Transplants and Brain Death. “L’Osservatore Romano” Has Broken the Taboo

Rome, September 7, 2008

Tradução deste artigo para o português e com mais links:

https://biodireitomedicina.wordpress.com/2009/02/01/transplantes-e-morte-cerebral-losservatore-romano-rompe-o-tabu/

Endereço desta matéria neste espaço:

https://biodireitomedicina.wordpress.com/2009/01/31/transplants-and-brain-death-losservatore-romano-has-broken-the-taboo/

em sua publicação original:

http://chiesa.espresso.repubblica.it/articolo/206476?eng=y


“But years later, when from february 3-4, 2005, the Pontifical Academy of Sciences again met to discuss the question of the “signs of death,” the positions had been reversed. The experts present – philosophers, jurists, neurologists from various countries – found themselves in agreement in maintaining that brain death is not the death of a human being, and that the criterion of brain death, not being scientifically credible, should be abandoned.


The pope’s newspaper has called into question whether cessation of brain activity is enough to certify a death. And with this, it has reopened the discussion on taking organs from “warm cadavers” while the heart is still beating. The scholars of the Pontifical Academy of Sciences are even more critical. And, when he was a cardinal, Ratzinger…

by Sandro Magister

ROMA, September 5, 2008 – With a prominent front-page article, “L’Osservatore Romano” two days ago reopened the discussion on the criteria for establishing the death of a human person.

The article is by Lucetta Scaraffia, a professor of contemporary history at the Rome university “La Sapienza,” and a regular writer for the Vatican newspaper. The director of the press office, Fr. Federico Lombardi, clarified that the article “is not an act of the Church’s magisterium, nor a document of a pontifical organism,” and that the reflections expressed in it “are to be attributed to the author of the text, and are not binding for the Holy See.”

That’s right. “L’Osservatore Romano” acts as an official outlet of the Holy See only in the section “Our Information,” which presents the appointments, audiences, and activities of the pope. Almost all of its articles are printed without advance review by the Vatican authorities, and fall under the responsibility of the authors and the director, Professor Giovanni Maria Vian.

This does not change the fact that the article has broken a taboo, in a newspaper that is in any case “the pope’s newspaper.”

40 years ago, on August 5, 1968, the “Journal of the American Medical Association” published a document – referred to as the “Harvard report” – that established the total cessation of brain activity, instead of the stopping of the heart, as the moment of death. All of the countries of the world rapidly adopted this standard. Even the Catholic Church took the same position. In particular, with a statement in 1985 from the Pontifical Academy of Sciences, and then again in 1989 with another statement from the same academy, reinforced with a speech by John Paul II. Pope Karol Wojtyla returned to the topic on later occasions, for example with an address to a world congress of the Transplantation Society, on August 29, 2000.

In this way, the Catholic Church in fact legitimated the removal of organs as universally practiced today on people at the end of life because of illness or injury: with the donor defined as dead after an “irreversible coma” has been verified, even if he is still breathing and his heart is beating.

Since then, there has been no more discussion on this point in the Church. The only voices heard have been those in line with the Harvard report. Among these standard voices was that of Cardinal Dionigi Tettamanzi, prior to the year 2000, when topics of bioethics were his bread and butter. After him, the Church authorities most often consulted on this matter have been Bishop Elio Sgreccia, until a few months ago the president of the Pontifical Academy for Life, and Cardinal Javier Lozano Barragán, president of the pontifical council for health pastoral care.

Still today, one of the most highly respected experts in the ecclesial camp, Francesco D’Agostino, professor of the philosophy of law and president emeritus of the Italian bioethics committee, fiercely defends the criteria established by the Harvard report. The doubts presented by the article in “L’Osservatore Romano” do not sway his certainty: “Lucetta Scaraffia’s thesis is present in the scientific realm, but it is distinctly in the minority.”

Beneath the surface, however, doubts are growing in the Church. From Pius XII on, the pronouncements of the hierarchy on this question have been less clear-cut than they appear. This “ambiguity” of the Church is illustrated in an entire chapter of a book published recently in Italy: “Brain death and organ transplant. A question of legal ethics,” published by Morcelliana in Brescia. The author is Paolo Becchi, professor of the philosophy of law at the universities of Genoa and Luzern, and a pupil of a Jewish thinker who dedicated concerned reflections to the question of the end of life, Hans Jonas. According to Jonas, the new definition of death established by the Harvard report was not motivated by any real scientific advancement, but rather by interests, by the need for organs for transplants.

But it is especially in the Church that critical voices are gaining strength. Since 1989, when the Pontifical Academy of Sciences took up the question, Professor Josef Seifert, rector of the International Philosophical Academy of Liechtenstein, advanced strong objections to the definition of brain death. At that conference, Seifert’s was the only dissenting voice. But years later, when from february 3-4, 2005, the Pontifical Academy of Sciences again met to discuss the question of the “signs of death,” the positions had been reversed. The experts present – philosophers, jurists, neurologists from various countries – found themselves in agreement in maintaining that brain death is not the death of a human being, and that the criterion of brain death, not being scientifically credible, should be abandoned.

