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Mostly dead

Science | Organ sharing network seeks to speed up the clock on declarations of death

Issue: "Steve Jobs 1955-2011," Oct. 22, 2011

A group responsible for arranging organ transplants is revising its donation guidelines, and has touched a nerve in the process. The United Network for Organ Sharing (UNOS), which has a contract with the U.S. government to match donated organs to transplant candidates, is changing its policy regarding "donation after cardiac death," or DCD.

Cardiac death, popularly characterized by a flat line on a video monitor, was once the standard prerequisite for organ donation, but was replaced by brain death in the 1970s. Most organ donations in the United States take place after brain death, but DCD is regaining its popularity, accounting for 6 percent or more of all donations today. Because a stopped heart can resume beating spontaneously in very rare cases, doctors normally wait two to five minutes before declaring cardiac death and allowing organs to be removed from the body. The UNOS transplant guidelines since 2007 have referenced that two-minute wait time.

Now, UNOS says the two-minute wait was never mandatory and isn't its business to impose: "What we've come to realize is the hospital and the care team in charge of that patient is really the most qualified to make the determination of death," said Charles Alexander, the former president of UNOS. That has critics worried: How soon might some doctors choose to declare death? Will they begin viewing patients as donors before they've taken their final breath?

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Another change UNOS plans to make is to redefine DCD as "donation after circulatory death," implying that death should be determined not by heart inactivity but by a lack of adequate blood circulation. A Georgetown University bioethicist said the name change was a "potentially intentionally deceptive" way of avoiding debate about the definition of death.

Fast track

Photo by Martial Trezzini/Keystone/AP

Particle physicists have carried out an experiment that shouldn't be possible. Albert Einstein's special theory of relativity dictates nothing can travel faster than the speed of light-but if measurements made by researchers at the OPERA (Oscillation Project with Emulsion-tRacking Apparatus) project in Italy are accurate, neutrinos have bested light speed by 60 nanoseconds. The researchers made their discovery by shooting neutrinos-particles with almost no mass that can pass through matter easily-underground 454 miles through rock from the CERN (European Organization for Nuclear Research) particle accelerator near Geneva, Switzerland, to a detector near L'Aquila, Italy, and timing the journey with GPS and two ultra-accurate cesium clocks.

The notion that a central law of physics could be broken isn't sitting well with the scientific public, and most think some measurement error is to blame. The OPERA scientists tend to agree, but after six months of checking and rechecking their data, they're asking researchers at other particle labs to replicate the experiment and help them solve the puzzle. "The potential impact on science is too large to draw immediate conclusions or attempt physics interpretations," said OPERA spokesman Antonio Ereditato.



Pro-life activists celebrated the passage of an embryo patent ban on Sept. 16, part of the America Invents Act, a law reforming the U.S. patent system.

The act made permanent a ban that formerly had to be renewed year-by-year, preventing biotechnology companies from trying to claim rights on an embryo that, for instance, is cloned or has particular genetic traits.

Daniel James Devine
Daniel James Devine

Daniel is managing editor of WORLD Magazine and lives in Indiana. Follow Daniel on Twitter @DanJamDevine.


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