The Right to Use Anencephalic Newborns as Organ Donors to Save Infants in Need

Editorial:

Shouldn't Parents Have The Right to Donate Their Dying Child's Organs?

The Right to Use Anencephalic Newborns as Organ Donors to Save Infants in Need

ABC News 

March 9, 2013

Anencephaly is a serious neural tube birth defect that is characterized by the absence of the forebrain, skull and scalp. This includes lack of brain development above the level of the brain stem. However, there is still brain stem activity, which enables the heart and the lungs to function for a short time; developing less and less regular breathing and eventually causing the infant to die from respitory failure. An estimate of 2,000-3,000 anencephalic infants is born each year. The majority of anencephalic infants die within days or weeks without life support.

There is a growing need and increasing shortage of transplant organs for infants and whether parents should have the right to donate the organs of their anencephalic infants before physicians announce and declare the child legally brain dead. Although it is possible to keep the infant on life support machines for some time, maintenance of the vital organs is unsafe and dangerous.  Because of the lack of higher brain coordination, the newborn constantly forgets to breathe. These interruptions and lack of coordination in respiration causes irreversible damage to the organs by depriving them of consistent oxygen and blood flow. By the time the infant is legally brain dead, the organs are no longer usable and or feasible for donation and transplantation. Regularly parents choose to volunteer their infant’s organs for transplants to acquire some positivity out of a negative situation; but because the use of anencephalic newborns as organ donors before they are announced and declared brain dead is illegal in the United States, these newborns must wait to die naturally, with their organs becoming nonviable for transplant purposes.

Because it is extremely difficult to find donors and transplants for infants and young children, the loss of these organs has created a legal and ethical debate regarding the policy issues behind both determination of death and organ transplantation. One side of the debate indicates that the law should declare these infants similar to brain dead so that their organs may be taken and used while the organs are still viable. The other side of the debate reiterates that anencephalic newborns have full rights under the law, including the right to bodily integrity and the right to die naturally.  It would seem to be that the unethical route to take is to not use these organs to save another life, a life that, unlike the anencephalic, has potential to live many years to come.

Some state legislators have proposed defining anencephalic newborns as "dead" as a limited exception to the legal definition of brain death. Despite the uneasiness of labeling a breathing newborn dead, one can see the development to this line of reasoning through the history of the definition of "death." According to common law, “courts define death as the irreversible cessation of all vital functions, specifically circulation and respiration”. This definition became known as the heart-lung definition of death.