This conference was a shock to the Vatican officials who subscribe to the Harvard report. Bishop Marcélo Sánchez Sorondo, chancellor of the Pontifical Academy of Sciences, prevented the proceedings from being published. A substantial number of the speakers then gave their texts to an outside publisher, Rubbettino. The result was a book with the Latin title “Finis Vitae,” edited by Professor Roberto de Mattei, deputy director of the National Research Council and editor of the monthly “Radici Cristiane.” The book was published in two editions, in Italian and English. It presented eigtheen essays, half of them by scholars who had not participated in the conference of the Pontifical Academy of Sciences, but shared its views. These include Professor Becchi. Among those who did speak at the conference, special mention should be made of Seifert and of the German philosopher Robert Spaemann, who is highly respected by Pope Joseph Ratzinger.

Both the twofold volume published by Rubbettino and the book by Becchi published by Morcelliana gave Lucetta Scaraffia an opening to reopen the discussion in the columns of “L’Osservatore Romano,” at the fortieth anniversary of the Harvard report.

* * *

And Benedict XVI? He has never spoken directly on this question, not even as a theologian and cardinal. But it is known how much he respects the arguments of his friend Spaemann.

At the consistory in 1991, Ratzinger gave a speech to the cardinals on the “threats against life.” And here’s how he described these threats:

“Prenatal diagnosis is used almost in routine fashion on so-called ‘at risk’ women, in order to eliminate systematically all of the fetuses that could be more or less malformed or diseased. All of those that have the good fortune of being carried to term by their mothers, but have the misfortune of being born with handicaps, run a serious risk of being killed immediately after birth, or of having food and basic care withheld.

“Later, those who are not put into an ‘irreversible’ coma by disease or injury will often be put to death to meet the demand for organ transplants, or will be used in medical experimentation as ‘warm cadavers’.

“Finally, when death seems to be near, many will be tempted to hasten this through euthanasia.”

It can be gathered from these words that Ratzinger already had strong reservations about the Harvard criteria and the practice derived from them. In his judgment, the removal of organs from donors at the end of life is often performed on people who are not yet dead, but are “put to death” for that purpose.

Furthermore, as pope, Ratzinger published the Compendium of the Catechism of the Catholic Church. At no. 476, it reads:

“Before allowing the noble act of organ donation after death, one must verify that the donor is truly dead.”

In his book, Becchi comments:

“Because there are good arguments today for maintaining that brain death does not mean the real death of the individual, the consequences in the matter of transplants could be truly explosive. And one might wonder when these will be the matter of an official statement of the Church’s position.”

__________

The article by Lucetta Scaraffia in “L’Osservatore Romano” on September 3, 2008:

I segni della morte. A quarant’anni dal rapporto di Harvard

http://www.vatican.va/news_services/or/or_quo/205q01.pdf

__________

The books:

Roberto de Mattei (ed.), Finis Vitae. Is Brain Death Still Life?”, Rubbettino, Soveria Mannelli, 2006, 336 pp., 35.00 euros.

http://www.rubbettino.it/rubbettino/public/dettaglioLibro_re.jsp?ID=3469

Paolo Becchi, “Morte cerebrale e trapianto di organi. Una questione di etica giuridica”, Morcelliana, Brescia, 2008, 198 pp.,12.50 euros.

http://www.libreriadelsanto.it/libri/9788837222406/morte-cerebrale-e-trapianto-di-organi.html

http://www.politeia-centrostudi.org/doc/SCHEDE%20LIBRI/becchi,%20morte%20cerebrale.pdf

Cartilha da Associação dos Magistrados Brasileiros para adoção de crianças

Nesta cartilha tem todas as orientações para quem quiser adotar uma criança.

No link a seguir pode ser feito seu download.

https://biodireitomedicina.files.wordpress.com/2009/01/cartilha_passo_a_passo_2008.pdf

Alternativa Espanhola protesta contra política abortista de Obama

.- O Partido Alternativa Espanhola (AES), entregou na embaixada dos EUA “uma nota de protesto” pela decisão do Presidente Barack Obama “de retirar barreiras à prática do aborto”.

Através de uma nota de imprensa, AES informou que uma representação do partido entregou à sede diplomática “uma nota de protesto pedindo que se mantenham as restrições postas em vigor pelo Presidente Ronald Reagan”.

Como se lembra, em 23 de janeiro Obama assinou uma ordem executiva levantando as restrições que por anos evitaram que o dinheiro dos contribuintes americanos fora usado para financiar a prática e promoção do aborto no mundo.

Durante oito anos, o aborto não podia ser financiado com dinheiro público graças a “Mexico City Policy”, uma iniciativa que nasceu em uma conferência de Nações Unidas realizada no México DF em 1984 durante o governo do republicano Ronald Reagan.

