Dead mother incubator

[TheMercenary]

2 days is not much of a big deal here guys. But here is where the controversy is, I don't think many of you know what it takes to keep someone on "lifesupport" when they are brain dead. The usual goal is to preserve organ function for harvest. In that case it is not simply a case of organ preservation, it is a problem related to organ preservation without doing harm to the baby. Even one or two days would most likely put the baby at some risk, the longer the need to preserve the fetus in utero, the greater the risk to the mother and infant. There is no way anyone is going to say there is no risk to the fetus in this case. So no it is not that simple of a decision.

[Pie]

Originally Posted by TheMercenary

So no it is not that simple of a decision.

But it's a medical decision, not an ethical one.

[TheMercenary]

Originally Posted by Pie

But it's a medical decision, not an ethical one.

Why would you think that keeping someone on lifesupport is not an ethical decision or not, fetus in utero or not?

[monster]

Originally Posted by Aliantha

I find it interesting that some people are against this decision by the husband and the hospital.

Who is against it?

[Aliantha]

The report they had on the news the other night had a comment that some 'groups' were against the decision by the father, but they didn't elaborate.

I imagine it'd be moral/ethical issues that've been raised here.

[Urbane Guerrilla]

One cannot take the idea that every sperm and egg is sacred, or even great too far, either in logic, or religion, or biology. You end up trying to believe that menstruation is murder (women only) or that masturbation is murder (men only) when the fact of the matter is every reproductive action in the natural world is accompanied by an expenditure of a large number of reproductive cells, eggs, units, cloud of fish sperm, or other bio-whatevers.

But to topic: this was a technically elaborated version of that old sorrow of dying in childbirth -- and saving the baby. This should be a consolation to the family.

[Pie]

Agreeing with UG... The world is about to end.

[jinx]

Originally Posted by TheMercenary

2 days is not much of a big deal here guys. But here is where the controversy is, I don't think many of you know what it takes to keep someone on "lifesupport" when they are brain dead. The usual goal is to preserve organ function for harvest. In that case it is not simply a case of organ preservation, it is a problem related to organ preservation without doing harm to the baby. Even one or two days would most likely put the baby at some risk, the longer the need to preserve the fetus in utero, the greater the risk to the mother and infant. There is no way anyone is going to say there is no risk to the fetus in this case. So no it is not that simple of a decision.

Did you read the article, or the OP?

For 48 hours they pumped large doses of steroids into her body to help the baby's lungs develop.

[Pie]

Aha, much is clearer now, jinx. Merc was arguing against something that wasn't even being considered.

[TheMercenary]

Originally Posted by jinx

Did you read the article, or the OP?

Yes I read it. Steroids were not the only thing she received. The admin of steroids to pregnant women is a normal thing if they are threatening premature birth.

[TheMercenary]

Originally Posted by Pie

Aha, much is clearer now, jinx. Merc was arguing against something that wasn't even being considered.

No, I was not arguing against anything, other than a statement that it was an ethical decision as well as a medical one. I was pointing out some facts related to the preservation of brain dead people and that information was missing.

[Aliantha]

Originally Posted by TheMercenary

2 days is not much of a big deal here guys. But here is where the controversy is, I don't think many of you know what it takes to keep someone on "lifesupport" when they are brain dead. The usual goal is to preserve organ function for harvest. In that case it is not simply a case of organ preservation, it is a problem related to organ preservation without doing harm to the baby. Even one or two days would most likely put the baby at some risk, the longer the need to preserve the fetus in utero, the greater the risk to the mother and infant. There is no way anyone is going to say there is no risk to the fetus in this case. So no it is not that simple of a decision.

So what you're saying is that while giving the mother steroids to develop the lungs is necessary, if that were to be ongoing it could cause damage to the mothers organs which in turn would endanger the health of the baby? Or are there other health risks that laypeople wouldn't know about unless they were in that situation, in which case, can you give us a rundown? Might help people understand your point better.

[TheMercenary]

Originally Posted by Aliantha

So what you're saying is that while giving the mother steroids to develop the lungs is necessary, if that were to be ongoing it could cause damage to the mothers organs which in turn would endanger the health of the baby? Or are there other health risks that laypeople wouldn't know about unless they were in that situation, in which case, can you give us a rundown? Might help people understand your point better.

Sure, no prob.

The administration of steroids is common to women who are in premature labor, specifically because studies have shown that you can help speed the maturity of the lungs of the fetus and improve, but not ensure, their outcome, morbidity and mortality.

When people are brain dead and on life support their bodies shut down. The only way to keep them alive is through ventilatory support and the administration of quite a few drugs to maintain, heart rate, blood pressure, oxygenation, perfusion of the kidneys, etc. These other drugs are the things that can affect the blood flow to the fetus, and in many cases affect the fetus directly. These direct and indirect effects can be detrimental to the fetus. Twenty-four and better forty-eight or seventy-two hours of treatment with steroids is better, but all of that is balanced against the fight to keep the body alive, esp if she is an organ donor.

[Aliantha]

Thanks Merc, that was helpful for me at least. I had no idea that people on life support had to have other drugs as well as ventilation.

[TheMercenary]

Here is a comment from someone who is involved in organ harvest, not me.

"We do about one per week at my institution. Each harvest is a bit different, depending on the hemodynamic stability of the donor and the organs being harvested. Often these patients are on dopamine, dobutamine, epinepherine, neosynepherine, nipride, nitro, beta blockers, or any other vasoactive/cardioactive gtt you can think of. Preservation of the kidneys and the heart require specific protocols for each. Since most are head injuries, increased intracranial pressure and specific affected brain tissue can cause a host of hemodynamic and physiologic difficulties. Many are trauma patients requiring continued resucitation with blood products.
Anesthetic agents are most oftened tailored to hemodynamic response desired to maitain organ perfusion. Muscle relaxants facilitate a relaxed surgical field for greater access. Often there are multiple surgical teams, one for each organ type. The heart is stopped in a similar manner as in open heart surgery with bypass. Once the heart stops, anesthesia is done, the monitors and the machine are all turned off and the heart is harvested (snip, snip...pretty quick). The final harvest for bone tissue, corneas and skin takes place after this."