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body's immune system, designed to
defend against invading bacteria
and viruses, attacks the "foreign"
tissue.
Doctors went to work to find
sorne way to neutralize the immune
response, to penetrate the body's
armor. But they soon found that
immunosuppression, as the tech–
nique carne to be called, was a two–
edged sword. lt opened the body
not only to foreign tissue trans–
plants, but to marauding bacteria
and viruses as well.
The "magic threshold" was
crossed with the development of
cyclosporine, a new drug that pre–
vents rejection of organs in the
human body, at the same time
keeping the immune system on
alert to fight infection- a leading
cause of death among transplant
pat ients.
Cyclosporine is considered the
With patients waiting
One U.S. publication reported
that at Stanford University Medí–
cal Center about one out of three
candidates for a heart transplant
dies before a suitable heart
becomes available. According to
Fortune
magazine, about 14,000
people each year need heart trans–
plants in the United States. Last
year 172 got new hearts.
Organs that could be procured
from traffic accident victims are
often too old, or damaged or incom–
patible. Moreover, doctors in the
emergency room may sometimes
appear "pushy," "greedy," or
"cold," causing sorne families to
refuse to allow physicians permis–
sion to extract an organ for trans–
planting. A brother of a possible
donor described one doctor' s pur–
suit of body parts as "almost like
stripping a car."
To combat the dearth of organs,
physicians at hundreds of
transplant centers in 40
countries have set up
for donors around the world,
unnerving questions remain:
communications networks
stretching from Brazil to
Belgium. And a new
source was devised: pa–
tients declared officially
dead when their brain
waves stopped- even if
their interna! organs were
still functioning. No lon–
ger would the time-hon-
Who will receive the
new technology? Who will judge
who is medically worthy?
And who will judge the judges?
first of a new generation of
powerful wonder drugs that has
prompted doctors to proclaim con–
fidently that heart transplants are
" just the beginning."
Yet the unpleasant side effects of
cyclosporine are that it contributes
to kidney and liver damage and
perhaps to the development of cer–
tain cancers. Sorne medica! writers
say it is "like calling in Satan to
drive out the devil."
Another problem facing medica!
science is acquiring body parts.
There aren't enough to go around.
Even if an organ is found it must be
in excellent condition, and the
donor ' s immune system must
match that of the recipient. That
combination is hard to find. Others
waiting for replacement organs
often must depend for years on life–
saving machines that are also in
short supply.
12
ored definition of death
be "when the heart and
circulation
~o
longer function."
The heart and lungs can be kept
going by machines.
What controversy this change
has caused! How can a 'brain-dead
person sign a waiver granting per–
mission to remove vital organs? So
Canadian law now allows the
removal of corneas during autopsies
without prior consent of the
deceased. Sweden, Israel, Italy and
France presume that people are
willing to donate body parts at the
time of death unless they, or their
next of kin, have filed an objec–
tion.
But even if a matched donor is
found, hitches in transportation
persist. "We have a lifesaving sur–
gical technique with a horse-and–
buggy delivery system," said one
person waiting for a donor.
Then come the price tags
for
transplantation-about
US$135 ,000 for a
liver,
US$1 00,000 for a heart- far
beyond the reach of most. Such
surgical transplants are still consid–
ered experimental and are not cov–
ered by most insurance policies or
public aid programs.
Who Lives, Who Dles?
While patients waiting for donors
continue to die around the world,
unnerving questions remain: Who
will receive the new technology?
Who will judge who is medically
worthy? And who will judge the
judges?
Potential organ recipients must
undergo an almost ruthless medica!
screening, including their worth to
society and the loss their death
would cause-"in competition, so
to speak , with other dying
patients." How should factors such
as age, productivity, number of
children, earning power, and value
as a ci tizen be considered?
Often the only way a person can
make his need public is by enlisting
the help of the media to spread the
news. "The trend seems to be that
whoever gets the most publicity
gets to live," said the assistant
director of bioethics at the U.S.
National Institute of Health.
Committee members who weigh
the value of one's life have a
strange responsibility to their fel–
lowman. "They always think of
themselves as choosing in favor of
one, not against anyone.
They have
the gift of lije to bestow on some–
one,"
said author Harold M.
Schmeck Jr.
Is science giving life? "No,
that's a hyperbole," D. Jack Pro–
vonsha, director of the Center of
Christian Bioethics at Loma Linda
University, told this writer.
"Science is prolonging life that has
already been given. Only God can
give life."
The greatest protests, neverthe–
less, have always been over the idea
of men taking the power of life into
their own hands. Many say the
moral decision should hinge on who
has been waiting the longest or
even be decided by lottery.
If
human heart transplants aren' t
posing enough ethical knots to
untie, then the frightening prospect
of brain transplants will. At the
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The PLAIN TRUTH