Entretanto, em janeiro 1993, durante a administração democrata de Bill Clinton se revogou esta proibição; mas em janeiro de 2001 George W. Bush, restabeleceu-a com a convicção de que os impostos dos cidadãos não deveriam usar-se para pagar abortos ou financiar o trabalho dos abortistas.

A decisão de Obama de financiar o aborto com dinheiro dos contribuintes gerou críticas e protestos das organizações pró-vida dentro e fora dos Estados Unidos.

http://obamagab.com/?p=18489

Anencéfalos: a Resolução 1752/2004 do CFM “permite” o tráfico de órgãos e a prática do homicídio

“A Organização Mundial da Saúde estima que um quinto dos 70.000 rins transplantados no mundo vêm do tráfico de órgãos” [3]


A Revista Newsweek de 19 de janeiro corrente [3] traz mais uma reportagem sobre tráfico de órgãos.

Poucas pessoas sabem deste tráfico porque a mídia recusou-se a noticiá-lo para não comprometer interesses dos lucros que gravitam em torno do sistema transplantador no Brasil: no ano de 2004, houve a realização de uma CPI do Tráfico de Órgãos que comprovou a existência de tráfico de órgãos dentro de hospitais brasileiros, retirando por completo o rótulo de “lenda urbana” sobre este assunto. Mais: esta CPI, com a qual colaboramos, não constatou apenas a venda de um dos órgãos vitais duplos de pessoas que continuavam vivendo, mas o homicídio de crianças e jovens para a retirada de todos os seus órgãos.

No decorrer destes acontecimentos, inclusive, o administrador de um hospital em Minas Gerais, onde havia caso de tráfico, conseguiu praticar “suicídio” com dois tiros na cabeça. A versão do suicídio com dois tiros foi aceita pelas autoridades e a razão pela qual ele morreu não foi investigada.

Foi constatado que o Brasil está entre os cinco países onde há maior incidência do tráfico de órgãos, junto com países como China e India.

Estes dados já eram denunciados pela antropóloga Nancy Scheper-Hughes da ONG http://sunsite.berkeley.edu/biotech/organswatch/

Neste espaço iremos disponibilizar todas as atas desta CPI de 2004.

Na coluna à direita desta página já pode ser consultada a categoria de links em “Tráfico de Órgãos”.

A Resolução 1752/2004 do CFM [1], quando “autorizou” os médicos a retirarem os órgãos dos anencéfalos para transplantes, procurou “oficializar” esta prática em um universo de pessoas (anencéfalas) altamente vulneráveis.

Esta Resolução do CFM tem um conteúdo homicida, pois causar a morte do anencéfalo encontra tipificação no artigo 121 do Código Penal.

Antes da reportagem da Revista Newsweek de 19 de jan. colocamos links relacionados com este assunto [2].

[1] https://biodireitomedicina.wordpress.com/2008/12/29/anencefalia-morte-encefalica-e-o-conselho-federal-de-medicina/

[2]https://biodireitomedicina.wordpress.com/2009/01/05/transplantes-revista-dos-anestesistas-recomenda-em-editorial-realizacao-de-anestesia-geral-nos-doadores-para-que-nao-sintam-dor-durante-a-retirada-de-seus-orgaos-se-estao-mortos-para-que-a-recomend/

[2] http://www.nazioneindiana.com/2008/12/19/il-mercato-degli-organi-il-buco-nero-della-globalizzazione/

[2] https://biodireitomedicina.wordpress.com/2009/01/18/a-dura-realidade-do-trafico-de-orgaos/

[2]https://biodireitomedicina.wordpress.com/2009/01/11/morte-encefalica-o-teste-da-apneia-somente-e-feito-se-houver-a-intencao-de-matar-o-paciente/

[3] https://biodireitomedicina.wordpress.com/2009/01/27/trafico-de-orgaos-e-uma-realidade-comprovada-no-brasil/

Celso Galli Coimbra – OABRS 11352

Link para esta página e para a reportagem da Revista Newsweek:

https://biodireitomedicina.wordpress.com/2009/01/27/trafico-de-orgaos-e-uma-realidade-comprovada-no-brasil/

Leia como é fácil o desconhecimento e a “lei da selva” promoverm absurdos de análise “jurídica”:

“Nascimento de anencéfalo pode ser útil em transplantes”

http://www.conjur.com.br/2005-dez-28/nascimento_anencefalos_util_transplantes


“The World Health Organization estimates that one fifth of the 70,000 kidneys transplanted worldwide every year come from the black market.”

http://www.newsweek.com/id/178873

___

Tráfico de órgãos é uma realidade comprovada no Brasil e no exterior

A Revista Newsweek de 19 de janeiro corrente, reproduzida após estes comentários, traz mais uma reportagem sobre tráfico de órgãos.

