that paper is ... interesting. I'm not a medical doctor, hence maybe I'm not getting the implicit messages being conveyed by the quoted text excerpts. Do you?
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We find evidence in 71 of these reports, spread nationwide, that brain death could not have properly been declared. In these cases, the removal of the heart during organ procurement must have been the proximate cause of the donor's death.
Yeah, the "must have been" quotation is interesting, isn't it?
The PRC papers we have identified do not describe how the donor was incapacitated before procurement, and the data is consistent with multiple plausible scenarios. These range from a bullet to the prisoner's head at an execution site before they are rushed to the hospital, like Tsai's description, or a general anesthetic delivered in the operating room directly before procurement. Paul et al. have previously proposed a hybrid of these scenarios to explain PRC transplant activity: a lethal injection, with execution completed by organ procurement. They write: “in cases in which thiopental's effect is insufficient and organ explantation begins immediately after cardiac arrest, the inmates may suffer from excruciating pain induced by organ explantation surgery, the surgical opening of the abdomen and/or chest.”11 It is also possible that a specialized device was used to inflict brain death in close quarters and thus insulate medical professionals from the process. A patent for a “Primary brainstem injury percussion machine” was held by a former PRC police chief involved in organ transplants.53 The patent description says it was to be used for medium-sized animals. There is no public evidence that it was ever used on humans. Previous anecdotal, eyewitness, and textual evidence is consistent with these accounts—including procurement from donors prior to death,12 and targeted execution procedures intended to forestall cardiac arrest and thus minimize warm ischemic time.
There's a lot of speculation in the paper, and the only thing that I can see is that they can't document brain-death prior to organ harvest in those cases.
Again, I completely believe that execution by organ procurement is a real possibility (China is an asshole), but I don't see this in the meta-analysis here.
You?
