by Susan Brinkmann, OCDS
Staff Writer
(Mar. 3, 2008) For the first time ever, a California transplant surgeon has been charged with hastening the death of a patient in order to harvest his organs. The charges are sending shockwaves through the transplant community and dampening the hopes of 85,000 Americans who are currently waiting for organs.
The New York Times is reporting that Dr. Hootan C. Roozrokh has been charged with prescribing excessive and improper doses of drugs in an attempt to hasten the death of a 25 year old man with brain damage.
The criminal complaint states that Dr. Roozrokh gave the victim, Ruben Navarro, excessive doses of morphine and Ativan, an anti-anxiety medication typically given to calm dying patients, along with Betadine, a topical antiseptic known to be harmful if ingested.
Navarro, who had been suffering from a neurological disorder, was in an assisted care facility in California when he was found unconscious after suffering cardiac and respiratory arrest. Doctors told his mother that he had suffered brain damage and would never recover, and advised her to disconnect life support. She took their advice and agreed to donate his organs.
According to an interview with a nurse, the transplant team, which included Dr. Roozrokh, arrived at the hospital on Feb. 3, 2007, and was in the room when Navarro was removed from the ventilator. This is in direct violation of organ donation protocol which states that the transplant team is not permitted in the room of a potential donor until five minutes after the patient has been declared dead.
Not only was Dr. Roozrokh in the room, the nurse claims that she heard him tell an intensive care nurse to administer more “candy” when Navarro did not die right away.
Protections have always been in place to prevent people from being killed in this way for their organs. This protection, known as the “dead donor rule,” requires that an individual be declared dead five minutes before organs can be removed.
According to the Uniform Determination of Death Act, a person is considered dead when they have sustained either an irreversible cessation of heartbeat and respiration, or of all functions of the entire brain, including the brain stem. Once a potential organ donor has been declared dead and the five minute waiting period is over, organs are removed as quickly as possible in order to prevent the rapid deterioration that occurs after death.
Unfortunately, this system is often circumvented by “right-to-die” enthusiasts and utilitarian-minded ethicists who advocate for an earlier withdrawal of organs – from two to five minutes – after heartbeat and breathing has stopped. Referred to as the “two minute rule”, this method overlooks the fact that just because the heart has stopped does not necessarily mean the patient is dead. If this were the case, CPR would not be able to resuscitate heart-attack victims. However, after five minutes, resuscitation is almost impossible.
Brain death occurs when the brain completely stops functioning, which can happen as a result of severe head trauma and extensive bleeding into the brain from a stroke or aneurysm. However, because a patient may be on life support, their heartbeat and respiration will continue. Brain death is determined by physical examinations and an electroencephalograpy (EEG) when necessary.
One way that the brain death criteria can be circumvented is by expanding the definition to include those who do not quite fit this description, such as persons who are considered hopeless or “vegetative” as a result of a several stroke or head injury and is being kept alive by artificial means. The September 2004 issue of the Kennedy Institute of Ethics devoted an entire issue to the discussion of whether or not to create a more “nuanced” definition of death that might include the brain-damaged.
For instance, ethicist Tracy C. Schmidt suggested: “There might lie significant public acceptance of future policies that violate the dead donor rule, or that further extend the boundary between life and death to include brain-damaged patients short of ‘brain death.’”
The case against Dr. Roozrohk will certainly reignite public outrage over these and other controversial means of procuring organs, much like what occurred in 1997 after an episode of “60 Minutes” first brought this subject to the attention of the American people.
In that episode, Mike Wallace explored the case of a young woman who had been shot in the head. Doctors determined that the injury was fatal and her family consented to have her removed from the ventilator and her organs harvested. However, during a routine autopsy, the coroner determined that the gunshot wound was survivable. The episode left everyone to wonder just how often death is hastened in order to procure organs.
The case against Dr. Roozrohk proves that at least in some quarters, this is indeed a very real problem.
The mother of the victim has filed a civil suit against Dr. Roozrokh, the donor network and other doctors who were present in the operating room at the time of her son’s death. She recently settled a lawsuit against the hospital and a spokesman for the hospital said that a plan to correct the problem had been accepted by federal health officials.
According to The Times article, the Roozrokh case “sent a shudder through the tight-knit filed of transplant surgeons. If convicted on all counts, Dr. Roozrokh could face eight years in prison, while also worrying donation advocacy groups that organ donors could be frightened away.”
Attorney Wesley Smith, widely respected author and Senior Fellow at The Discovery Institute, says about the Roozrokh case, “It is important to emphasize that this case is an anomaly. However, it reflects a dire need within transplant medicine to create uniform standards for obtaining organs that apply universally.”
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