Poucas pessoas sabem destes fatos porque a mídia recusou-se a divulgá-los para não comprometer interesses dos lucros que gravitam em torno do sistema transplantador no Brasil: no ano de 2004, houve a realização de uma CPI do Tráfico de Órgãos que comprovou a existência de tráfico de órgãos dentro de hospitais brasileiros, retirando por completo o rótulo de “lenda urbana” sobre este assunto. Mais: esta CPI, com a qual colaboramos, não constatou apenas a venda de um dos órgãos vitais duplos de pessoas que continuavam vivendo, mas o homicídio de crianças e jovens para a retirada de todos os seus órgãos. No decorrer destes acontecimentos, inclusive, o administrador de um hospital em Minas Gerais onde havia caso de tráfico conseguiu praticar “suicídio” com dois tiros na cabeça. A versão do suicídio com dois tiros foi aceita pelas autoridades e a razão pela qual ele morreu não foi investigada.

Foi constatado que o Brasil está entre os cinco países onde há maior incidência do tráfico de órgãos, junto com países como China e India.

Estes dados já eram denunciados pela antropóloga Nancy Scheper-Hughes da ONG http://sunsite.berkeley.edu/biotech/organswatch/

Neste espaço iremos disponibilizar todas as atas desta CPI. Na coluna à direita desta página pode ser consultada a categoria de links em “Tráfico de Órgãos”.

A Resolução 1752/2004 do CFM [1], quando “autorizou” os médicos a retirarem os órgãos dos anencéfalos para transplantes, procurou “oficializar” esta prática em um universo de pessoas (anencéfalas) altamente vulneráveis.

Esta Resolução do CFM tem um conteúdo homicida, pois causar a morte do anencéfalo encontra tipificação no artigo 121 do Código Penal.

Antes da reportagem da Revista Newsweek de 19 de jan. colocamos links relacionados com este assunto [2].

[1] https://biodireitomedicina.wordpress.com/2008/12/29/anencefalia-morte-encefalica-e-o-conselho-federal-de-medicina/

[2]https://biodireitomedicina.wordpress.com/2009/01/05/transplantes-revista-dos-anestesistas-recomenda-em-editorial-realizacao-de-anestesia-geral-nos-doadores-para-que-nao-sintam-dor-durante-a-retirada-de-seus-orgaos-se-estao-mortos-para-que-a-recomend/

[2] http://www.nazioneindiana.com/2008/12/19/il-mercato-degli-organi-il-buco-nero-della-globalizzazione/

[2] https://biodireitomedicina.wordpress.com/2009/01/18/a-dura-realidade-do-trafico-de-orgaos/

[2] https://biodireitomedicina.wordpress.com/2009/01/11/morte-encefalica-o-teste-da-apneia-somente-e-feito-se-houver-a-intencao-de-matar-o-paciente/

Celso Galli Coimbra – OABRS 11352

Link para esta página e para a reportagem da Revista Newsweek:

https://biodireitomedicina.wordpress.com/2009/01/27/trafico-de-orgaos-e-uma-realidade-comprovada-no-brasil/

“The World Health Organization estimates that one fifth of the 70,000 kidneys transplanted worldwide every year come from the black market.”


HEALTH

Not Just Urban Legend

Organ trafficking was long considered a myth. But now mounting evidence suggests it is a real and growing problem, even in America.

By the time her work brought her back to the United States, Nancy Scheper-Hughes had spent more than a decade tracking the illegal sale of human organs across the globe. Posing as a medical doctor in some places and a would-be kidney buyer in others, she had linked gangsters, clergymen and surgeons in a trail that led from South Africa, Brazil and other developing nations all the way back to some of her own country’s best medical facilities. So it was that on an icy February afternoon in 2003, the anthropologist from the University of California, Berkeley, found herself sitting across from a group of transplant surgeons in a small conference room at a big Philadelphia hospital.

By accident or by design, she believed, surgeons in their unit had been transplanting black-market kidneys from residents of the world’s most impoverished slums into the failing bodies of wealthy dialysis patients from Israel, Europe and the United States. According to Scheper-Hughes, the arrangements were being negotiated by an elaborate network of criminals who kept most of the money themselves. For about $150,000 per transplant, these organ brokers would reach across continents to connect buyers and sellers, whom they then guided to “broker-friendly” hospitals here in the United States (places where Scheper-Hughes says surgeons were either complicit in the scheme or willing to turn a blind eye). The brokers themselves often posed as or hired clergy to accompany their clients into the hospital and ensure that the process went smoothly. The organ sellers typically got a few thousand dollars for their troubles, plus the chance to see an American city.

As she made her case, Scheper-Hughes, a diminutive 60-something with splashes of pink in her short, grayish-brown hair, slid a bulky document across the table—nearly 60 pages of interviews she had conducted with buyers, sellers and brokers in virtually every corner of the world. “People all over were telling me that they didn’t have to go to a Third World hospital, but could get the surgery done in New York, Philadelphia or Los Angeles,” she says. “At top hospitals, with top surgeons.” In interview after interview, former transplant patients had cited the Philadelphia hospital as a good place to go for brokered transplants. Two surgeons in the room had also been named repeatedly. Scheper-Hughes had no idea if those surgeons were aware that some of their patients had bought organs illegally. She had requested the meeting so that she could call the transgression to their attention, just in case.

Hospital officials told NEWSWEEK that after meeting with Scheper-Hughes, they conducted an internal review of their transplant program. While they say they found no evidence of wrongdoing on the part of their surgeons, they did tighten some regulations, to ensure better oversight of foreign donors and recipients. “But that afternoon,” Scheper-Hughes says, “they basically threw me out.”

It’s little wonder. The exchange of human organs for cash or any other “valuable consideration” (such as a car or a vacation) is illegal in every country except Iran. Nonetheless, international organ trafficking—mostly of kidneys, but also of half-livers, eyes, skin and blood—is flourishing; the World Health Organization estimates that one fifth of the 70,000 kidneys transplanted worldwide every year come from the black market. Most of that trade can be explained by the simple laws of supply and demand. Increasing life spans, better diagnosis of kidney failure and improved surgeries that can be safely performed on even the riskiest of patients have spurred unprecedented demand for human organs. In America, the number of people in need of a transplant has nearly tripled during the past decade, topping 100,000 for the first time last October. But despite numerous media campaigns urging more people to mark the backs of their driver’s licenses, the number of traditional (deceased) organ donors has barely budged, hovering between 5,000 and 8,000 per year for the last 15 years.

In that decade and a half, a new and brutal calculus has emerged: we now know that a kidney from a living donor will keep you alive twice as long as one taken from a cadaver. And thanks to powerful antirejection drugs, that donor no longer needs to be an immediate family member (welcome news to those who would rather not risk the health of a loved one). In fact, surgeons say that a growing number of organ transplants are occurring between complete strangers. And, they acknowledge, not all those exchanges are altruistic. “Organ selling has become a global problem,” says Frank Delmonico, a surgery professor at Harvard Medical School and adviser to the WHO. “And it’s likely to get much worse unless we confront the challenges of policing it.”

For Scheper-Hughes, the biggest challenge has been convincing people that the problem exists at all. “It used to be a joke that came up at conferences and between surgeons,” she says. “In books and movies, you find these stories of people waking up in bathtubs full of ice with a scar where one of their kidneys used to be. People assumed it was just science fiction.” That assumption has proved difficult to dismantle. In the mid-1980s, rumors that Americans were kidnapping children throughout Central America only to harvest their organs led to brutal attacks on American tourists in the region. When those stories proved false, the State Department classified organ-trafficking reports under “urban legend.” Scheper-Hughes’s evidence, which is largely anecdotal and comes in part from interviews with known criminals, has not convinced department officials otherwise. “It would be impossible to successfully conceal a clandestine organ-trafficking ring,” Todd Leventhal, the department’s countermisinformation officer, wrote in a 2004 report, adding that stories like the ones Scheper-Hughes tells are “irresponsible and totally unsubstantiated.” In recent years, however, the WHO, Human Rights Watch and many transplant surgeons have broken with that view and acknowledged organ trafficking as a real problem.

At first, not even Scheper-Hughes believed the rumors. It was in the mid-1980s, during a study of infant mortality in the shantytowns of northern Brazil, that she initially caught wind of mythical “body snatcher” stories: vans of English-speaking foreigners would circle a village rounding up street kids whose bodies would later be found in trash bins removed of their livers, eyes, kidneys and hearts.

When colleagues in China, Africa and Colombia reported similar rumblings, Scheper-Hughes began poking around. Some stories—especially the ones about kidnapped children, stolen limbs and tourists murdered for organs—were clearly false. But it was also clear that slums throughout the developing world were full of AWOL soldiers, desperate parents and anxious teenage boys willing to part with a kidney or a slice of liver in exchange for cash and a chance to see the world—or at least to buy a car.

Before long, Scheper-Hughes had immersed herself in an underworld of surgeons, criminals and those eager to buy or sell whatever body parts could be spared. In Brazil, Africa and Moldova, newspapers advertised the sale and solicitation of human body parts while brokers trolled the streets with $100 bills, easily recruiting young sellers. In Istanbul, Scheper-Hughes posed as an organ buyer and talked one would-be seller down to $3,000 for his “best kidney.” In

But not all organs flowed from poor countries to rich ones; Americans, for example, were both buyers and sellers in this global market. A Kentucky woman once contacted Scheper-Hughes looking to sell her kidney or part of her liver so that she could buy some desperately needed dentures. And a Brooklyn dialysis patient purchased his kidney from Nick Rosen, an Israeli man who wanted to visit America.

Unlike some organ sellers, who told of dingy basement hospitals with less equipment than a spartan kitchen, Rosen found an organ broker through a local paper in Tel Aviv who arranged to have the transplant done at Mount Sinai Medical Center in New York. An amateur filmmaker, Rosen documented a portion of his odyssey on camera and sent the film to Scheper-Hughes, whose research he had read about online. The video excerpt that NEWSWEEK viewed shows Rosen meeting his broker and buyer in a New York coffee shop where they haggle over price, then entering Mount Sinai and talking with surgeons—one of whom asks him to put the camera away. Finally, after displaying his post-surgery scars for the camera, Rosen is seen rolling across a hotel bed covered in $20 bills; he says he was paid $15,000. (Brokers, on the other hand, typically net around $50,000 per transplant, after travel and other expenses. In America, some insurance plans will cover at least a portion of the donor’s medical expenses.)

The money changed hands outside the hospital’s corridors, and Rosen says that he deliberately misled the Mount Sinai doctors, but that no one there challenged him. “One hospital in Maryland screened us out,” he says. Tom Diflo, a transplant surgeon at New York University’s Langone Medical Center, points out that many would-be donors do not pass the psychological screening, and that attempting to film the event would probably have set off an alarm bell or two. “But the doctors at Mount Sinai were not very curious about me,” Rosen says. “We told them I was a close friend of the guy who I sold my kidney to, and that I was donating altruistically, and that was pretty much the end of it.” Citing privacy laws, Mount Sinai officials declined to comment on the details of Rosen’s case. But spokesperson Ian Michaels says that the hospital’s screening process is rigorous and comprehensive, and assesses each donor’s motivation. “All donors are clearly advised that it is against the law to receive money or gifts for being an organ donor,” he says. “The pretransplant evaluation may not detect premeditated and skillful attempts to subvert and defraud the evaluation process.”

Because many people do donate organs out of kindness, altruism provides an easy cover for those seeking to profit. And U.S. laws can be easy to circumvent, especially for foreign patients who may pay cash and are often gone in the space of a day. Diflo, who has worked in numerous transplant wards over the past two decades, says that while they are in the minority, hospitals that perform illegal transplants certainly exist in the United States. “There are a couple places around that have reputations for doing transplants with paid donors, and then some hospitals that have a ‘don’t ask, don’t tell’ policy,” he says. “It’s definitely happening, but it’s difficult to ferret out.”

Diflo became an outspoken advocate for reform several years ago, when he discovered that, rather than risk dying on the U.S. wait list, many of his wealthier dialysis patients had their transplants done in China. There they could purchase the kidneys of executed prisoners. In India, Lawrence Cohen, another UC Berkeley anthropologist, found that women were being forced by their husbands to sell organs to foreign buyers in order to contribute to the family’s income, or to provide for the dowry of a daughter. But while the WHO estimates that organ-trafficking networks are widespread and growing, it says that reliable data are almost impossible to come by. “Nancy has done truly courageous work, literally risking her life to expose these networks,” says Delmonico. “But anecdotes are impossible to quantify.”

Scheper-Hughes acknowledges that in gathering these anecdotes she has frequently bumped up against the ethical boundaries of her own profession. While UC Berkeley (which funds most of her work) granted special permission for her to go undercover, she still takes heat from colleagues: misrepresenting oneself to research subjects violates a cardinal rule of academic research. “I expect my methods to be met with criticism,” she says. “But being an anthropologist should not mean being a bystander to crimes against the vulnerable.”

While Rosen has fared well since the surgery—he recovered quickly, used the money to travel and stays in touch with his kidney recipient via Facebook—most of the donors Scheper-Hughes and her colleagues have spoken with are not so lucky. Studies show that the health risks posed by donating a kidney are negligible, but those studies were all done in developed countries. “Recovery from surgery is much more difficult when you don’t have clean water or decent food,” says Scheper-Hughes. And research on the long-term effects of organ donation—in any country—is all but nonexistent.

Last may, Scheper-Hughes once again found herself sitting across from a group of transplant surgeons. This time they were not as incredulous. More than 100 of them had come from around the world to Istanbul for a global conference on organ trafficking. Together, they wrote and signed the Declaration of Istanbul, an international agreement vowing to stop the commodification of human organs. But unless their document is followed by action, it will be no match for the thriving organ market. Even as illegal trade is exposed, a roster of Web sites promising to match desperate dialysis patients with altruistic strangers continues to proliferate unchecked. These sites have some surgeons worried. “We have no way to tell if money is changing hands or not,” says Diflo. “People who need transplants end up trying to sell themselves to potential donors, saying, ‘I have a nice family, I go to church,’ etc. Is that really how we want to allocate organs?”

Maybe not. But in the United States, the average wait time for a kidney is expected to increase to 10 years by 2010. Most dialysis patients die in half that time, and the desperate don’t always play by the rules.

http://www.newsweek.com/id/178873

Leia mais em:

Are Kidneys a Commodity?

http://www.newsweek.com/id/137544?tid=relatedcl

Organ Brokers

http://www.socyberty.com/Crime/Organ-Brokers.470441


O juramento dos médicos: “manterei o mais alto respeito pela vida humana, desde sua concepção”

Leia:

Impossibilidade de legalização do aborto no Brasil desde sua proibição constitucional de ir à deliberação pelo Poder Legislativo

Assista:

Aborto: debate na TV Justiça, no STF, em junho de 2007

Endereço destes comentários neste espaço:

http://biodireitomedicina.wordpress.com/2009/01/24/o-juramento-dos-medicos-manterei-o-mais-alto-respeito-pela-vida-humana-desde-sua-concepcao/


Juramento de Hipócrates – Na Declaração de Genebra da Associação Médica Mundial  de 1948 [1] está o juramento mais antigo que tem sido utilizado em vários países na solenidade de recepção aos novos médicos inscritos na respectiva Ordem ou Conselho de Medicina. A versão clássica em língua portuguesa possui a seguinte redação:

“Eu, solenemente, juro consagrar minha vida a serviço da Humanidade. Darei como reconhecimento a meus mestres, meu respeito e minha gratidão.  Praticarei a minha profissão com consciência e dignidade. A saúde dos meus pacientes será a minha primeira preocupação. Respeitarei os segredos a mim confiados. Manterei, a todo custo, no máximo possível, a honra e a tradição da profissão médica. Meus colegas serão meus irmãos. Não permitirei que concepções religiosas, nacionais, raciais, partidárias ou sociais intervenham entre meu dever e meus pacientes. Manterei o mais alto respeito pela vida humana, desde sua concepção. Mesmo sob ameaça, não usarei meu conhecimento médico em princípios contrários às leis da natureza. 

Faço estas promessas, solene e livremente, pela minha própria honra.”

Em versões divulgadas por outros interesses é subtraída a expressão “desde a concepção”.  Em 1994, a Assembléia Geral da Associação Médica Mundial modificou ligeiramente o texto. Sua versão em português ficou com  a expressão “manterei o mais alto respeito pela vida humana”, que, mesmo assim, não exclui a vida desde a concepção como humana, obviamente, de acordo com os conhecimentos científicos vigentes.

Já o texto proposto pela British Medical Association em 1997 dá ênfase à autonomia do paciente, admite o aborto, desde que permitido em lei e praticado dentro de “princípios éticos”, e inclui o consentimento esclarecido do paciente para a sua participação em qualquer investigação científica [2].

Entretanto, dia 13 de janeiro de 2009, ocorreu importante decisão: foi editado o Novo Código Deontológico de Portugal, que permite o aborto apenas para salvar a vida da gestante [3]. Em que pese a legalização do aborto em Portugal no ano de 2007, o Novo Código de Ética Médica daquele país não permitiu sua prática pelos profissionais da medicina, o que deixou a referida legalização fora da prática médica. Este Código Deontológico de 2009 vai muito mais além do que representaria a objeção de consciência, pois firma um consenso ético disciplinar para toda a classe médica daquele país.

Este precedente inovador de Portugal será um forte obstáculo para as pretensões do Conselho Federal de Medicina em redigir novo código de ética médica no Brasil com a permissão para a prática do aborto, apesar de que o CFM considera ter “competência” legislativa acima da própria Constituição Federal como demonstra sua Resolução 1752/04, que “autorizou” o homicídio de anencéfalos (após o nascimento, evidentemente) para retirada de seus órgãos [4].

Se o CFM quiser “legalizar” o aborto em seu novo código de ética, ele entrará em rota de colisão com o art. 4o., I, da Convenção Americana de Direitos Humanos (Pacto da São José da Costa Rica) [5], firmado pelo Brasil em 1992 e vigorando como cláusula pétrea de direitos humanos no bloco constitucional brasileiro, o que significa que não pode ser alterado senão por nova Assembléia Constituinte.

Celso Galli Coimbra – OABRS 11352

[1] http://www.cirp.org/library/ethics/geneva/

[2] http://www.imagerynet.com/hippo.ama.html

[3] https://biodireitomedicina.wordpress.com/2009/01/19/medicos-novo-codigo-deontologico-de-portugal-permite-aborto-apenas-para-preservar-vida-da-gravida/

[4] https://biodireitomedicina.wordpress.com/2008/12/29/anencefalia-morte-encefalica-e-o-conselho-federal-de-medicina/

[5] https://biodireitomedicina.wordpress.com/category/convencao-americana-de-direitos-humanos/page/3/

Leia também:

http://sardinhainnaldo.spaceblog.com.br/219617/JURAMENTO-DE-HIPOCRATES/ 


Movimento contesta uso do critério da morte cerebral – “Brain Death” — Enemy of Life and Truth

Em 12 de dezembro de 2000, A Declaração Internacional Brain Death” — Enemy of Life and Truth foi noticiada no JB, que vinha há anos cobrindo a veiculação dos erros declaratórios da morte encefálica. Desde 05 de outubro de 1997, com a matéria “Transplantes com Vivos – Interpelação Judicial acusa que declaração de morte favorece comércio de órgãos[1], ajuizada por nós em 17 de setembro daquele ano, este Jornal tornou público e com continuidade os acontecimentos sobre estes assuntos, objeto de severa censura, pela primeira vez desta forma na história da mídia brasileira, através do jornalista José Mitchell.

Antes disto, apenas o Jornalista Mendes Ribeiro havia escrito sobre o assunto no Jornal Correio do Povo e feito três entrevistas na Rádio Guaíba, no mês de junho de 1997.

Celso Galli Coimbra – OABRS 11352

JORNAL DO BRASIL

Terça-feira, 12 de Dezembro de 2000

Movimento contesta uso do critério da morte cerebral

Condenação de procedimento usado em transplantes tem apoio de 19 países

JOSÉ MITCHELL

PORTO ALEGRE – Uma declaração internacional contra a adoção da morte cerebral como justificativa para retirada de órgãos vitais destinados a transplante, assinada por 117 cientistas, médicos, psiquiatras e advogados de 19 países, começou a ser divulgada ontem pela Internet, denunciando que ”pessoas condenadas à morte pela chamada morte encefálica não estão certamente mortas, mas ao contrário, estão certamente vivas”.

O documento, que será divulgado esta semana pelos órgãos de imprensa, deverá ter fortes reflexos inclusive no Brasil, um dos países que mais realizam transplantes no mundo, e reaviva a polêmica sobre a morte cerebral. Segundo um dos signatários da declaração, o neurologista Cícero Galli Coimbra, da Escola Paulista de Medicina, os critérios adotados para determinar se há morte cerebral não têm base científica.

Coimbra considera ”homicida” o teste da apnéia, que consiste na retirada dos aparelhos em pacientes mantidos vivos por meio de respiração artificial. Esse é um dos meios utilizados no Brasil para determinar se ocorreu ou não morte cerebral.
Intitulado Morte encefálica – inimiga da vida e da verdade, o documento está sendo divulgado por iniciativa da CURE, uma organização católica contra a eutanásia mas que conta também com a participação de médicos e personalidades protestantes, budistas, entre outras religiões, e mesmo sem religião. A mobilização dos cientistas se baseia, também, na mensagem que o papa João Paulo II enviou ao Congresso Internacional da Sociedade de Transplantes, em agosto passado.

João Paulo II alertou para a existência de controvérsias na comunidade científica sobre a morte cerebral. Ressaltou que há necessidade de comprovação da ”completa e irreversível cessação de toda a atividade cerebral, no cérebro, cerebelo e tronco encefálico”, para que se concretize a morte efetiva e se faça a retirada de órgãos para transplante, de forma a que se cumpra a defesa da vida de forma eticamente aceitável.

Mandamento – Segundo cientistas, entretanto, a morte cerebral detectada pelos atuais critérios não é garantia de que isso efetivamente ocorra. O documento, assinado entre outros pelo Presidente da Federação Mundial dos Médicos que Respeitam a Vida, o holandês Karel Gunning, e especialistas como os médicos ingleses David Evans e David Hill e o médico japonês Yoshio Watanabe, afirma que a adesão às restrições apontadas pelo papa e a proibição imposta por Deus na lei natural moral ”impedem os transplantes de órgãos vitais únicos como ato que causa a morte do doador e viola o quinto mandamento: não matarás”.

Médicos como o ex-presidente da Associação Médica Católica dos Estados Unidos, Paul Byrne, dizem que os parâmetros para constatação da morte cerebral ”não são consenso” na comunidade científica. Eles ressaltam que já surgiram mais de 30 protocolos sobre a definição e testes relativos à morte cerebral, só na primeira década após o primeiro transplante, em 1968, acrescentando que, desde então, os transplantes cresceram ”de forma permissiva”.

O documento ressalta que nenhum daqueles protocolos preenche os requisitos estabelecidos pela mensagem do papa João Paulo II. Acrescenta ainda que nem as exigências científicas têm sido rigorosamente aplicadas para comprovação da morte cerebral, enquanto cresce o número de cientistas que questionam o uso desse critério como comprovação do fim da vida.

No link abaixo está a tradução desta declaração para o português com uma introdução que foi veiculada no ano de 2000:

https://biodireitomedicina.wordpress.com/2009/01/22/declaracao-internacional-em-oposicao-a-morte-encefalica-e-ao-transplante-de-orgaos-vitais-unicos-traduzido-para-portugues/

[1] Transplantes com Vivos – Interpelação judicial argumenta que conceito de morte no Brasil privilegia comércio de órgãos e é cientificamente ultrapassado”




%d blogueiros gostam disto: