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Unmitigated gall.
February 22, 2003 5:35 PM Subscribe

Unmitigated gall. The illegal aliens who got two hearts and two lungs for their daughter REFUSED to have any of her organs donated when it was clear she was brain-dead...
posted by MattD (240 comments total)

One thing, at least, is comforting: I think we can trust John Ashcroft's INS to have a paddy wagon waiting for them when they come to the courthouse to try to sue Duke for malpractice. A bumpy flight to Mexico, shackled to the floor of a Bureau of Prisons plane, rather than a payday at the cost of all of our insurance premiums, seems well deserved.
posted by MattD at 5:39 PM on February 22, 2003

Interesting way to start a discussion, MattD.
posted by anathema at 5:43 PM on February 22, 2003

Err.. perhaps we should wait for some confirmation that the organs actually were harvestable before tying the family to a burning stake?

IANAD, but I seriously doubt organs transplanted once are in any condition to be re-used.
posted by PrinceValium at 5:45 PM on February 22, 2003

Oh, and MattD, with such antipathy to parents who lost their child about 8 hours ago, you'd be a prime candidate for attorney general yourself.
posted by PrinceValium at 5:47 PM on February 22, 2003

Did they pay for the operation? This isn't made clear. If they paid for the operation, they paid for those organs, and morally they don't have to 'give them back'. If they didn't pay for the operation, then yeah, it's in bad taste, and they should either pay or play.
posted by wackybrit at 5:47 PM on February 22, 2003

I think I'd wait until my own child died in front of me due to gross medical malpractice before I cast any stones. Feh.
posted by vraxoin at 5:50 PM on February 22, 2003

What, are donated organs licensed under GPL now?
posted by condour75 at 5:51 PM on February 22, 2003

in my opinion, an FPP ought to set the tone for a discussion. in that spirit, fuck you, mattd.
posted by Ignatius J. Reilly at 5:52 PM on February 22, 2003

Whether or not any organs -- not just heart and lungs -- were harvestable is a medical decision, not one to be made by the parents. They refused to allow the medical decision even to be made.

How can someone who just lost a child NOT have a sympathy for all those other people out there who have loved ones dying on a transplant list, when they, themselves, benefited from such generosity? That is the DEFINITION of unmitigated gall, and I judge them without hesitation. If Ashcroft has that same clarity of vision, more power to him.

Whether or not they paid for the operations couldn't matter in the least to their moral obligation.
posted by MattD at 5:52 PM on February 22, 2003

but I seriously doubt organs transplanted once are in any condition to be re-used.
Good point, PrinceValium.

If they paid for the operation, they paid for those organs, and morally they don't have to 'give them back'.
wackybrit, please explain how morals fit into that equation?
posted by anathema at 5:52 PM on February 22, 2003

OK, OK, your second post actually clarified a position. but tht being the real issue, why is her parents' immigration status relevant? sorry for my counterproductive brashness, it's just that all one can glean from your post is that accidents of birth determine who deserves organs.
posted by Ignatius J. Reilly at 5:56 PM on February 22, 2003

Prince: I'm pretty sure they were talking about the other organs.
posted by kfury at 5:57 PM on February 22, 2003

Err, okay, so the wonk they quoted at the end was referring to all the organs, but he's a wonk.
posted by kfury at 5:58 PM on February 22, 2003

Their (lack of) immigration status matters a great deal, because it makes abundantly clear their absolute lack of personal character -- happy to prevail upon a legal and medical system to which they have no entitlement, and then reciprocate by putting a finger in our eyes.
posted by MattD at 5:59 PM on February 22, 2003

Jesus, nice empathy, MattD.

Gotta agree with vraxoin here... I think organ donations were probably a fairly touchy subject with the family after their daughter just died after a botched transplant. I know I'd feel a little raw, anyway.
posted by RylandDotNet at 6:00 PM on February 22, 2003

Surely stuff like the corneas were harvestable.

Additionally, she was a type O.
posted by benh57 at 6:01 PM on February 22, 2003

wackybrit said: If they paid for the operation, they paid for those organs, and morally they don't have to 'give them back'.

Definately the most convoluted logic. Ever.

MattD said: How can someone who just lost a child NOT have a sympathy for all those other people

Maybe it's because they JUST lost a child, on top of everything else they've gone through, plus their distrust of Duke. Not just a lack of sympathy but empathy as well, do you own any pets?
posted by yonderboy at 6:05 PM on February 22, 2003

Here's a little background concerning Jesica's immigration status, for those who are interested.
posted by RylandDotNet at 6:06 PM on February 22, 2003

I know it's a sacrifice, but for the sake of the deserving and needy around me -- I'm willing to donate my pancakes.
posted by Pretty_Generic at 6:07 PM on February 22, 2003

do you think that people really salivate and rub their hands, staring across the border at a glorious system ripe for the raping? and twirling their tiny mustaches? their child needed an organ transplant, they couldn't afford it, they did all they could. i would hope that your "morals" would not prevent you from doing the same in that situation. and i love the implication that if she had been born in ohio and named madison mackenzie johnson or some shit then it would have been well within her "moral rights" to get buried chock full o' precious organs.

"Whether or not any organs -- not just heart and lungs -- were harvestable is a medical decision,.."
so why are you making it a political one?
posted by Ignatius J. Reilly at 6:09 PM on February 22, 2003

It seems to me that their choice to donate or not is within the relm of None Of Our Business, and likely it ought to be held as part of their medical privacy.
posted by yonderboy at 6:10 PM on February 22, 2003

Nice work throwing Ashcroft into the mix. Pure bile. Easily one of the worst posts ever. Worse than the last 20 Iraq posts combined.
posted by anathema at 6:13 PM on February 22, 2003

From the linked article and from a press conference I just saw on television there seems to be some doubt about whether the family consented to have the child removed from life support. Donating organs is a choice and I wouldn't be in a giving mood after an institution had botched an operation on my daughter and then taken her off life support without my consent. Also, I think MattD's bit about them being illegal aliens is just nasty. I can't really believe that this is the one part of this story he chose to focus on.
posted by rdr at 6:15 PM on February 22, 2003

"Her immigration status played no role because hospitals may place non-U.S. citizens on their waiting lists and must give them the same priority as citizens, said Anne Paschke, spokeswoman for the organ network. But they cannot perform more than 5 percent of their transplants on non-citizens."

-- Washington Post (More complete story)

Given this, that her immigration status shouldn't matter, why does it seem unreasonable that they bring a malpractice suit against the Professionals involved? IANAL, but just because you're an illegal immigrant shouldn't mean you don't have rights in the US. Or is this the case? I don't know, I don't live there.

I am pissed that they would refuse to donate organs, but someone's mistake killed their daughter.

Are there any catholics reading? Does catholicism have anything to do with it? I think I saw this on an episode of ER once....
posted by damclean2 at 6:16 PM on February 22, 2003

Given the context of their situation, their grave misfortune and Duke's gross negligence, it seems quite understandable. When the time comes for me, i'll be quite dead and won't have much use for my organs, so donation is fine for me. But it's a deeply personal decision.... it's not mandatory or expected that we recycle the guttyworks when we through with them. With the gravity of that poor family's situation, I applaud them for taking a stance based on their values rather than some implied obligation.

May Jesica rest in peace.
posted by moonbird at 6:20 PM on February 22, 2003

Ignatius -- I certainly would go anywhere in world, legal or not, to help my child. I certainly hope, as well, that I would be grateful to the people and the system who tried to help my child, and would not be so grossly selfish as to refuse to give the same aid when I had the opportunity (however tragic) to do so.

Damclean -- illegal aliens have some, but not all, of the right to initiate lawsuits that people who have status have. The right to initiate a lawsuit, if any, is not a right NOT to be deported for being an illegal alien, nor is there any right to return to the US to testify or be deposed.
posted by MattD at 6:22 PM on February 22, 2003

I'm more shocked at the thread than the post. I find this to be an absolutely heartwrenching story, and one that merited discussion (especially in light of the recent controversy over medical malpractice in West Virginia and Pennsylvania, among other places). I'm just taken aback by the lack of empathy here for the family. Maybe its just that their misfortune is obvious, and doesn't merit discussion. But I don't feel able to reasonably criticize any decision of a family that's had to deal with triple trauma of Jesica's heart deformity, the initial botched operation, and then the possibility that further irreversible brain damage was caused by the hubris of the same hospital staff. I'm agnostic, and as cynical as they come, but I, for one, am praying for the Santillans.
posted by gsteff at 6:23 PM on February 22, 2003

MattD, you seem to imply that there is something wrong with a possible lawsuit brought against the hospital by an alien. As a lawyer I'm sure you are familiar with the Alien Tort Claims Act of 1789 which not only allows nationals of foreign countries to bring tort claims against U.S. citizens, but also to sue other foreign nationals in U.S. courts. And here I thought you were familiar with international law issues.
posted by anathema at 6:29 PM on February 22, 2003

<fark>
worst post ever
</fark>
posted by kickingtheground at 6:29 PM on February 22, 2003

I suppose that it might be mentioned that if any part of her is xplanted or otherwise not available for cross-examination, it might help mitigate any future criminal or civil action for malpractice.
posted by kablam at 6:31 PM on February 22, 2003

I certainly hope, as well, that I would be grateful to the people and the system who tried to help my child, and would not be so grossly selfish as to refuse to give the same aid when I had the opportunity (however tragic) to do so.

Perhaps you missed the small detail that in trying to help their child the doctors killed the child through incredible negligence.

Also, I love the way you started the post talking about getting two sets of organs, as if it they got an extra special bargain. Two for the price of one! They got the second set because the first set was a horrible mistake. How dare they not be twice as grateful!

We'd all like to think that we'd be wonderfully selfless in such a situation, but if some doctors had just killed my daughter and came to me asking for organ donations, I'm not sure I'd be so charitable. And given your complete assholery towards these grieving people, it seems pretty unlikely that you would be, either.
posted by anapestic at 6:31 PM on February 22, 2003

gsteff, I agree with feeling compassion, but I have to side with MattD here (despite his Ashcroft bat wielding tirade at the top of all this). How can you use a system that involves giving and receiving of vital, useful, living organs... then turn around and say 'No! If my daughter couldn't live then no one else's children should be able to live tonight either'?

It just seems wrong to me. Does that make me amoral or without compassion?

They needed organs for their daughter, they got them twice.
posted by damclean2 at 6:33 PM on February 22, 2003

MattD, I have a simple question for you - would you say this to their face? Right now, as they're grieving over a daughter they have fought so hard to save? Go ahead, take a little trip to Duke U and tell them just what you think about it. They'd probably be a hell of a lot more interested than we are.
posted by pyramid termite at 6:35 PM on February 22, 2003

Okay... I retract that "twice" statement.
posted by damclean2 at 6:35 PM on February 22, 2003

then turn around and say 'No! If my daughter couldn't live then no one else's children should be able to live tonight either'?

Can you please provide a link for that quote?
posted by anathema at 6:36 PM on February 22, 2003

Jesus MattD.

What the fuck is wrong with you?

...happy to prevail upon a legal and medical system to which they have no entitlement.

You mean the system that gave these people hope, then messed up the initial transplants allowing them to benefit from allowing her to undergo another round of transplants entitling them the benefit of watching her die a lingering death?

Yeah, the nerve of some people not wanting to sit by and watch their daughter be butchered a third time.

BTW, her immigration status is irrelevant. The transplant list is based on need and prognosis, citizenship is not a factor although hospitals cannot perform greater than 5% of the procedures on foreign nationals. Whether you like it or not, by all accounts she fell well within the guidelines.

You also may not be aware that there has been a two year fundraising effort on this girls behalf. You seem under the impression that she snuck on over the border walked into a hospital and took organs destined for another. That's not how the system works.

Additionally, every media report I have read questions whether her organs would even be viable. Between the stress of back to back double transplants, the anti-rejection medication and the systemic failure it's quite unlikely. Before jumping to conclusions you may want to consider waiting until some facts are revealed. Or maybe your a doctor privy to the case records and just forgot to mention it.

If you want to discuss immigration policy or health care in the United States that's just fine and dandy. To take what is a terrible tragedy prematurely ending a youngsters life and using it to further some personal agenda is inexcusable. To cast aspersions on the character of a family who has struggled for years to save the lives of a loved one reveals far more about your character than theirs.

I'm going to go wash my hands now, they suddenly feel very dirty.
posted by cedar at 6:41 PM on February 22, 2003

anathema: as I said, illegal aliens have some, but not all, of the rights to initiate law suits that persons of legal status have. 18th-century laws notwithstanding, there are all kinds of claims which cannot be initiated by people lacking legal status. A medical malpratice claim may not be among them.

However, all these rules do is keep a judge from dismissing the case on the grounds of the plaintiff's status. They do not protect a putative plaintiff from being deported, nor do they give a plaintiff grounds for a visa to come back to prosecute the case or testify. The defendants certainly could move to dismiss on the basis that they are unable to cross-examine the defendants on their claim for their own emotional trauma (the only basis on which you can seek damages for a child lost due to malpractice).

Under current INS regulations, if they are deported, they will not be eligible for any kind of return visa for five or possibly ten years. If they file the suit now, it can be dismissed for frustration of the defense's right to cross-examine if they try to submit evidence on affidavits (and they will not be allowed to delay trial for five or ten years). The statute of limitations will run before they could initiate the case anew when visa-eligible.
posted by MattD at 6:41 PM on February 22, 2003

It seems wrong to me too, damclean2. Donating her organs would have been classy, it would have been the high road. It would have been the right thing to do. I just think that no one that hasn't gone through their two week hell can reasonably chide them for taking the low road.

Amoral? No. Without compassion? To the infinitesimally tiny extent that the aimless wanking of MeFites has anything to do with compassion, maybe.
posted by gsteff at 6:42 PM on February 22, 2003

Should have used em tags instead of quotes... sorry.

You're right, I don't know what they said, or where their thought process was.

The fact remains, based on preliminary media reporting, the family has refused to donate the child's organs. They took part in a program that relies on donations. They refused to donate, but expected someone else to donate for their daughter's sake.

Give and Receive. That's all I'm saying.
posted by damclean2 at 6:45 PM on February 22, 2003

damclean2 said: How can you use a system that involves giving and receiving of vital, useful, living organs... then turn around and say 'No! If my daughter couldn't live then no one else's children should be able to live tonight either'?

It's easy to say 'no' when the hospital was the one that chose to remove her from life support, as was the case here, and when the question was asked when they weren't emotionally prepared to answer it. Ethically, you could argue it was just as much the responsibility of the hospital to allow them an appropriate amount of time before making such a decision. Duke doesn't look good in all this.
posted by yonderboy at 6:47 PM on February 22, 2003

Somewhat of a tangent: Someone else may have died in this case as well. The first set of transplanted organs should have gone to that 'someone else'.
posted by mischief at 6:48 PM on February 22, 2003

We are all assuming that what has been reported was correct. At this point to me that's a stretch. But assuming it was, perhaps the scenario was that the family was asked before she was taken off final life support, and they said no for the simple reason they did NOT want her taken off life support at all.

and let us all remember that the attention this case gave to the cause of organ donation ought to be worth something. Now it would be nice if people could step back and let this family grieve in private without criticism of their PRIVATE decisions.
posted by konolia at 6:49 PM on February 22, 2003

It's easy to say 'no' when the hospital was the one that chose to remove her from life support, as was the case here, and when the question was asked when they weren't emotionally prepared to answer it.

" Doctors declared her brain dead at 1:25 p.m., said Duke University Medical Center spokesman Richard Puff. At that point, they stopped giving her medication that kept her heart beating, and it gradually slowed until she died at about 5 p.m., he said.

The family's permission was not needed to stop supplying the medication, Puff said."

Again from the Washigton Post article.

Well, I guess it's all left up to the Doctors of Spin to clean up the mess...
posted by damclean2 at 6:51 PM on February 22, 2003

I have enough empathy for the family to refrain from making all those illegal alien comments.

I do not have enough empathy to give them a pass on not giving up the organs. Who is more aware of the need to donate organs than people whose daughter has desperately needed a donation for years? This decision may have been motivated by rage and pain, but it makes it no less selfish and cruel even if their objections are religious in nature. (Fine religion they have -- their daughter can take all the organs she needs, but anyone who needs hers now that she's gone is out of luck.)

MattD was at least half right.
posted by Epenthesis at 6:58 PM on February 22, 2003

I don't see how anyone, I don't care who they are or where they came from, can turn down the chance to save lives with their loved one's organs. To refuse is the height of selfishness. I don't care what their reasoning is - at the end of the day, someone (or several someones) on the transplant list die while the usable organs rot in a box underground or get cremated. It's unconscionable.

In this case, it may have been a moot point anyway, as others have noted. But if anything *was* usable, and her parents refused, I would have no problem looking them straight in the eye and telling them what I thought of them. They're in grief, yes, but why must they force grief on another family by denying them the same chance their daughter got?
posted by beth at 6:59 PM on February 22, 2003

My sister had a heart transplant, died 9 months later. The only organ (tissue, really) that was usable was her corneas.

It's still a bad blow for UNOS, organ donation in general for them to do this. But then again, they've been through a lot.
posted by nagrommit at 7:01 PM on February 22, 2003

MattD - "I would tell those worthless people to their face exactly what I thought of them, without hesitation."

And this would make you a worthful person, of course, wouldn't it?

MattD - "We're too damn polite in this society, that we allow such scum to be treated with kid gloves."

We even give them web sites where they can spew their bile and reveal themselves as the scum they are. Shocking, isn't it?
posted by pyramid termite at 7:04 PM on February 22, 2003

How the hell can one be "too polite"?

All I can say, MattD, is that I hope nothing like this ever happens to you. I hope your moral fortitude is never tested by having a loved one die horribly after a botched operation. And I hope that, gods forbid, it ever does happen, that your neighbors and fellow citizens show more compassion and empathy than you have.
posted by RylandDotNet at 7:09 PM on February 22, 2003

Let's quit judging the poor girl's family and start watching Duke go into code red CYA mode.
posted by konolia at 7:10 PM on February 22, 2003

I only have to look at my own young son to imagine how I'd feel if he was waiting on a transplant list tonight, knowing how these people behaved. No punishment is bad enough for them, and if my certainty of that bothers any of you, than I guess I can live with that.

And still, xquzphyr, and pyramid termite, I wouldn't hesitate to have my son's organs donated to one your children, if my son got killed in a car accident or otherwise was lost to me, if if yours needed it, because it's the decent thing to do, even for the kids of someone who's called me names online. And these parents down in North Carolina, far from being called names, have been given an almost unimaginable level of hospitality by our nation and its healtcare system -- and yet they can't be decent for a moment. Pretty clear situation if you ask me.

Ryland -- if I refused to donate organs after losing my child, I would deserve no compassion, and would ask none either.
posted by MattD at 7:13 PM on February 22, 2003

I would tell those worthless people to their face exactly what I thought of them, without hesitation. We're too damn polite in this society, that we allow such scum to be treated with kid gloves.

I motion to vote MattD off the island.
posted by kickingtheground at 7:15 PM on February 22, 2003

I would tell those worthless people to their face exactly what I thought of them, without hesitation. We're too damn polite in this society, that we allow such scum to be treated with kid gloves.

Fortunately, I'm not one of those polite people and you my friend are a pompous jerk, standing on the summit of your pretty little clapboarded and picket fenced house in the burbs passing judgement on the unsoiled masses beneath.

Don't you get it? A girl died due to massive medical negligence, what was left of her was removed from life support without her parents permission and you expect them to express their gratitude in the form of some benevolent bequest that may possibly help another?

You call them scum because they don't fit your preconception of how they should act and figure the best way to treat them now is with a bumpy flight to Mexico, shackled to the floor of a Bureau of Prisons plane, rather than a payday at the cost of all of our insurance premiums? Not being as expierienced as you with the nuances of the laws that the priviledged use to evade responsibility I can't be sure of this, but it would seem to me that if your health insurance premiums should go up as a result of this tragedy the fault would be with the doctors who so badly bungled this girls care.

I pity your unborn child, to be parented by someone so utterly devoid of compassion as you seem to be, is inevitably going to lead to a life as tragic as this poor girls. It's my sincere hope that he or she never suffers from a life threatening health problem as Dad sits by weighing the cost/benefit analysis and potential tax and insurance repercussions that extreme measures could potentially lead to.

On preview, the above seems a little over the top. I'm sure you would react like any other father... after all, your kid will be blessed with the right complexion, the finest in health insurance and an American passport. Obviously a much more valuable and worthy life.

I have to say that I have developed a loathing for you that is quite remarkable.... words fail me, I can only imagine what an unfeeling prick you must be and trust that you will recieve all that you so richly deserve.
posted by cedar at 7:18 PM on February 22, 2003

We're too damn polite in this society

I hardly think resisting the urge to shit on grieving parents is some form of politeness.

Also, I'm with konolia...we are not sure of the details of how the decision was made not to share her organs after death. Common sense might tell us that organs that have been placed into someone whose body was completely fucked over might not work especially well when placed into another person. It's entirely likely that the hospital offered the chance for organ donation, perhaps as a matter of routine, at the same time as telling them that the organs could not be used anyway.

At the very least, empathy might reveal to us that parents who have just lost their child in a painful, prolonged ordeal might hesitate to offer what they might see as false hope to someone else.

Without the illegal aliens angle, MattD had a good point for debate; yet the bad comment does reflect a tendency in the US to view ourselves, our bodies, our concerns as somehow innately superior to those of other countries, other places, other cultures (which is perhaps a natural thing, as much as we would like to feel like we've moved beyond it). Still, it implies (1) that we would give legal residents more leeway in turning down organ donation in the situation, without this kind of criticism, and, as such, (2) that the parents owe us some extra gratitude for treating their daughter as a human being and not an animal.
posted by troybob at 7:18 PM on February 22, 2003

From Matt's (MattD) website:
"Matt is active in Republican party politics..."

I guess that says it all, He's a compassionate conservative.
posted by jpburns at 7:19 PM on February 22, 2003

That's cheap and irrelevent, jpburns.
posted by gsteff at 7:21 PM on February 22, 2003

Not to mention that a personal ordeal like this is indeed a mitigating factor, and thus the term unmitigated is more than a bit foolish.
posted by troybob at 7:21 PM on February 22, 2003

More cheap and irrelevant than MattD's original post, gsteff?
posted by troybob at 7:22 PM on February 22, 2003

Maybe I'm heartless, but I think their illegal immigrant status means a whole lot. I really can't fault Jesica's parents for wanting the best for their daughter's health. However, the main purpose of any country is to serve the interests of their citizens. It just leaves a bad taste in my mouth when someone that broke the law in entering the country ended up getting organs that could have gone to a citizen or someone that followed the rules in entering the country, and leaves an even worse taste when they don't even allow the doctors to search for usable organs in her body that could be donates.
posted by gyc at 7:23 PM on February 22, 2003

hmmm...after further review, I'm guessing "doning" isn't a word (although that's how I would spell it if it was...). I guess that would be "madatory organ donation"
posted by stifford at 7:27 PM on February 22, 2003

Cedar -- do you get it, at all? The compassion you preach is the kind of slack, contentless permissiveness which gets no anywhere but ill. The compassion that matters is where the rubber hits the road -- the compassion that these parents benefitted from in spades and then showed they had none of their own to spare. The only thing sounding in charity which they have coming is forgiveness. But, of course, contrition has to procede forgiveness.
posted by MattD at 7:30 PM on February 22, 2003

Luckily, medicine tends not to mind the borders when trying to save someone's life.

Good point, stifford...it sounds like some of these people have let those organ donation ads get to their heads. Perhaps their next venue will be protesting at the funerals of anyone who did not sign an organ donation card.

Yes, MattD...it's the type of compassion that Republicans have been putting forth for years. And it has gotten us so far. Really.
posted by troybob at 7:38 PM on February 22, 2003

for the sake of mefi, i will donate my brain to mattd.
posted by sgt.serenity at 7:38 PM on February 22, 2003

"Sorry we killed your daughter. Ummm...... Can we have her eyeballs?"
posted by y6y6y6 at 7:39 PM on February 22, 2003

It seems wrong to me too, damclean2. Donating her organs would have been classy, it would have been the high road. It would have been the right thing to do.

No, it would have been the only moral course of action open to them.

I just think that no one that hasn't gone through their two week hell can reasonably chide them for taking the low road.

I can chide them for it, and am. I can chide everyone who isn't an organ donor, and am about to do so: if you are not an organ donor, or you choose not to allow somebody else's organs to be harvested, you are despicable. Your dead body or somebody else's dead body has organs that, I assure you, they don't need and that other people might need.

I don't care what your reasons are -- I don't care how grieving and angry and pissed-off you are, you're still choosing that others die, or be blind, or suffer with burns, or whatever, with no real consequence to yourself. You are choosing death over life and suffering over healing, and choosing that is always despicable.

Now it would be nice if people could step back and let this family grieve in private without criticism of their PRIVATE decisions.

Organ donation isn't a private decision. Deciding that somebody you don't know is going to die or suffer is not a private decision.
posted by ROU_Xenophobe at 7:40 PM on February 22, 2003

I would tell those worthless people to their face exactly what I thought of them, without hesitation. We're too damn polite in this society, that we allow such scum to be treated with kid gloves.

From MattD's website:
Matt currently practices corporate law in association with Alston & Bird LLP, a major New York-based firm.

That's right. And he just called other people, or brown parents if you will, worthless and scum, even in light of the fact that Jesica died mere hours ago. Things are just now beginning to churn. Including the fascists. A fascist, racist lawyer practicing law for corporations in the United States. Whodathunkit!

I don't know about you. But I'd want my lawyer to be a little more level-headed. But see, I'm not a corporation. Neither are Jesica's parents.
posted by crasspastor at 7:41 PM on February 22, 2003

We do not know how educated and informed these parents are or their religious beliefs. Using them for an example as if they were as competent as a middle class American with a high school diploma is a stretch. Until it can be ascertained they knew the full implications of organ donation, this coversation is premature at best.

Internal organs aside, there always things that can be harvested. Skin and corneas are almost always usable. And, um, despite the word donation is involved, skin and corneas are sold.

On another note, when dialysis was invented, the immediate ethical dilemma was if it was going to be only for people who could afford it. Because if that were true, an effective medical device could keep people alive for years would be beyond the reach of poor people. The answer rightly was no--you don't put doctors and hospitals in the position of breaking their Hippocratic Oath and playing God with people's lives.

I had a girlfriend once, a very sweet womman. But she worked in Alaska and became infected with Libertarianism. She had this wacky cult Christian sister--sthis woman wouldn't let her kids have Christmas or any holidays or even have toys!--with an interst in hig colonics who ended up with a perforated large intestine and hence perotonitis and hence kidhey failure. She ended up on dialysis.

Barbara would be going on and on about how there should be no public assisitance, no welfare, no goverment hand outs, that the government should just be a private police force for rich people. I pointed out that in her ideal world, her sister would already be dead.

Oh, THAT was DIFFERENT.

Transplants, I think, follow the same policy as dialysis.

Rich or poor, if people are sick, you heal them if you can. Which is why poor people often wait longer than they should to get treated end up using the Emergency Room. Sometimes they abuse this policy but this is not true in the majority of cases. And if we had universal health care, we wouldn't have be having this problem at all.

And listen, when you go overseas and get sick, you are often shit out of luck. When you visit the USA from a foreign country and get sick, I don't think it's a problem. Someone can correct me if I'm wrong. So, we give foreigners free health care, so what. We are supposedly the greatest nation on earth, so why not act like it?

Also there is this tiny point, this itsy bitsy possibility that from the parents' point of view,THE hospital FUCKED UP AND KILLED THEIR DAUGHTER and were quite possibly so angry and grief stricken that they were in no mood or emotional state to want to to do anyone at the hospital a favor when asked.

Note, she got two transplant operations because the hospital fucked up the first time and they owed her the second one. Either that or face the fact they had killed the girl outright with their incompetence and, um, ahem, malpractice suit and future business? Hi, we're AssMed and we killed a transplant patient and you all know her name--We look out for you!

Her parents hence get a pass and some of you are pretty much total pricks for playing judge and jury in the Keystone Kourt of Public Opinion.
posted by y2karl at 7:44 PM on February 22, 2003

I really don't want to believe this shit is endemic. I mean cedar nailed MattD. Nailed 'em!

MattD lost his composure. He's got a job as a high flyin' lawyer and I friggin' wait tables. I lose my composure all the time. What the fuck is this world coming to?
posted by crasspastor at 7:45 PM on February 22, 2003

um, high colonics--all the other typos you can figure out.
posted by y2karl at 7:45 PM on February 22, 2003

The compassion you preach is the kind of slack, contentless permissiveness which gets no anywhere but ill. The compassion that matters is where the rubber hits the road -- the compassion that these parents benefitted from in spades and then showed they had none of their own to spare. The only thing sounding in charity which they have coming is forgiveness.

I don't even know what this means.

Do you expect the family to forgive the doctors or are we supposed to forgive the family... remind me what they did wrong again?

While your at it, would you clarify the contrition part also? I assume you mean the doctors should show contrition in the hopes they may be forgiven, but considering your previous posts I'm not too sure.

As far as my preaching compassion, I really don't see why it is such a stretch to feel compassion for a family that has suffered such a loss. I don't care where they're from, or what decisions they made concerning organ harvesting after their daughters death. There are many reasons, both cultural and religous that people chose to not to opt for organ donation, I'm not privy to the reasoning the Santillans (yes, they have a name) used, do you?
posted by cedar at 7:45 PM on February 22, 2003

contrition has to procede forgiveness
Could you tell us what religion believes that a sinner must first contrite before you forgive him/her?
posted by Zootoon at 7:46 PM on February 22, 2003

"Stripped for parts" - article from Wired News.
posted by betheon at 7:48 PM on February 22, 2003

A girl died due to massive medical negligence, what was left of her was removed from life support without her parents permission and you expect them to express their gratitude in the form of some benevolent bequest that may possibly help another?

Yes, I expect that, and so should you. I expect people to make moral choices when the consequences of their choices are clear.

On the one hand, their daughter is dead, and other people go or stay blind, and stay in the burn ward for another few months, and otherwise suffer. On the other hand, their daughter stays exactly as dead, and the suffering of others is ameliorated.

Choosing the first is despicable. Monstrous.

Commonplace, sure. Vaguely understandable in the sense that they're responding only to their own immediate suffering in an overly emotional way. But still monstrous and despicable.
posted by ROU_Xenophobe at 7:49 PM on February 22, 2003

However, the main purpose of any country is to serve the interests of their citizens. It just leaves a bad taste in my mouth when someone that broke the law in entering the country ended up getting organs that could have gone to a citizen or someone that followed the rules in entering the country

And that, as they say, is the very crux of the issue here, and very well said.
posted by hama7 at 7:51 PM on February 22, 2003

Don't forget, it was the hospital's decision to choose when to remove life support and thus they chose when to ask the parents about organ donation. There may have been a more appropriate time in the near future to pose such a question to her parents. It is quite possible that tomorrow they would have had an entirely different answer.
posted by yonderboy at 7:52 PM on February 22, 2003

Could you tell us what religion believes that a sinner must first contrite before you forgive him/her?

Oh, it's not a religious thing. If MattD has prequalifications for earning his compassion (apparently race-based and devoid of emotional considerations), he certainly has prequalifications for earning his forgiveness.
posted by troybob at 7:52 PM on February 22, 2003

Here's the initial New York Times report (reg req.), which makes no mention of the "refused organ donations" bit but does suggest that there are a number of, shall we say, confusions in the official account.
posted by thomas j wise at 7:53 PM on February 22, 2003

I'm willing to bet that her organs cannot be used. First of all, two rounds of transplants does not healthy tissue make -- that's an immense strain on and shock to her system right there. Second of all, she was on an immense amount of anti-rejection drugs (immunosuppresants, drugs that keep your immune system from reacting). They're not drugs to fool around with; immunosuppresants are pretty toxic and can severely affect your liver and kidneys. (Two immunosuppresants are tacrolimus and cyclosporine. Do a Google search on either plus "toxic" and you'll get the picture.) Last, while life-support does keep you, well, alive, it's not the same as blood and oxygen circulating through your body in the "normal" fashion. Again, more reason to doubt the viability of her organs.

But there's a bigger picture here. I'm sure the ethical debate over this will be (is!) huge. For the record, there are currently 197 people waiting for heart-lung operations, and more than 7,000 people waiting for either a heart or a lung (more than 3,800 in each category [data from the same link]). The second set of organs she received could have gone to save either one life or three (with the heart and two lungs going to three people). Knowing that her chances of survival were slim, should she have received that second set of organs at all, organs that could have saved others?

I don't know. And I hope I'll never be in that position, to ask that and make that decision and have that knowledge, that to save my child others are losing out.

Having said all that -- MattD, I don't think you're putting any of this in perspective. It sounds like a circus down there, and it DEFINITELY sounds like the parents are not getting enough information, or even information that they can understand. The family spokesman is claiming her organs were ruined by being on life support; if their "official" claim/statement is that the time spent on life support killed her and ruined her brain, then it follows that they wouldn't donate her organs. It also sounds like the parents didn't know she was being taken off life support; they'd been saying they wanted a second opinion.

Stop being so harsh, MattD. This family came to America with the hope of saving their daughter; instead they've been living through a nightmare for almost a month.
posted by metrocake at 7:54 PM on February 22, 2003

"if you are not an organ donor [...] you are despicable."

Well, since you seem to be such a pompous ass about it I think I'll just be cremated with mine in place. I'll be despicable and you will smug in your virtue. Must be nice to live in a black and white world.
posted by y6y6y6 at 7:56 PM on February 22, 2003

MattD wrote: I would tell those worthless people...

When I'm vacationing in Canada, Mexico, Europe, or Australia, does that make me a worthless person, since I'm not a citizen of the place I'm in? What if I stayed? What if I stayed longer than I was allowed? At what point do I become worthless?
posted by mathowie at 7:57 PM on February 22, 2003

Boy, can't you wait til this event and thread becomes a fascinating "ripped from the headlines" episode of E/R?!
posted by tittergrrl at 7:57 PM on February 22, 2003

I get it, MattD. You're going to find some family whose child MIGHT have been able to use those undonated organs, offer to represent them on consignment and sue those worthless scum for everything they've got and get Duke U for not thinking of a good way to talk them into it, as they're the ones with the deep pockets. Clever. You might even get a new SUV out of it. You're just practicing your righteous indignation act for the jury here, aren't you? Make sure that jury's as WASP as possible, too.

Is it really possible that jerks like you are the mainstay of the political and economic structure these days? Because if that's true, we are in deep shit ...
posted by pyramid termite at 7:58 PM on February 22, 2003

Y'all, there was a time when I wanted nothing more than to wait tables -- in fact, I only hoped to buss tables after they'd been waited upon, as that constituted a promotion from the dishwashing room! And I wouldn't have felt any differently had I never changed my profession. This is not about how much education I have, or how much education that Santillans have.

I am -- maybe in my head alone, it would seem from the passion I aroused -- actually speaking from what I see as the core of decent behavior. Responsiblity. Reciprocation. The Golden Rule. Excusing the Santillans because they have suffered a loss, or any subjective grounds, and where do you draw your lines. The social contract depends upon all of us acting within certain bounds, none of which is more important than the ones the Santillans violated -- the Golden Rule in its most blatantly obvious manifestation.
posted by MattD at 7:58 PM on February 22, 2003

Glad I'm not the only one, y6y6y6...if my organs can't be made available to anyone who needs them, regardless of race or citizenship, I'm not terribly excited about giving them up.
posted by troybob at 8:01 PM on February 22, 2003

For those interested in learning how to become an organ donor.
posted by letitrain at 8:04 PM on February 22, 2003

Pyramid -- aren't the Santillans analagous the classic bad guys of the SUV fable, those who drive the SUV because it keeps THEIR kids a little safer while people OTHER people's kids at risk? (P.S. I drive an old sedan and my wife has a station wagon...)

Mathowie -- the Santillans may have had a higher moral obligation because they benefited gratuitously from our system, but I'd feel the same about anyone who did what they did regardless of nationality.
posted by MattD at 8:04 PM on February 22, 2003

Yes, I expect that, and so should you. I expect people to make moral choices when the consequences of their choices are clear.

It's times like this I wish I had a better knowledge or religion. However, I do believe there are several faiths that regard organ donation as sacriligeous and a desecration of the body. If that is the case, to donate organs would be immoral.

There is also the matter of whether the consequences were made clear to them, these people do not speak English and it's entirely possible they may be overwhelmed.

I'm going to be backing away from this thread, it is actually causing me pain. The entire thing is absurd, these people lose a loved one and we sit back and pass judgement on them knowing nothing of their reasons.

Hell, we don't even know that there was anything viable to harvest.

BTW, I certainly wish that they had chosen otherwise, but I'm not so arrogant as to think that I have any justification to impose my morality on them. Last I heard organ donation was voluntary, if not just think of all the goodies we could get from executed criminals. Hey, there's a plan... works for the Chinese.
posted by cedar at 8:05 PM on February 22, 2003

I'd feel the same about anyone who did what they did regardless of nationality

...which is why the first three words of your post were The illegal aliens...
posted by troybob at 8:06 PM on February 22, 2003

Well, since you seem to be such a pompous ass about it I think I'll just be cremated with mine in place.

This is why mandatory donation might be good: to deny you that asinine, immoral choice.

I'll be despicable and you will smug in your virtue. Must be nice to live in a black and white world.

You're actually willing to have people die and suffer just to prove some sort of point against me? Then you are despicable.

Organ donation is black and white. You don't need them any more, because you're a rotting corpse. Other people can use them. What good reason do you offer to people dying in hospital beds -- sorry, I'd have given you a heart, but I think ROU_Xenophobe is a prick so I didn't? What sort of sorry-ass excuse is that? What good reason is there, ever, to choose that other people die or suffer at no cost to you?

troybob: MattD's bringing up their immigration status or how much melanin is in their skin was over-the-top and shameful AFAIC. I'd agree in a heartbeat that organs should always be given in a race- and citizenship-blind way.
posted by ROU_Xenophobe at 8:10 PM on February 22, 2003

Pyramid -- aren't the Santillans analagous the classic bad guys of the SUV fable, those who drive the SUV because it keeps THEIR kids a little safer while people OTHER people's kids at risk?

No, they're more like the people who were crossing the road with the light when one of them got run over by an ambulance.

(P.S. I drive an old sedan and my wife has a station wagon...)

Exactly my point - if you want that SUV, you're going to have to learn to chase ambulances. There it goes - catch it!!

the Santillans may have had a higher moral obligation because they benefited gratuitously from our system

Only a lawyer would describe getting things getting fucked up and getting fucked over as a gratuitous benefit.
posted by pyramid termite at 8:11 PM on February 22, 2003

I am pissed that they would refuse to donate organs, but someone's mistake killed their daughter.

This comment, and others like it, are somewhat misleading. Yes, a clerical error hastened this girl's death, but the five year survival rate for heart/lung transplants is less than 50% (lower in cases with congenital defects, as was the case here). Their daughter would definitely have died without any surgery, and would only have had a 50% chance of survival had the surgery gone well. "Someone's mistake" isn't really what killed their daughter, the heart defect she was born with is what killed her. Mistakes happen, I don't mean to diminish the tragedy in this case, but mistakes do happen - there are risks to all surgeries, especially ones of this nature, and thinking that everything would have been hunky-dory had the original mistake not been made is inaccurate.

Also, while I agree that it's extremely unlikely that they could have donated most of her organs (and definitely not the heart and lungs), they most definitely could have donated her corneas and skin. It's shocking that people who have been allied so closely with the transplant process should make such a decision. I think it's wrong not to donate organs no matter who you are, but I think it's doubly wrong when you know what's at stake, as these people did. I worked as a nurse on a pediatric cardiology floor, I saw many kids die, some with transplants, some without, but in that time I never met a parent of a child who needed a transplant who would refuse to donate organs (their own, or their loved one's).

That said, I think MattD is completely on the wrong track here - I don't see what their immigration status has to do with anything, and thirsting for the punishment of these poor people, when they've just been through the most horrible experience anyone can endure, pretty much, is very low. I'm furious that they didn't donate any organs which could have been transplanted, and I think anger over that should suffice - there's no need to bring their immigration status into it.
posted by biscotti at 8:15 PM on February 22, 2003

It's times like this I wish I had a better knowledge or religion. However, I do believe there are several faiths that regard organ donation as sacriligeous and a desecration of the body. If that is the case, to donate organs would be immoral.

Bluntly, I don't care. Your religious scruples stop when they start resulting in other people's deaths. Clearly these people didn't regard organ donation so, as they were willing to accept them.

There is also the matter of whether the consequences were made clear to them, these people do not speak English and it's entirely possible they may be overwhelmed.

I'm sure they were overwhelmed by the whole experience. I can vaguely understand that they don't want their daughter's body cut up (more), or that they're lashing out at the hospital because they're understandably upset beyond limits. That doesn't make their choice a good or moral choice, though. At the end of all this, when their tempers have cooled and they're done grieving, there are still going to be people who went untreated because of their decision.

Yes, people are sometimes/often driven to make monstrous, immoral choices out of their passions at the time. That might make their decision comprehensible, but it doesn't somehow turn it into a good or moral decision.
posted by ROU_Xenophobe at 8:16 PM on February 22, 2003

the Santillans may have had a higher moral obligation because they benefited gratuitously from our system

I hope I never "benefit from our system" the way Jesica Santillan did. If I ever do, I don't expect my loved ones to be very damned grateful for it.
posted by RylandDotNet at 8:17 PM on February 22, 2003

Matt's all heart. Or all ass. I can't decide.
posted by websavvy at 8:19 PM on February 22, 2003

It would seem to me that the religious objections to providing an organ transplant (having your whole body) would be present in both situations. Oddly though, I've never heard the objection mentioned in the case of a transplant, only in the case of a donation.

Has anybody heard the religious argument used against donation by a denomination other than the Christian Scientists?
posted by mosch at 8:20 PM on February 22, 2003

Link to Duke's official Chronology of Events
posted by thatweirdguy2 at 8:22 PM on February 22, 2003

This is why mandatory donation might be good: to deny you that asinine, immoral choice.

At least now I know how I'll be battling during "The Organ Wars" in the future. Fuck anyone who thinks they are "obliged" to my parts...
posted by stifford at 8:23 PM on February 22, 2003

May I be the first to politely observe that personal attacks toward MattD or his website are really off topic, unnecessary and ridiculous?

There are strict laws in place concerning illegal immigration, but it's clear that they need even more reinforcement.
posted by hama7 at 8:24 PM on February 22, 2003

"I am actually speaking from what I see as the core of decent behavior."

You live in a world where decent behavior is determined by gossip, assumptions and righteousness. You are condemning people you've never met, for an event you know almost nothing about, which you read about on a website.

Where I come from we try to interject some empathy and understanding before we condemn people like you have.

Your "decent behavior" has no room for error. It exists in and black and white fantasy land where what is decent is codified by hard and fast rules that have no context or latitude.

What a fucked up world you live in.

"offer to represent them on consignment and sue those worthless scum for everything they've got"

Bingo. This is the world you have created for yourself MattD. And your version of the golden rule is way too vindictive and righteous for me. Count me out.
posted by y6y6y6 at 8:25 PM on February 22, 2003

Oddly though, I've never heard the objection mentioned in the case of a transplant, only in the case of a donation.

The only time I've heard an affirmative answer to the question "Would it be wrong to accept an organ transplant?" was in a philosophical-cum-theological discussion conducted by a rabbi, and even then he was only speaking to the possibility of animal-to-human transplants.
posted by thomas j wise at 8:25 PM on February 22, 2003

I'm with you, MattD. Leaving their immigration status aside, there's a whole lotta people out there waiting for organs. Lots of people die every day, and take their perfectly useful giblets into the pine box with them. Why? Better to feed the worms than to do a solid for your neighbor? If anyone ought to be expected to understand the importance of organ donation, you would think it would be a family that it has personally touched. I'm sure this girl had something that could be used by someone. They could have at least allowed for the possibility. Like the great philosopher Fat Albert once said, the Santillans are like school on Saturday.... no class.
posted by spilon at 8:26 PM on February 22, 2003

I get what you're saying ROU_Xenophobe. I think that "lashing out" is strong, considering that, if anything, the parents were probably completely physically and emotionally drained from this experience and were not in the place to make a rational decision. (Consider, for instance, the guilt they might feel in that this happened in part as a result of decisions they helped make for their daughter--keeping in mind biscotti's excellent points about true causation, not to mention acknowledgement of the humanity of physicians/health care workers; my guess is that they weren't too confident about their decisions at this point.)

I still think its overkill to refer to their decision, whatever it might have been (as we still don't know the details) as an immoral choice. Morality exists in a vaccum only theoretically. Its practice is subject to many factors, and I think we can agree that this family was exposed to quite a few harsh ones.

May I be the first to politely observe that personal attacks toward MattD or his website are really off topic, unnecessary and ridiculous?

Not only are you not the first to do so, but MattD's belief system, to the degree that it informs his position in this matter, is indeed relevant, and by making it available, he has offered it up for consideration. Not to mention that his attack on the parents of this girl is itself personal.
posted by troybob at 8:29 PM on February 22, 2003

At least now I know how I'll be battling during "The Organ Wars" in the future. Fuck anyone who thinks they are "obliged" to my parts...

Oh, no doubt there are lots of good reasons to not do mandatory organ harvesting.

But the organs aren't yours anymore. You're a dead, rotting corpse and don't have any property.
posted by ROU_Xenophobe at 8:30 PM on February 22, 2003

Pope's address to the International Congress of the Transplantation Society

Pope: ...every organ transplant has its source in a decision of great ethical value: "the decision to offer without reward a part of one's own body for the health and well-being of another person"
posted by thatweirdguy2 at 8:30 PM on February 22, 2003

I apologize in advance to mathowie for this, 'cause I know he tries to encourage intelligent debate and comments that contain actual content. But fuck you MattD, and the Randite horse you rode in on, and your representing-the-worst-of-America, pompous, self-righteous "morality". People die every day in America, and few of them have organs that are healthy enough for transplant; and relatives often, for religous or personal grounds, refuse to allow the harvesting of organs that are in good enough condition to survive a transplant. (Or, for example, they wouldn't touch them with a 10 foot pole because the donor has been exposed to Hep C, as in my case; they won't have my blood either, and fair enough, even though I'm perfectly healthy.) Yes, I think that everyone who can should arrange in advance to donate their organs, and in a perfect world every parent, child, brother, sister, would be able to sign the forms in a calm and rational manner. Life isn't like that; people are more fragile. And your "worthless scum" bigotry makes me very glad that I do not, personally, know you, nor ever will. Ask yourself this: What exactly would Jesus do, MattD? Be outraged that his insurance premiums were going up? Again: fuck you.
posted by jokeefe at 8:30 PM on February 22, 2003

Please spare a moment for those of us on the other side, who have had their organs rejected even by criminals, never mind illegal aliens. It's no fun sitting by the phone for weeks, with a gun in your hand and nobody calls for your liver.
posted by MiguelCardoso at 8:32 PM on February 22, 2003

Considering that this whole situation has been horrific and preventable, any family that is depending on organ donation (and who ended up receiving 2 sets of heart-lung donations--thus condemning whoever was on the waiting lists--see metrocake's post above) for the survival of their child that wouldn't consent to the donation of whatever was usable is suspect. Although mattd's wording is bad, there is something wrong in the family's refusal to allow someone else' s life to continue, making a bad situation worse.
posted by amberglow at 8:34 PM on February 22, 2003

I get what you're saying ROU_Xenophobe. I think that "lashing out" is strong, considering that, if anything, the parents were probably completely physically and emotionally drained from this experience and were not in the place to make a rational decision.

Sure. I can understand that. I can see how they weren't in a position to really be rational. But that doesn't make their decision any better, it just points up how irrational it is.

I still think its overkill to refer to their decision, whatever it might have been (as we still don't know the details) as an immoral choice.

People will suffer who would not have if they'd donated her organs. Their choice will cause people suffering and pain, or perhaps death on the off-chance that some vital organ was useable. People will suffer or die at no benefit to them. I can understand their position until my brain hurts, but at the end of the day they still chose to make other people suffer, and that's immoral. Understandable or forgivable, sure, but still immoral.
posted by ROU_Xenophobe at 8:37 PM on February 22, 2003

"This is why mandatory donation might be good: to deny you that asinine, immoral choice."

In other words you'd rather live in a world where your morality and ethics were codified into law, so that when people did things you didn't approve of they could be deprived of their right to make choices you object to.

Loon.

"sorry, I'd have given you a heart, but I think ROU_Xenophobe is a prick so I didn't?"

Here's the deal. I despise you. You want the law to force me to live by your rules. You want to take my rights away and force me to live up to your ethical dictates. I loath you. I'm only hoping that you'll hate me so much that you'll lie awake in bed thinking about how much you want to punch me in the face. I'm hoping your hatred of people who don't follow your ethics will eat whatever is left of your riddled soul.
posted by y6y6y6 at 8:39 PM on February 22, 2003

jokeefe - What exactly would Jesus do

It wouldn't do to donate organs that you'd be taking back in 3 days.
posted by pyramid termite at 8:40 PM on February 22, 2003

You're a dead, rotting corpse and don't have any property.

Right...but guess where said property vests?
posted by anathema at 8:41 PM on February 22, 2003

If the Organ transplant agency (or whoever is in charge) wants to make it a rule that you have to agree to "give in order to get", I'm all for it. But as long as it's still a choice (for whatever reason), I don't think people should be expected to give them up. And other than "That's not what I would do with my parts", I don't really see what the problem is, or what anyone else's business it is (regardless of the random chance that someone might die because I selfishly decided to randomly die in a car wreck that day, but not to donate my organs...)
posted by stifford at 8:43 PM on February 22, 2003

I am out of this dicussion on account of the hour, East Coast time. I will close my contribution with the thought "To those whom much is given, much is expected." Republican or not, I honestly think that those are words which must guide the behavior of anyone who has been fortunate or blessed.

Being allowed the benefits of the US health system -- something that few of us would be allowed in a nation we were visting without papers -- was not least among the "much" they were given, together of course with two sets of organ transplants. I apologize if I provoked anyone with the rhetoric with which I referred to their lack of immigration status.

I see the Santillans in the difficult position of having been both profoundly fortunate -- but also emotionally traumatized. The difficulty of the latter does not reduce or mitigate the duty imposed by the former, nor do I feel called to sympathize with a wrong decision simply because the wrong decision had some underlying sympathetic facts. The breach of that duty in question is truly outrageous, and I am truly outraged. I don't particularly take that as a sign of the decline and fall of American civilization, or the particularly corruption of the practice of corporate law (where, believe it or not, we actually labor to create American jobs and build American businesses...), but I'm just one fella.
posted by MattD at 8:44 PM on February 22, 2003

You're a dead, rotting corpse and don't have any property.

Right...but guess where said property vests?

Nowhere. There is no property in a corpse.
posted by ROU_Xenophobe at 8:44 PM on February 22, 2003

thus condemning whoever was on the waiting lists

People will suffer who would not have if they'd donated her organs.

You guys are so definite on this. It's presumptuous to assume that people were necessarily condemned by how these organs were routed. Transplanation is a complicated process, and the best you can say is that there was a chance someone else could have benefited; there's a much higher chance that the organs could not have been routed in time to a compatible recipient, or that they would not have been successfully implanted, and thus would have been wasted anyway. Every organ made available by donation is not utilized. I don't base my view of this case on that fact, but I think we should remain wary of such assumptions.
posted by troybob at 8:45 PM on February 22, 2003

I must place myself among those who are disturbed by, what seems to be, the parents lack of thought for others who might benefit.

Yes, a mistake was made. Afterwards, heaven and earth was moved to try and right the wrong, with no thought given towards their status as illegal aliens. That was only right. Yet, having received this, and having received the outpouring of care and concern from the entire nation, I'm a bit shocked at the parents attitude.

Having myself benefited from care given at a hospital in a land not of my own, I found myself going out of my way to let all concerned know how grateful I was for the care I received. To me, not being a citizen of their country, I felt obligated to insure that they knew of my sincere gratitude. I find it hard that anyone in that kind of a situation would feel different.
posted by Plunge at 8:49 PM on February 22, 2003

But the organs aren't yours anymore.

You imply that the organs are property. Continuing that reasoning, the family would become "owners" of the organs after the death.
posted by anathema at 8:49 PM on February 22, 2003

And after Mandatory Organ Donation comes into law, how about we gut anyone that has been in a coma for more than two years? (those selfish fucks...)
posted by stifford at 8:49 PM on February 22, 2003

"This is why mandatory donation might be good: to deny you that asinine, immoral choice."

In other words you'd rather live in a world where your morality and ethics were codified into law, so that when people did things you didn't approve of they could be deprived of their right to make choices you object to.

When their choices kill people, yes. I wouldn't speak to lesser matters than that. I don't much care about who you have sex with or how you do it, if that's what you mean. But should you condemn others to death for no benefit to yourself? No, never.

"sorry, I'd have given you a heart, but I think ROU_Xenophobe is a prick so I didn't?"

Here's the deal. I despise you. You want the law to force me to live by your rules. You want to take my rights away and force me to live up to your ethical dictates.

No, I just want you to not kill people when you could save them at precisely zero cost to yourself. That should be a pretty easy rule to live with.

I loath you. I'm only hoping that you'll hate me so much that you'll lie awake in bed thinking about how much you want to punch me in the face. I'm hoping your hatred of people who don't follow your ethics will eat whatever is left of your riddled soul.

Why would I want to punch you in the face? Then we'd be right where we were before, except you'd have a sore face and I'd have a sore hand. Apart from that being a wicked thing for me to do, it would be supremely useless.
posted by ROU_Xenophobe at 8:52 PM on February 22, 2003

troybob--this girl stayed alive at least two weeks longer (even with incompatible organs implanted in her). It's safe to say that it's not just a chance someone else could have benefited; but a certainty.
posted by amberglow at 8:53 PM on February 22, 2003

Transplanation is a complicated process, and the best you can say is that there was a chance someone else could have benefited

Yeah, but even a small probability of success is much greater than the exactly-zero probability of the dead girl's organs helping anyone when they're 6 feet under, or turned to ash.
posted by ROU_Xenophobe at 8:54 PM on February 22, 2003

What if the SUV dealer ran over their daughter and kill her when he was backing it out of the lot for them? And shouldn't we divert a little wrath to the hospital which fucked up the tissue match and killed their daughter--there's your culpabilities?

Her heart and lungs are out. I wouldn't want her kidneys in anyone I know, considering the stress and trauma she went through. We're talking some skin, corneas and maybe plasma in this case.

Should we then condemn them for denying someone commercial product that are sold to other people at an amount that may not even qualify for grand larceny? Can the pitiful amount and worth the things that could taken from their daughter make for a waiver here?

The Golden Rule. Excusing the Santillans because they have suffered a loss, or any subjective grounds, and where do you draw your lines?

God forbid it should ever happen, or better yet, here's a thought experiment. What if someone perfectly sober and through a course of quite possibly alterable events backs the SUV over your daughter--or the person who most matches--in your presence. The driver runs up crying and babbling I'm sorry, I'm sorry, I didn't see her...Responsiblity. Reciprocation. The Golden Rule. Can you assure us, guarantee us, that you will be emotionless, detached and capable of noble behavior at that moment--that no emotion could possibly ever cloud your judgment, that we can rest assured you couldn't lose it? If it's yes, then you are a true superman and we should all heed your word and worship you

You discount the effect of strong feelings as if they were mere trifles not really part of the equation. What is this? Asimov's Laws Of Moral Robotics?

But then here's another ideal: Innocent Until Proven Guilty.

We don't know the facts. Getting on a high horse before the fact is 100% pure Making Yourself Right By Making Someone Else Wrong. It's moral voo doo.
posted by y2karl at 8:55 PM on February 22, 2003

And after Mandatory Organ Donation comes into law, how about we gut anyone that has been in a coma for more than two years? (those selfish fucks...)

Which is of course the supremely good argument against mandatory harvesting. I'll leave it to someone else to bring up Larry Niven and the Organleggers.
posted by ROU_Xenophobe at 8:56 PM on February 22, 2003

in any detail, that is.
posted by ROU_Xenophobe at 8:57 PM on February 22, 2003

I see the Santillans in the difficult position of having been both profoundly fortunate -- but also emotionally traumatized. The difficulty of the latter does not reduce or mitigate the duty imposed by the former, nor do I feel called to sympathize with a wrong decision simply because the wrong decision had some underlying sympathetic facts.

It's incredibly unfair to subject anyone to judgment based on a test-tube view of how morality is practiced. (Where would we be if motion physics ignored external factors such as gravity?)

But maybe this disagreement is just a matter of degree. Perhaps some of us consider the painful process these parents went through in losing their child as more than "some underlying sympathetic facts." Perhaps we can recognize that, in reality, their ability to make any decision was impaired in this particular situation, and thus they should not be subject to so rough an assessment by those who can speak to it only in theoretical terms.

amberglow: You are still assuming that the organs would have gotten to anyone. A nurse friend of mine who has worked with transplant teams assures me that, for a wide variety of reasons, most organs available for transplant are not utilized.

ROU_Xenophobe:

People will suffer who would not have if they'd donated her organs.

...even a small probability of success is much greater...

All I was asking is that you see the difference between the level of certainty in these two statements.
posted by troybob at 9:00 PM on February 22, 2003

the difficult position of having been both profoundly fortunate [subsequently, immediately profoundly unfortunate but that doesn't count for this abstract example profoundly unfortunate but that doesn't count, sorry. Nothing here to look at. Move Along.] -- but also emotionally traumatized. The difficulty of the latter does not reduce or mitigate the duty imposed by the former, nor do I feel called to sympathize with a wrong decision simply because the wrong decision had some underlying sympathetic facts. The breach of that duty in question is truly outrageous, and I am truly outraged.

Oh... you are a superman. Never mind.
posted by y2karl at 9:02 PM on February 22, 2003

A bumpy flight to Mexico, shackled to the floor of a Bureau of Prisons plane, rather than a payday at the cost of all of our insurance premiums, seems well deserved.

... I am actually speaking from what I see as the core of decent behavior.

Huh?
posted by mattpfeff at 9:02 PM on February 22, 2003

troybob, i'm willing to bet that with the amount of scrutiny that this case has engendered, her body will not be treated like an average case or an average death (if there is such a thing), and if anything was usable, it would have been.
posted by amberglow at 9:04 PM on February 22, 2003

I don't think I've read a more revolting FPP than this. MattD, thanks for framing your thoughts in the most foul, incomprehensible manner possible. I must confess that I did not read the commentary, so if you apologized for your position herein, I retract my statement.
posted by Fezboy! at 9:05 PM on February 22, 2003

was not least among the "much" they were given, together of course with two sets of organ transplants

What is it about the two sets of organ transplants that makes a difference to you here, and why do you keep insisting on the extra set as an extra benefit. What you have here is analogous to a starving child showing up at a food bank. The child will starve to death at some point in the future unless she gets food, so the people at the food bank give her poisoned food. It makes her very sick, but still starving, so they give her some good food to cover their asses. Unfortunately, the poisoned food made her die significantly sooner than she would have otherwise. But her parents should be grateful because she was fed twice.

If you want to say that people who benefit from organ donations should donate organs themselves, then fine. If you want to say that people who get killed by a bad organ donation given by well-meaning doctors should still donate organs, then fine also. But the donation of a set of lethal organs certainly doesn't heighten whatever responsibility exists.
posted by anapestic at 9:06 PM on February 22, 2003

I'm sorry, amberglow--maybe I didn't make it clear. I was responding very specifically to your statement:

...who ended up receiving 2 sets of heart-lung donations--thus condemning whoever was on the waiting lists...

You assumption that someone was condemned is a gross overstatement, considering that there is a greater than 50% chance that if this girl had not received the organs, no one would have.
posted by troybob at 9:08 PM on February 22, 2003

Please spare a moment for those of us on the other side

Ha ha!! Miguel, why am I not surprised by your selfless commitment to humanity? Bravo!

by the way, is that liver still available?
posted by hama7 at 9:09 PM on February 22, 2003

Wait, non-sequitor. . . so if you apologized for your position herein, I retract my open condemnation of said foul, incomprehensible framing.
posted by Fezboy! at 9:09 PM on February 22, 2003

And after Mandatory Organ Donation comes into law, how about we gut anyone that has been in a coma for more than two years? (those selfish fucks...)

WTF? Dead is dead...Coma is NOT dead. call me crazy, which i may well be, but i see a clear delineation between being clinically dead with NO heartbeat and any other situation where you still have a heartbeat.
posted by jmd82 at 9:13 PM on February 22, 2003

Wouldn't her body, in whatever condition it was at the time of death, be considered evidence in the investigation of how the transplant procedure went wrong? Wouldn't "re-harvesting" come under destroying such evidence? Why would these parents even be asked by the hospital under investigation to donate? I'm pretty sure there were investigators and police all over the place advising against this, since there was already talk of a lawsuit; I would guess that the "refused to donate" was a leak from someone wishing to discredit the parents in favor of the hospital...in other words, a particularly nasty, hate-mongering lawyer trick. What charming creatures we humans are.
posted by cookie-k at 9:14 PM on February 22, 2003

WTF? Dead is dead...Coma is NOT dead. call me crazy, which i may well be, but i see a clear delineation between being clinically dead with NO heartbeat and any other situation where you still have a heartbeat.

that means the parts are still fresh...even better precious organs. think of all the poor kiddies dying as those juicy plump organs are just sitting there. The Moral Authority will judge when the odds of saving lives are greater than coma patients waking up...then at that point, those coma patients will become despicable...

(I wasn't arguing for this by the way...)
posted by stifford at 9:21 PM on February 22, 2003

You assumption that someone was condemned is a gross overstatement, considering that there is a greater than 50% chance that if this girl had not received the organs, no one would have.

The fact that there even was a second set of organs available for her seems to make that statistic suspect, at least to me...where did that second set come from, and who was next on the list, and who is, right now, waiting for any of those organs? If the doctors at Duke had to wait for an O-positive person to die to fix their mistake, that doesn't take away from the fact that there was an A blood type person on the list who didn't get the organs they could have, along with whichever O positive people on the list right below her.
posted by amberglow at 9:25 PM on February 22, 2003

Scum? Worthless? Awee bit over-the-top, innit?

Looks like someone had an extra-large bowl of Bitch-Flakes this morning. . .
posted by bwg at 9:29 PM on February 22, 2003

Would the Duke U's prestigious Medical Dept have liked to have this blemish on their record for all of time? Fuck no. Duke University would always have that inauspicious astrix next to their name.

As some say:

They got errrr done. They secured her replacement organs extra-ligitimately.

As a prestigious institution you can fuck things up just as easily as you can attempt to make things right when you do fuck up. You lean on those who pull the strings. Hopefully you can save your reputation by doing it. That's how I imagine it went at least.
posted by crasspastor at 9:35 PM on February 22, 2003

amberglow: Again, my problem is with statements of certainty on this with regard to transplants, and how people here are deriving implications of moral culpability of the parents based on false statements of certainty. (My problem is with a certain type of statement; I like to call it blanket.)

You don't know that there was an A blood type person on the waiting list, or an O positive person on the list. In fact, that Jesica got the second set of organs would more likely indicate that (taking into consideration where the organs might have come from, since transportation time is a big factor in whether organs can be used for transplant; and the compatibility of the organs, itself a huge and complex factor in whether the organs can be used in the first place) for the second set of organs, Jesica was either on a short list, or the rating of her need for the organs exceeded that of others on the list. This is because the policies in place for transplant have no room for public relations or political factors in deciding who gets organs.

All I'm saying is that it's fine to go ahead and say that others might have had a chance to receive these organs (if you're going to go the route that Jesica somehow didn't deserve the chance that they might have helped her); however, there is a bit difference between saying someone else had a chance to live and saying that someone else definitely died as a result of the way these organs were used. There are too many other factors involved, and the unfair statement of certainty gives this case a false slant.
posted by troybob at 9:40 PM on February 22, 2003

Fezboy!: in short, he just pooped out a bunch of racist vitriol. you may call him a dick.
posted by Ignatius J. Reilly at 9:53 PM on February 22, 2003

fuck this shit. everyone's fucking wrong.

/me throws water on the frothing gangsters
posted by oog at 10:05 PM on February 22, 2003

God, but this ROU_Xenophobe has a streak of self-righteousness more strident than MattD's.

Organ donation is black and white... Other people can use them

Black and white? You're so cocksure you know so much about human beings and their needs, that you can just rule out as illegitimate anything that gets in the way of harvesting an organ.

You know, the idea that the Organ Harvesting Team has a right to seize corpses without the consent of relatives and communities is a pretty narrow-minded kind of morality. Human beings often navigate their passage through life by reference to the pole-star of death; consequently, the load of cultural value (value for living our lives as human beings in cultures with some kind of hope for meaning) borne by human rituals at death is immensely heavy.

If, for you (a self-proclaimed "Offensive Unit"?), the only human value worth professing is life for the living and (as Heraclitus first said) to throw out the dead like dung, that's fine. But it's damn arrogant to want to enforce it on the other 6 billion of us. (A) The evolved positive value of organ donation, and (B) the right to refuse this, the fact that it is voluntary: these are two branches from the same tree, so hack away at your own peril.

yonderboy was right to invoke the word "privacy," and in fact the value of privacy - of personal integrity of life for the living - is deeply violated if we dictate the processing of a corpse as if the rights and interests of the personality that animated it have passed into oblivion. Even leaving aside the values according to which I and my loved ones may live, I have disposition of my body. Any legal process (the one you propose, ROU_Xenophobe) that could only be thwarted by sabotaging my own body while alive is self-evidently a violation of my integrity as a willing creature endowed with the right to make sense out of my own life and death.

The name suits you well, Xenophobe, because every alternative human morality has been excluded from your ken that doesn't fit into your enlightened dictatorship of the General Good as narrowly seen by you.
posted by Zurishaddai at 10:15 PM on February 22, 2003

MattD: Part of what made it so difficult to accept your post and comments is that you based them on a single quote from a single report. I couldn't find confirmation in any other report. Even in follow-up the Post didn't report the family refusing donation.
posted by ?! at 10:21 PM on February 22, 2003

"Being allowed the benefits of the US health system -- something that few of us would be allowed in a nation we were visting without papers -- was not least among the "much" they were given, together of course with two sets of organ transplants."

If you bought this as an argument I ask: How can you claim a high moral ground for the US and regulate all non-Americans to second-class status?

I would sneak my way into any country. I would tug every heartstring. I would break any regulation. I would commit certain crimes. I would do any and all of those things to save my child's life. What kind of parent would do less? How could you blame the family for what they did?
posted by ?! at 10:28 PM on February 22, 2003

/me throws water on the frothing gangsters

Thanks, oog. Man, I've never been happier to miss a discussion; how many different people with contrasting attitudes can I disagree with at one time? The "you can have my organs when you pry them from my cold, dead body, and maybe not even then" crowd are just fucking nuts, as is y6 with his "I'll let others die out of my Spite for ROU_Xenophobe", and MattD obscured and interesting point with an INSANE racist screed that revealed so much more about the poster than it did about the issue. Fuck, people.
posted by jonson at 10:30 PM on February 22, 2003

Don't forget, it was the hospital's decision to choose when to remove life support [...]

There have been several statements like this by various people. To clarify: it wasn't really the hospital's decision. The girl had brain death. 'Brain death' is death, legally. (It's not the same thing as the 'chronic vegetative state' that exists in patients who are unconscious, on ventilators, for years, such as Karen Quinlan.)

The patient who has brain death must be removed from 'life support' (the term becomes meaningless) promptly, or the hospital can be sued for abuse of corpse.

Seriously.
posted by Slithy_Tove at 10:30 PM on February 22, 2003

Did anyone read the articles?

The family wanted a SECOND OPINION. They wanted to be sure of their daughter's brain death. Their daughter was removed from life support without their permission.

Of course, they didn't donate her organs, they were waiting for another doctor to concur with the first doctor. You know the doctor that fouled up on the first transplant.

Would anyone here have allowed that doctor to make any decisions for their child, after he had already transplanted one set of WRONG organs?
posted by SuzySmith at 10:37 PM on February 22, 2003

It sounds like the family did not want to take her off life support until they could get a second opinion. For some strange reason, they didn' t trust the staff that had already botched the earlier transplant.
Of course, the fact they were illegal "mudpeople" renders this moot.

http://www.cbsnews.com/stories/2003/02/18/health/main540907.shtml
"An attorney for the family, Kurt Dixon, had said hours earlier that the Santillan's had wanted to keep Jesica alive and get another, outside opinion on her chances of recovery, but that permission to do so had been denied by hospital officials. "

"Strassman reports that, before Jesica died, the hospital asked the family if they would like to redonate her heart and lungs. The family refused."
posted by 2sheets at 10:40 PM on February 22, 2003

Ah, I see you read the article Suzy :)
posted by 2sheets at 10:41 PM on February 22, 2003

This post will henceforth be the hallmark for how NOT to post to MetaFilter. But hey, 'got lotsa comments so it musta been a great post, huh?

(kudos to those who actually read the article and responded appropriately)
posted by Wulfgar! at 10:47 PM on February 22, 2003

To raise a third to what Suzy and 2sheets said, that is the impression that I get from the news coverage. The surgeons involved botched one transplant. Most of her major organs were already severely weakened. The family was wanting a second opinion organ harvesting kills any option for a postmortem for any legal case.

Does this mean that the family made the best ethical decision? Not necessarily. But it is an understandable one given that they appear to have been railroaded.

I also see it as an issue of balancing patient rights vs. altruism. While I see a big need to encourage altruism, at all times I think that it is important to respect the rights of patients to make their own decisions.
posted by KirkJobSluder at 11:02 PM on February 22, 2003

I have not had time to read all of the posts, and the front page link has evidently changed, so that there is no mention of organ donation in the original link that I followed; here is my take on the situation:

I have worked with transplant surgeons enough to have a good idea of what constitutes an appropriate donor; additionally, we had this discussion regarding my father when he died in 1998. Other than (possibly) bone, there is no organ that this young lady could have donated under current criteria. She had been critically ill for some time and had probably gotten numerous blood transfusions, making tissue typing more difficult as well as increasing the recipients' exposure to infectious disease. Her organs had also been in a critically ill body for some time, getting less viable by the hour. It is inconcieveable to me that the hospital would even consider using her heart and lungs for another patient: certain death would result.

It is a reasonable question to ask why an immigrant can get state of the art medical care when so many native citizens go without, but there are more diplomatic ways to address it.

The surgery was not botched, regardless of what the media says. I have heard nothing of post-op bleeding or infection that would indicate a problem with surgical technique. What was botched was the administrative end of things; as anyone involved in transfusion medicine will tell you, the biggest risk from blood transfusion is clerical error. That is the only reason I have seen patients get mismatched blood in my experience.
posted by TedW at 11:07 PM on February 22, 2003

I'm typically better at restraining myself from joining a stoning, but what a vile post. Talk about reflecting poorly on the community.
posted by blissbat at 11:23 PM on February 22, 2003

Organ donation is black and white... Other people can use them

Black and white? You're so cocksure you know so much about human beings and their needs,

I'm pretty certain that live human beings have need of organs, and that dead ones don't. Ergo, everyone should be an organ donor. This really does seem cut-and-dried to me. Life and healing are good things, and if their elements can be procured at no tangible cost to anyone, they ought to be.

Human beings often navigate their passage through life by reference to the pole-star of death; consequently, the load of cultural value (value for living our lives as human beings in cultures with some kind of hope for meaning) borne by human rituals at death is immensely heavy.

Sure. And to the extent that their human rituals at death harm actual living no-shit human beings, I condemn them.

If I were God-Emperor of Earth, would I actually make it mandatory? No; the idea of y6y6y6 actually leaving people to die and suffer just irritated me beyond good behavior. I might call people who don't donate their organs nasty names, though, and I certainly think less of them in real life.

If, for you (a self-proclaimed "Offensive Unit"?)

The demilitarized Rapid Offensive Unit Xenophobe is a character in Use of Weapons by Iain M. Banks, that's all (even if technically it's a Very Fast Picket). I like Xeny; it's a smartass.
posted by ROU_Xenophobe at 11:24 PM on February 22, 2003

Okay ROU_Xenophobe here's how I see things.

We can think of the organs of a dead person as luxury items to that person while he's alive and to his loved ones after he's passed on. I say luxury because it provides some value (probably something like peace of mind), but is not necessary in the purest sense of the word. On the other hand, organs from the dead can be life saving tools to people who need them.

You're saying that in every case the organs should be transferred, the luxury item given up, so that someone may live. How many luxury items do you have? How many do we all have? If we traded them in, how many lives could we save? How many people are starving to death at this very moment that we will not help because we don't want to give up our luxury items. A lot.

Now I agree with organ donation. I plan on being a donor myself. But to suggest that people should be forced to give up their luxuries (I think we can agree that in many cases the organs are achieving some value right where they are) for the lives of others would require quite a shift in the western way of doing things.

Writing this out has made me realize that I need to give more to charity.
posted by ODiV at 11:24 PM on February 22, 2003

I'd just like to poke my head in and note that as of six days from now, the enforcement duties of the INS will be handed over to the DHS. So it'll be Tom Ridge's Directorate of Border and Transportation Security paddywagon, not Ashcroft's. Have a nice day.
posted by aaron at 11:28 PM on February 22, 2003

Oddly though, I've never heard the objection mentioned in the case of a transplant, only in the case of a donation.

Probably because it's not newsworthy.

The major religious denomination in the US that objects to organ donation is the Jehovah's Witnesses, and they only really object to blood transfusion. But many of them do refuse that, and some die because of it.

This has really been a deeply ugly thread, hasn't it? This was about the only worthwhile post.
posted by Slithy_Tove at 11:28 PM on February 22, 2003

At very long last, a voice of reason calls out from the black hole that is this thread. And is promptly ignored. Thanks for trying, TedW.
posted by hippugeek at 11:31 PM on February 22, 2003

ROU_Xenophobe: unlike mr. d, i don't think most people disagree with your logic, just that you want to force it on everyone else. of course, rationally, we should all donate organs after we die to help save lives. but hearing of the unnuanced world that you inhabit makes me long for a time before i knew that spagettios were shite.
posted by Ignatius J. Reilly at 11:33 PM on February 22, 2003

Well, someone sure touched a nerve.

It's sad that she's dead. That really sucks.

I don't care if her parents eat American flags, fart The Star Spangled Banner and shit apple pie--refusing to donate their daughter's organs so some good could come from this tragedy is 100% fucked up and wrong, given the circumstances. They should be shot and harvested on the spot.

And if their religious beliefs proscribe against organ donation ... what the fuck were they doing with four lungs and two hearts "extra"?

This whole thing is sad.
posted by KiloHeavy at 11:33 PM on February 22, 2003

The patient who has brain death must be removed from 'life support' (the term becomes meaningless) promptly, or the hospital can be sued for abuse of corpse.

Seriously.

You are exactly right, Slithy tove. My only question is why (if we can believe the news reports that I already find questionable) the hospital didn't allow a second opinion on brain death (it can be tricky to diagnose), if for no other reason than to make the family more accepting of the situation.
posted by TedW at 11:34 PM on February 22, 2003

In general organs are not recycled multiple times due to technical factors that make this almost impossible from a surgical point of view. Organs are not implanted in the same way they grow normally, thus removing them after they have been transplanted does not result in an organ that can be transplanted again. However, organ transplant recipients can donate other organs -- a heart recipient could donate kidneys and liver, etc.

How many times can the same organ be transplanted?
posted by LimePi at 11:40 PM on February 22, 2003

Maybe it's because they JUST lost a child, on top of everything else they've gone through, plus their distrust of Duke. Not just a lack of sympathy but empathy as well, do you own any pets?

They'd been going through this for years though; they were intimate with the trials of waiting for organs. It's incredible to me that parents who had been through that would have so little sympathy or empathy for all the other families going through the same thing. Even if an error contributed to her dying now, they had to be aware that she had a very high chance of dying soon. I can't believe they hadn't already committed to donating anything salvagable. From a utilitarian standpoint, of course everyone should donate their organs, but even from a wider, more emotional ethical system, people who have received should feel intuitively compelled to give back, when they're in the position to do so.

and nice post, Biscotti.
posted by mdn at 11:44 PM on February 22, 2003

First and foremost, I think it's important to remember that the hospital asked them to donate the organs BEFORE Jessica was "declared" brain dead. The parents wanted a second opinon about her condition, and rather than allowing that to happen, the hospital unplugged her life support.

That being said...this is possibly the worst front page post I've ever seen on MeFi. It's racist, it's inflammatory, it's jingoistic, and it's a troll of the utmost caliber.
posted by dejah420 at 11:48 PM on February 22, 2003

Ugly doesn't begin to describe it, Slithy.

The crux of living an ethical life is in the accepting that there are occasions that will never make for neat parables with which to guide our childrens' evolution. This is obviously one such occasion.

MattD took what *may in the abstract* have been a tenable position, and poisoned it so utterly with baseless hatred and contempt that any moral authority he may wanted to have invoke had surely long ago fled the scene.

I see, and even partially agree with, some of the logic he uses to construct his odious position. He says he wishes only to reinscribe ethical integrity. But of what use is being coldly and "ethically" correct, when such correctness leads you to a position of such heartlessness and cruelty? Fine, here's your corneas: enjoy 'em.

Doesn't it say, somewhere in your Bible, "what profit it a man if he gain the whole world, and lose his soul?" Or words to the effect?
posted by adamgreenfield at 11:51 PM on February 22, 2003

Here's CNN's version of the story, minus the refusal part.

I fail to see how disdain for illegal immigration translates to "racism", but maybe that's just me.
posted by hama7 at 11:52 PM on February 22, 2003

unlike mr. d, i don't think most people disagree with your logic, just that you want to force it on everyone else. of course, rationally, we should all donate organs after we die to help save lives

Well, as I noted, I don't actually think it should be made mandatory, [joke] except maybe for y6y6y6 [/joke].

Better statement of what I think: it is a moral duty incumbent upon everyone to donate their organs or those for whom they're allowed to make that decision. Not doing so is always wrong.

but hearing of the unnuanced world that you inhabit makes me long for a time before i knew that spagettios were shite.

Not donating organs results in harm -- death, or the extension of horrific pain, or blindness -- to real people and provides no tangible benefit to anyone. It's one thing to talk about nuanced morality when it's piddly shit like illegally entering the US to seek treatment (something I have little trouble with beyond it rubbing me vaguely the wrong way), but no amount of nuance will cause the dead to rise or grow skin on a burn victim.
posted by ROU_Xenophobe at 11:56 PM on February 22, 2003

The family was unaware life support was being turned off until it was happening, if not after it had already happened. These people were hysterical. Heartbroken. They did not understand the language being used; they did not understand what was going on around them. I still have not found a definitive answer, but I believe their requests for a second opinion went ignored – after the hospital fucked up the first time around, wouldn’t YOU want to be sure too?

So it sounds as though they had not been made to understand that she was truly gone and despite that, suddenly the plug is pulled. For the moment I am convinced that these poor, scared, hurt people were not even sure that their daughter was dead.

Read a few more articles online. Watch the news. That little tidbit linked in the FPP says nothing. There were various people around them "helping" including a self-declared godfather and benefactor, and at least one lawyer offering advice. Most likely any lawyer would suggest that they not have the organs harvested and in this situation, who else can they trust? Not the hospital obviously. I do not know about this case, but in my experience they ask about organ donation before death. If they were not convinced that their daughter was dead or just wanted that second opinion so for the rest of their lives they could be sure, I doubt they would be all anxious to offer up her organs.

CNN or one of those news channels said the heart and lungs were unusable and after considerable time on the machines (which is being blamed for her brain swelling and subsequent brain death) her kidneys and other organs might have also been damaged and possibly unusable (repeating what I heard here, not commenting based on personal medical knowledge).

But this thread…man. A girl dies and what do we get from it – a discussion about what went wrong, a discussion praising those that did try to help, anything positive or potentially useful? Nah, we get suggestions that the grieving parents should die and the like.

This has been a very telling thread and although I have no interest in sinking to the personal level of some or bothering to even respond directly to venom without purpose, I will say that my Metafilter mental-killfilter just grew a little bit and threads like this remind me why I am so loathe to join in on any of these lovely sweet discussions. I mean hell, the partisan bickering and back and forth hand jobs are just swell, but this hate, this consuming atrocious hate. Wow.
posted by bargle at 12:01 AM on February 23, 2003

msnbc weighs in with more.

''Relatives have said her family paid a smuggler to bring them from their small town near Guadalajara, Mexico, to the United States so she could get medical care"
posted by hama7 at 12:01 AM on February 23, 2003

Also,

YOU THINK WHEN I DIE MY ORGANS STOP BEING MY PROPERTY? YOU STUPID BASTARDS WILL NOT KEEP ME DEAD!

If I decide that I want to be frozen, I think I might need those organs. Further, if people can be frozen there needs to be some consideration for them as still existing in that state, and therefore all that is of them is for them and them alone.

SO STAY THE HELL AWAY FROM MY ORGANS!

I feel better now. Carry on.
posted by bargle at 12:02 AM on February 23, 2003

there is no organ that this young lady could have donated under current criteria.

Corneas are acceptable under nearly all conditions. See here (Australian site, but criteria are comparable). They could probably have donated her corneas. At very least, whether the organs could have been used or not, I feel they should have offered.

It does not appear at all that the hospital unplugged her life support before a second opinion was given, read the timeline linked above. At 7am they did a neuro exam and found no brain activity, six hours later a second exam was done and she was declared dead. She was also left on life support for four full hours thereafter to allow the family time to say goodbye. Her official time of death was 1:25 and she wasn't removed from the ventilator until 5:10. No matter what your opinion of the hospital, or how much you believe that they're some evil entity trying to kill this girl, you'd have to think they were ridiculously stupid not to take immense care with this part of the whole thing. Also, bear in mind that the actions of the family "spokesperson" seem geared toward a lawsuit, and therefore will be unequivocally negative (note: I am in no way saying that the family doesn't deserve compensation, they most definitely do, but there certainly seem to be some manipulations going on on both sides, as one would expect, and one should take anything said on either side with a grain of salt).
posted by biscotti at 12:02 AM on February 23, 2003

(...)refusing to donate their daughter's organs so some good could come from this tragedy is 100% fucked up and wrong, given the circumstances. They should be shot and harvested on the spot.
???
Holy mother of fuck. This thread contains some of most horrible, dim-witted, mean behaviour I have ever read. It is just plain ugly. Despicable is too nice a word for the grotesque morality on exhibit here.
posted by Fabulon7 at 12:05 AM on February 23, 2003

wow.

I mean...wow.

I've seen a lot of thing on mefi over the years, but man, this...wow.

This thread takes the cake.
posted by Hackworth at 12:06 AM on February 23, 2003

Foxnews.

Available in many news places.
posted by hama7 at 12:07 AM on February 23, 2003

Wow. Moral Certainty needs a new PR firm.
posted by Opus Dark at 12:11 AM on February 23, 2003

I won't bother writing a long drawn out analysis of my viewpoint on this since it's already been done 16 ways to Sunday by 2 dozen others, often on opposing sides.

The only thing I want to point out is that it was not due to a failure or inability or negligence of the surgeon. It was a mislabeled organ. Telling the blood type is not something the surgeon could have done by observation.

It is exactly as if they gave her a blood transfusion with a blood bag that was labeled wrong. You cannot discern blood type by observation.

It is not the surgeon's fault. The same surgeon performed the 2nd surgery, so they obviously were comfortable with him and his abilities.

According to the reports on CNN, three different physicians reviewed the organs, and yet somehow it still got messed up. This basically falls under "the world is not perfect". Mistakes happen. It's very unfortunate that they do.
posted by Ynoxas at 12:15 AM on February 23, 2003

They'd been going through this for years though; they were intimate with the trials of waiting for organs.

This is an extremely good point. The families of those with congenital heart defects live with the possibility of death from the moment of diagnosis (which is sometimes even before birth). These are not people who found out three weeks ago that their daughter needed a transplant, and they should not have had any illusions about the chances of success. They have probably already been through more than one surgery (many heart defects are treated with progressive surgeries as the child grows, to keep the child as healthy as possible until they can be transplanted), any and all of which are life-threatening. They probably also (if my experience is anything to go by) knew many other families in similar situations, and saw first-hand the ups and terrible downs of living with a condition like this, the hoping for a transplant, the guilt mixed with joy when one arrives, the trepidation of watching for rejection. Most families with a child this ill cherish every day, have a pretty solid idea of how serious things are, and look upon organ donation as the greatest, most generous gift possible, one which they fervently wish to repay someday.
posted by biscotti at 12:17 AM on February 23, 2003

I fail to see how disdain for illegal immigration translates to "racism", but maybe that's just me.

I fail to see how starting a thread with a comment about the outright glee you would express at hearing about someone being arrested and deported in chains as a "benefit" of the Patriot Act out of contempt for someone who had, even if incorrect, at the very minimum a valid argument for dismay about the medical treatment of their now-deceased teenage daughter translates to "disdain."

I agree with dejah and others. This is the most horrible thing ever posted. It frightens me because I don't think it was a troll; I think it was a legitimate attempt to get a "me too" onslaught going against illegal immigrants, medical malpractice lawsuits, and victim-blaming that would make Libertarian-minded pundits like Bill O'Reilly orgasm live on his own show.
posted by XQUZYPHYR at 12:21 AM on February 23, 2003

'Relatives have said her family paid a smuggler to bring them from their small town near Guadalajara, Mexico, to the United States so she could get medical care"
posted by hama7 at 12:01 AM PST on February 23

kudos to them. if their great grandparents were on the other side of the european/american contact genocide gap wouldn't you call that gumption, or "good-ol' american know how"? really, guys, isn't all of this manifest destiny god bless america nonsense a little passe? we're supposed to be focusing on hating terrorists now! will someone think of the children?

if nothing else, you can bash immigrants all you want (as a member of _______ native american tribe, that is your right), but you ought to be aware that the meidcal community will continue to not give a shit. medical school prepares one to operate on human beings, irrespective of nationality, though i'm sure that american stretchers and beds have extra shock support for our ample imperial hind quarters.
posted by Ignatius J. Reilly at 12:23 AM on February 23, 2003

So the parents of a 17 year old girl that died because of inexcusable, entirely preventable negligence are asked to let doctors harvest that same girl's organs before the parents are convinced that she's dead.

They say, in effect, "No, we want a second opinion."

In response, the hospital cuts the medication that's keeping her heart beating without consulting with the parents - the same parents that just watched their daughter get fucked over by that same hospital.

And then mattd and rou_xenophope weigh in with hateful little rants about the 'morality' of their actions.

Well, I've got news for you - 'morality' is what you make it, it sure isn't the same for everybody, and you guys need a barb-wire enema posthaste. Your sickening little diatribes about how these parents somehow owe something to anybody after their daughter was killed make me want to vomit.

When your child dies in front of you because somebody made a stupid mistake, then you get to judge others in the same situation. Otherwise, STFU.
posted by Dipsomaniac at 12:24 AM on February 23, 2003

I don't think its fair to condemn the parents here for the decision that they made. It was afterall "their" decision. My personal beliefs in "choice" extend to this situation. I do however feel that if you are going to be on the waiting list for a donated organ, one requirement should be that you "opt in" to the program....meaning you believe in organ donation, therefore if there is ever anything that you yourself can donate to alleviate the suffering of another then so be it...take them.

If you do not believe in donating your own organs, then do not partake of someone else's ultimate act of generosity. This is not to say you should not be allowed on a list if you never agreed to donate prior to your own personal need, only that at that point should you if not willingly, be required to do so.

This in hopes that even if you never get the opportunity to reciprocate the gift, you will encourage family members, friends, acquaintances, whomever to do likewise. If it is against your religion, or just not something you are morally willing to do yourself, then you should not expect someone else to save your life or eliminate your suffering. I think more people would be willing to donate their organs if that meant they would be given the opportunity should they themselves need it. In other words instead of asking people to donate their organs, they should be asking people to volunteer for the Organ Transplant Program. This puts an entirely different political spin on the whole concept even if it is only a psychological panacea.
posted by SweetIceT at 12:27 AM on February 23, 2003

At this point we don't know for sure exactly what happened, or when, so all we can do is speculate. But one thing we can be fairly certain about is that there were surely lawyers swarming all over the scene. As a couple of people have pointed out, it is unlikely that the family were operating in a vacuum, and it may be that they were advised against donation. Just as it may be possible that Duke lawyers advised mentioning a "refusal to donate" in an official statement.
posted by taz at 12:32 AM on February 23, 2003

A slight correction Slithy_Tove: Jehovah's Witnesses do not object to organ donation or transplantation. Scroll down to the last paragraph under the heading Witness Position on Therapy.

Other than that, I'm staying out of this thread. This is ugly and sad.
posted by Tacodog at 12:37 AM on February 23, 2003

These hate filled comments surrounding the death of a young human show eloquently the foul fruit of looking at the world, as so many do, as "us" and "them".

That people here could actually memorialize this sad death by declaring open season on immigrants is absolutely despicable.

Really. You with such hearts....why not just barge into any local community clinic, ask all the brown-skinned kids for "their papers", and kick immigrant children out of the line for immunizations. I guess we can all thank our lucky stars that Native Americans don't control health resources. I mean, we immingrants would sure be shit out of luck.
posted by fold_and_mutilate at 12:52 AM on February 23, 2003

When your child dies in front of you because somebody made a stupid mistake, then you get to judge others in the same situation. Otherwise, STFU.

I, like many if not most physicians, have seen people die because I made a stupid mistake. May I comment?
posted by TedW at 12:52 AM on February 23, 2003

I find myself hoping that a permalink to this thread is handy for years to come as MattD remains "active in Republican politics." Evil should be its own reward.
posted by anser at 1:02 AM on February 23, 2003

I feel sick.
posted by lazaruslong at 1:30 AM on February 23, 2003

WTF is wrong with you people?

These people clearly did the wrong thing. They, more than anyone, should be aware of the necessity to donate organs and willing to do so. Their action can be summed up as irreverent. The argument that they are in a critical emotional state is countered by the urgency of organ donation. This decision is always made in a critical emotional state. It should be made beforehand.

Donating your organs is, like said above, black and white. No appeal to "you don't know what it's like" can sway me. The dead person's corpse is useless and void except for one urgent purpose of donation, and refusing to serve it is selfish.

This should have nothing to do with the ethnicity or disposition of the parents. This should have nothing to do with ability to pay for health care or citizenship. This should have nothing to do with us and them, as f&m said. This has everything to do with willing to contribute back to the society that expends its resources on you; very generously, in this case.

Comments alleging that this girl did not deserve the medical resources expended are despicable indeed. Comments deploring the parents for their decision are just.
posted by azazello at 1:30 AM on February 23, 2003

When y'all are done shooting the fish that MattD so nicely placed in a barrel for you, come join us in TedW's far more interesting and thoughtful FPP.
posted by boltman at 1:51 AM on February 23, 2003

The surgeon WAS at fault. He violated set procedure by not double checking the blood type of the first set of organs.

And as for a lot of you here, get off your stinking high horses.
posted by konolia at 3:45 AM on February 23, 2003

The surgeon WAS at fault. He violated set procedure by not double checking the blood type of the first set of organs.

Konolia, what is your basis for saying this? My underssanding of the problem was that all of the documentation on the first set of organs was in error, which led to a chain of problems which could not be altered without going outside of procedure. In any case, last time I checked, surgeons perform surgery. They don't do blood type testing or any other lab work. They rely upon other trustworthy and highly trained medical personnel to accurately and appropriately provide that information, and just as surgeons occasionally make mistakes during surgery, those other medical personnel sometimes make mistakes in their parts of the process, too.
posted by Dreama at 4:00 AM on February 23, 2003

The hospital is legally at fault, and was from the time that the mis-typed organs were implanted into the girl's body. That negligent act was the cause of her death. She was extremely likely to die once that had happened. Anything that occurred afterwards, being attempts to save her life, could only reduce the damages, not increase them, and the failure of these measures render them pretty much irrelevant. So the hospital is liable to pay damages to the girl's parents, and there is plenty of precedent of hospitals causing the death of patients under their care to establish a dollar amount. If the hospital actually tries to defend a lawsuit I would be amazed. Their legal division has probably drafted a settlement offer already.

Yes, a hospital is liable for its negligent error causing the death of a patient in its care. Doesn't matter who the patient is or why the operation was being done or who paid for it. I expect the hospital is backed up financially by the state government, and the costs will be spread out among the taxpayers of that state. Feel free to pump your tiny fists in the air and curse the human suffering that takes a whole 20c out of your pocket to compensate.

Now regarding the organ issue, we have one unsubstantiated report that suggests that Jesica's parents might have refused to, in the event that they were actually asked, donate her own organs on. I find it rather unlikely that they were asked. Organ donation programs need organs from healthy donors. After a lifetime of living with a severe heart and lung deformity, the rest of her organs are probably not in great shape. The organs that hospitals can extract even from the corpses of elderly or severely disabled people and still use are in plentiful supply, it's the tissue typing that's the major issue there, and we've not been told that Jesica had/has a rare tissue type. The delay with heart and lungs is due to the fact that people rarely die with a healthy set of them.

Secondly, the donation of the organs of a patient undergoing life-risking surgery, or even general anaesthetic, is a question hospitals routinely raise before the operation. I would be very surprised if this wasn't covered on a standard form already. If for no other reason, this means the question would be asked at a time when the patient is alive and her relatives are hopeful of success.

Assume, though, that the hospital staff did have the chutzpah to ask Jesica's parents if they could help themselves while the body's still warm, and they refused. That would be ingratitude, yes, but the wrongness of ingratitude, like all other slights, depends on its circumstances, and it depends who's asking for what kind of favor.
posted by aeschenkarnos at 5:02 AM on February 23, 2003

I take it matt is going to do something about this.
seeing as he was going to ban me for using a swear word against skot i'm sure he will be quite happy to take some form of action on the sick f##ks in this thread .
(sorry would've sworn there but i'll get banned)
posted by sgt.serenity at 6:05 AM on February 23, 2003

I wonder if Certain Individuals would insist on being rotten had the girl survived.
posted by mcsweetie at 6:35 AM on February 23, 2003

I found this to be a tragic story from the beginning. When I heard about the girl's initial plight, I thought there was no way for her to survive. You hear about the difficulty of getting organs all the time. Seemingly out of nowhere, she gets a correct set.

Imagine having her blood type and needing a transplant and hearing about this. Imagine doing the research on how likely her chances were of surviving the procedure in the first place. (50/50 odds were bandied about early on)

Would you be bitter that doctors fell over themselves trying to erase a mistake which cost a human life by making sure she had a nice set of innards to decompose inside her body?
posted by Busithoth at 6:44 AM on February 23, 2003

This is like some ethically ambiguous test question they'd give a D.Phil. on their final exam. Illegal immigrant, multiple organ donations, doctor mistake, hospital mistake, more organ donations... just wow.

The immigration status is irrelevant because of the 5% policy. Liberal as I may be, I still believe that the citizens of a country get preference to non-citizens when it comes to the distribution of its limited resources. The idea of a hospital offering a percentage of its work to non-citizens is an altruistic way of dealing with the inherit inequalities in the world that I can live with. Yes, we should have some compassion for the citizens of other countries who are less advantaged, but as long as we're living inside nations and not some unified world order, citizens get the bulk of our resources.

Now, when the hospital screws up a patient's organ transplant, does the patient get to jump the list of others who are waiting and get offered a do-over? I think not. The doctors and hospital screwed up, and they are culpable for thier mistakes, but they should not compound them by potentially taking the life of someone who is, by rights, next in line. If the doctors had botched the operation and the organs been the right blood type, would the patient still be entitled to another chance with fresh organs? I always saw the organ donor program as waiting in line for a chance at survival. But the key word is chance -- results are not guarranteed.

And the final issue: should the parents offer their child for organ donorship? As a few people have elluded to, their grief is inconsequential to the ethical question. Watching your child die because a doctor screwed up is terrible. I imagine it would not be any less terrible than watching your child die from an automobile accident. The awful irony makes no difference ethically.

The answer has to go two ways. Ethically, you are under no obligation to donate your organs. The fact that someone, somewhere, may die if they are not the recipients of your benevolance does not make you responsible for them or their lives. Some religions require cremation in order for ascension into the "higher plane" -- I'm sure they'd think it monstrous to deny their relatives their place in "heaven" just because you think you've got dibs on Uncle Bob's liver and kidneys. The point is, providing the circumstances of your health have nothing to do with me (that is, providing I am not the reason you are dying), I cannot be held responsible for something that would happen regardless of my existance.

On the other hand, the moral argument is entirely different. Morally, if I'm going to die, or am already dead, and I can help someone to live, I should donate my organs in a final gesture of goodwill to my fellow man, as I would certainly appreciate that kind of benevolance if the situations were reversed.
posted by Civil_Disobedient at 6:44 AM on February 23, 2003

This thread takes the cake.

It sure takes something.
posted by adampsyche at 6:50 AM on February 23, 2003

I have opinions about the topics and issues raised in this thread, but I can honestly say that nothing about this case makes me feel quite as nauseous as watching the progression of this thread. Yeah, I'm one of those MeFi "oldtimers" who laments on occasion the degenerating quality of our discourse, but I can leave now secure in the knowledge that there's not much lower you people can sink.

Yes, MattD's contentious tone started us off, but it's been all down hill from that point on. Like somebody above, I too hope this thread remains permalinked: because it marks the day I completely lost respect for "the MetaFilter community." Good God but you are a bunch sanctimonious assholes and I'm ashamed to admit I've been one of you. Nothing about the original post or anything else MattD subsequently said warrants this kind of juvenile, river sludge "fuck you fuck you no fuck you" responses I see here. Christ on a crutch, people, grow the fuck up.

Maybe Laurie Garrett was right about you all along...
posted by JollyWanker at 6:56 AM on February 23, 2003

I'm just curious; Who's Laurie Garrett and what did she say?
posted by wsg at 7:03 AM on February 23, 2003

Nothing about the original post or anything else MattD subsequently said warrants this...

Actually, MattD's posting set the tone for the responses here. He complicated an already-controversial topic by throwing in a crude emotional appeal to a viewpoint rooted in bias; of course people were going to respond to that, and some were going to respond in the same way.

I'm more bothered by the rise of the Metafilter HallMonitors(TM) who come in to clean up afterward, bemoaning the "degenerating quality of our discourse." There was crap all through this thread, and there was also legitimate debate over the facts of this case, its implications, and many shades of controversy. I find it very worthwhile to know that there are people who believe that medicine practiced in the US should put citizens first. I think it is very useful to hear from people who operate with a degree of moral certainty that does not allow for consideration of real-life situations. I find it very interesting that there are people who get so emotional over their position that they go into attack mode. Even the most hate-filled posts tell us something about the world we are living in and how people adopt positions they can't even begin to defend or explain.

I've always seen Metafilter as an online conversation. Despite what you've seen on TV, conversations are not pretty and are not neatly wrapped. They are messy, contain rash generalizations and loose ends, and get emotional. Perhaps we can move beyond our utopian vision of Metafilter to allow the conversations to proceed somewhat organically and derive some knowledge of the world around us from the nature as well as content of those conversations. It is the essence of meta.
posted by troybob at 7:34 AM on February 23, 2003

She's a journalist who's won all three major journalism awards -- the Peabody, the Polk and the Pulitzer. She writes a lot about infectious diseases such as Ebola and AIDS, and how we're currently witnessing the destruction of entire cultures due to disease. She said something about us being "food for viruses". And she's said stuff about antibiotic-proof diseases being bad.

I'm not exactly sure how that relates, however.
posted by Civil_Disobedient at 7:36 AM on February 23, 2003

Not that anyone will wade through this thread to get this far.... Everyone makes mistakes. Period. Finger pointing and judging is a complete waste of energy. Better used to foster movement away from our own preconceptions and prejudice worldwide. All we really have is each other.
posted by yoga at 7:49 AM on February 23, 2003

One thing I learned about the world from the progression of this conversation:

Society's view of organ donation is much stronger than I expected. Something once encouraged as a personal voluntary choice is now viewed as a strong moral obligation. I did not know this. It recalls the debates about organ donation from its earliest days, when supporters insisted that organ donation would always be voluntary and that no one would ever be forced into it; this could turn out to be false, particularly when so many people are ready to make it legally mandatory. This case highlights another point of contention from the earliest debates: the politicization of the organ transplant process.

Could the next steps fall in line with the early criticism as well? Could we be moving to a point where we decide that living people must donate organs/blood without having a choice? Could we be moving to the point of deciding that some people (or countries) are so worthy of organs that we can justify killing our "undesirables" (or foreigners) to get them?
posted by troybob at 7:50 AM on February 23, 2003

Here's what Laurie Garrett said. But you have to read some more of the thread to know what she referring to.
posted by wsg at 7:58 AM on February 23, 2003

Who'd have thought it? I'm now a convert to human vivisection. With the poster as the first subject.
posted by riviera at 8:47 AM on February 23, 2003

"Nothing about the original post or anything else MattD subsequently said warrants this kind of juvenile, river sludge "fuck you fuck you no fuck you" responses I see here."

"Christ on a crutch, people, grow the fuck up."

So, I guess your post doesn't count as a "fuck you" response?
posted by Stauf at 8:53 AM on February 23, 2003

this could turn out to be false, particularly when so many people are ready to make it legally mandatory.

Who are these "so many people"? The original person who mentioned it (ROU_Xenophobe) has since explained that this was a reaction to y6 etc's hostility, and that, while he views the situation as black and white from a moral standpoint (as, I'm sure, do many people, including myself), he wouldn't really want it to be mandatory.

In the rush to attack first and not ask questions later that this thread has been, the number of people who are only interested in the fight, rather than the argument, has been at an all-time high. Bleah.
posted by biscotti at 10:07 AM on February 23, 2003

Wooorst thread evar. To refuse is the height of selfishness. And it's funny, since I'm a mandatory organ donation supporter myself, but Matt makes me cringe. Not merely because he's so evil (like, hey, man, if you feel that people have to give their children's organs, then why do you complain so much about something as minor as paying taxes?) but because you'd think a lawyer would be able to present a logical, dispassionate argument.
posted by anildash at 10:27 AM on February 23, 2003

The surgeon WAS at fault. He violated set procedure by not double checking the blood type of the first set of organs.

Konolia, what is your basis for saying this?

My basis is what has been reported in our local news, as this happened about an hour and a half away from me. The surgeon was supposed to double check these organs for blood type. That was clearly in the protocol. He failed to do so. Yes, there are others who share the blame, but he was the final gatekeeper.
It was recorded that for the second surgery the protocol WAS followed.
posted by konolia at 10:35 AM on February 23, 2003

Could we be moving to the point of deciding that some people (or countries) are so worthy of organs that we can justify killing our "undesirables" (or foreigners) to get them?

Whoa, that's quite a stretch there.

Donation should always stay voluntary; mandatory donation opens numerous avenues for abuse. When there's potential for preferential treatment, the ability to force people to donate may be abused.
posted by azazello at 10:50 AM on February 23, 2003

I find myself hoping that a permalink to this thread is handy for years to come as MattD remains "active in Republican politics." Evil should be its own reward.

A few people have already mirrored it on their sites, so that it's safely archived for all time.
posted by zarah at 11:04 AM on February 23, 2003

A note about declaring someone brain dead, some people don't seem to understand it. A note is written by a physician stating they think the patient is brain dead. It REQUIRES a second physician to come and assess the patient. If they agree with the diagnosis, the 2nd physician writes a note stating brain death. The time of the 2nd note is officially the time of death. The time of death is NOT when they come off the ventilator.
posted by RunsWithBandageScissors at 11:20 AM on February 23, 2003

I would tell those worthless people to their face exactly what I thought of them, without hesitation. We're too damn polite in this society, that we allow such scum to be treated with kid gloves. That thing -- their traumatic loss -- which is adduced in their defense is the very thing which, if they had a single shred of decency en sus cuerpos...

Their (lack of) immigration status matters a great deal, because it makes abundantly clear their absolute lack of personal character...

A bumpy flight to Mexico, shackled to the floor of a Bureau of Prisons plane, rather than a payday at the cost of all of our insurance premiums, seems well deserved.

Nauseating.

But it certainly brings a question to my mind, MattD. You went on quite a tirade about the supposed "morality" and "ethics" exhibited by bereaved parents who just went through medical hell. Perhaps you and the supporters of your own odious philosophies could brief us on the "ethics" and "morality" of you elevating the size of your monthly insurance premium bill in importance over the health of (or justice for) humans just like you -- humans who just happen to be "illegal" immigrants, humans who often contribute in extraordinary ways (including financially) to all we earlier immigrants enjoy.

And I'm just honestly generally curious about folks on "your side" of the political spectrum. How often (if ever) are you advocates for anything, ANYTHING that isn't merely designed to put or keep money in your own pockets? Is that your working definition of "morality"? I mean, one admires you for your consistency, but it's hard to muster much respect for your love of the "bottom-line", an infatuation that appears to drive any passion you may have.

Compassion, charity, brotherhood, sacrifice for the common good. I submit that America is at its finest when we care for human beings in need, even people who dare commit MattD's unspeakable crime of not having the proper paperwork stamped, stapled, and collated over months before bringing their critically ill daughter into the country. I submit that America is at its absolutely despicable worst when some value the compelling moral imperative of their checkbook balance over the values of compassion, charity, brotherhood, and sacrifice for the common good.
posted by fold_and_mutilate at 11:37 AM on February 23, 2003

Translating the Language of Provocation: Globalization, Localization and Compassion.

{flame-bait_angry_FPP_tabloid_headline}

Unmitigated gall.

{/flame-bait_angry_FPP_tabloid_headline}

{temperate_query_FPP_headline}

Pay it Forward?

{/temperate_query_FPP_headline}

{racial/ethnic/jingoistic_personalized_characterization}

The illegal aliens who got two hearts and two lungs for their daughter...{/racial/ethnic/jingoistic_personalized_characterization}

{issue_characterization}

A non-American family who's daughter qualified for the 5% "compassion" group that the US transplant program offers, was transplanted with organs that were inappropriate for her blood type due to a clerical error. Jesica Santillan's body rejected the inappropriate organs, placing her in mortal jeopardy. Although she waited on the list for years for the first transplant, she was re-slated for the second transplant in an extraordinary few weeks. This second transplant operation, however, came concurrent with complications leading to what Duke diagnosed as brain death. She was then removed from life support by the hospital. {/issue_characterization}

{unsbstanciated_assumption_regarding_deceased's_medical/legal_status_at_death_and_survivors'_motives}

REFUSED to have any of her organs donated when it was clear she was brain-dead. {unsubstanciated_assumption_regarding_survivors'_motives_and_deceased's_medical/legal_status_at_death}

{less_judgemental_presentation_of_legal_questions/survivior's_motives_et.al.}

Jesica's parents accepted the advice of their legal counsel, who in speaking for the family said "they would not agree to remove her from life-support until they were allowed to get an outside doctor's opinion on her condition." The university hospital's administrative decision, however, was to remove Jesica from life support, and request harvesting of her organs. News reports currently say that the Santillans, again following advice of legal counsel, refused permission to allow harvesting of any remaining viable tissue or organs from Jesica's brain-dead pronounced body. Aside from the early reports regarding this specific tragedy, this complex and high-profile case leads us to a number of important legal, political, and philosophical questions that should be considered and answered so as to close the gaps apparent in our current policy regarding organ donation and transplant recipient obligations. {less_judgemental_presentation_of_legal_questions/survivior's_motives_et.al.}

{off_topic_vengance}

Should organ recipients be required in most situations and by some convention to repay the great gift of transplantable organs? Should the immigration status of the transplant program's 5% be an issue in cases where a malpractice suit is probable? Should the Patriot Act be invoked to leverage punishments in non-national security situations at any time? Discuss. {/rational_posits}

As both a world and an American citizen, to Jesica's family, the Santillans, I extend my deepest condolences.

To all those involved in her care, from the association that sponsored her treatment, to the doctors and medical workers that fought to save her life, I extend my gratitude for their humanitarian effort.

If ever is required an example of exactly how emotional posturing (from left, right, or wherever) poisons the arena of lively constructive discussion of complex societal issues, this FPP should be preserved and proffered as a prototypical exemplar.
posted by Dunvegan at 11:56 AM on February 23, 2003

Thank you, Dunvegan.
posted by Armitage Shanks at 12:06 PM on February 23, 2003

I just wonder if Duke would have been a little more careful if the girl hadn't been an illegal immigrant.
posted by whirlwind29 at 1:24 PM on February 23, 2003

I had MSNBC on while reading through this thread and at the top of the hour (4 pm Central) they reported that her body was kept intact pending an autopsy since there's apparently civil or criminal action pending... Jesica's organs are 'evidence'. Unless we're going to start involuntarily donating organs from crime victims, that is.

I Am Not A Doctor, but I don't think her internal organs at least would be in healthy shape to be donated, after the shock of two transplants, the toxic anti-rejection drugs, and being in critical condition on life support for an extended period of time. As for skin and corneas, I'm not sure how all that would affect their usage.

For those complaining that Jesica's intital transplant should have gone to someone else... "In Jesica’s case, Duke officials say, transplant coordinators called to offer the heart to two patients. The heart was the wrong size for one, and the other was not medically ready for a transplant. Jesica’s doctor then asked about giving the heart and lungs to Jesica. Although she was not listed on the match run, the transplant coordinator said OK. Neither the coordinator nor the doctor realized that she was not the right blood type — the reason she was not on the computer’s list of possible patients. Officials involved in this case have not said whether there were other patients on the match run who might have received the organs."
posted by SenshiNeko at 2:21 PM on February 23, 2003

Clearly when we start talking about immigrants and the health system, logic goes out of the window.

-- If they paid for the operation, they paid for
-- those organs, and morally they don't
-- have to 'give them back'.

wackybrit, please explain how morals fit into that equation?

If I buy a car, I have no obligation to give it to someone when I don't need it anymore. I can trash it, push it off a cliff, whatever I want. It might not be ethical to do these things, but it's not morally wrong.

If I rent a car, I morally cannot give it away or trash it, I have to give it back to where I got it. Not giving back something that doesn't belong to you is both ethically and morally wrong.

Compare to recycling. There is nothing morally wrong with throwing all of your trash in the regular way. Ethically, however, you should recycle as much as you can.

If these people paid for those organs, they have no moral pressure to give them away to other people. If they didn't pay, they do.

Remember.. ethics are social ideals, morals are effectively the opposite of malum in se's.
posted by wackybrit at 4:03 PM on February 23, 2003

I'm more bothered by the rise of the Metafilter HallMonitors(TM) who come in to clean up afterward, bemoaning the "degenerating quality of our discourse."

Amen. Boy, the end of the thread here seems to be for the holier than the holier than thou's, the sanctimonious assholes so deeply disappointed by all the rest of us sanctimonius assholes. Then I come on to complain about them... Ah, well. Make yourself right by making someone else wrong--the eternal text and subtext. It's so easy to take the moral high ground in one's own mind.

I wish I had not piped up, in retrospect, but the button pushing rhetoric with which this all began guaranteed the outcome. I don't think the post could have possibly been phrased more unpleasantly. It was a rhetorical molotov cocktail.

F&M's comment is so demur in this context.
posted by y2karl at 4:46 PM on February 23, 2003

MattD: Their (lack of) immigration status matters a great deal, because it makes abundantly clear their absolute lack of personal character -- happy to prevail upon a legal and medical system to which they have no entitlement, and then reciprocate by putting a finger in our eyes.

Like many in this conversation, I am troubled at the vitriol you are willing to spout at a family that just lost a child. I am even more troubled at your non-sequitor outburst about illegal immigrants, though.

The family probably should have donated the organs. I think we can all agree on that. But they just went through a very traumatic experience and they might be a little angry at the system right now. And rightfully so.

Let's return to your hatred of the family because of their "illegal immigrant" status.

If you were born in Mexico, and your daughter needed transplant surgery that could only be performed in the United States, would you watch her die? Would your clear code of ethics prevent you from seeking the best care for your own flesh and blood?

I think it's sick that you would say the family has "poor moral character" because they are trying to save their daughter's life. The fact that you zeroed in on their immigration status says more about you than it does about the family.
posted by hipnerd at 10:54 PM on February 23, 2003

I'm not going to read more than the 1/4 of this thread I've already wasted time on, but I did notice that the word "Helms" hasn't appeared yet so I'll just offer this:

Jessica's family spokesman Mack Mahoney...said then-Sen. Jesse Helms helped get them into the Amnesty program to clear those [immigration] hurdles.

When *Jesse Helms* has more compassion than you do, MattD, it's surely time to re-evaluate your position.

Others have mentioned the fact that an autopsy had already been requested, which means the parents *shouldn't have even been asked* about donating organs, but here's a bit more from Monday's Durham Herald-Sun (free reg'n):

Media accounts Saturday said that the parents did not want Santillan’s organs donated, but Dixon said Duke did not tell the whole story about the request. The parents had been told Santillan’s organs were not viable for donation. And around the time she was being taken off life support, the hospital asked if her corneas could be donated. Family members said no, partly because they were in shock and partly because they did not want Duke doctors to touch their dead daughter, Dixon said.

It has to be said, I think: If even half of the family's accusations are true, Duke Med Center's PR staff and lawyers have behaved abominably throughout this episode.
posted by mediareport at 11:06 PM on February 23, 2003

Jesica's family responds directly to questions about organ donation after Jesica's death. I've emailed MattD, who will, I'm sure, apologize for his attack, which was clearly based in ignorance:

About the Santillan family's decision not to donate Jesica's organs.

We have received several scathing e-mails from people who are concerned that the family refused to donate Jesica's organs. We want to make sure that there is an understanding of what has occurred. Jesica's mother had asked about donating Jesica's new heart and lungs, she thought it would be a shame for them to go to waste, and about donating Jesica's other organs. The doctors told the Santillans and Mr. Mahoney that the heart and lungs would not be serviceable for a re-transplant and that the kidneys and liver were ruined from being on life support for too lengthy a time and the other organs and tissues were so saturated with medications and anti-rejection drugs that they also would not be serviceable for donation. By the time that the doctors got around to telling the family that they may be able to use the corneas of Jesica's eyes (and that was all that would have been useable) the family had been put through the worst ordeal a family could face and a very tired and emotionally worn out mother took the advice of her legal counsel to leave Jesica as is, for the pending autopsy.
Please understand that the Santillan family and us here at JHC believe in the importance of donation. We are all extremely grateful to the two families who gave the most precious gift to Jesica to try to extend her life. The donation of the corneas, as we understand it, would not make a life saving impact for anyone.

Please consider becoming a donor and make sure to tell your family of your decision.
posted by mediareport at 12:29 AM on February 24, 2003

...and thus, a little of my essential faith in human nature is reaffirmed. Can we do other than be impressed?
posted by adamgreenfield at 12:58 AM on February 24, 2003

I would have never believed otherwise. Thanks mediareport.
posted by crasspastor at 1:39 AM on February 24, 2003

This seems to provide an explanation for what really happened :
"... Frush said Carolina Donor Services, which conducts organ procurements, had assessed Jesica and determined that some organs could be viable, though Jesica's kidneys had quit functioning, and other organs might also have been damaged by the length of time she had been on life support.

Mahoney contends, however, that he inquired on Magdalena Santillan's behalf about donating Jesica's organs. He said Jesica's doctor told him the organs would not be suitable for transplant because they were too saturated with anti-rejection medications, or had shut down; her kidneys had already quit functioning and she was dependent on dialysis.

As a result, Mahoney said, when hospital officials asked Magdalena Santillan about talking with organ procurement coordinators, she declined, thinking there was nothing to discuss. "The mother was just acting on what I had said," Mahoney said.

Mahoney said he convinced Jesica's parents that an autopsy should be done, but in their distrust of the Duke doctors, they insisted on an autopsy at the state medical examiner's office in Chapel Hill. It is scheduled for today, he said..."

So this is a non-issue. What unmitigated gall must one have to slander a family in mourning, publicly, on the most superficial of reports? A disgrace, this whole thread.
posted by talos at 7:54 AM on February 24, 2003

What a waste of a thread.. 200+ comments...

Sigh...
posted by eas98 at 8:37 AM on February 24, 2003

I, for one, am happy to see this highly emotional debate. Organ transplant is not a highly intellectual, clinical issue, but is instead an iteration of one of our most basic questions, "Who should live and who should die?"

I surprised no one raised the one question that came immediately to my mind "Should Jesica have received the second transplant?" The answer, at least my answer, is a sad "no."

There are over 80,000 people waiting for organs. And there are no where near that many organs available. They are a very limited resource and they have to be allocated. Someone has to decide and right now that's UNOS. Their decision tree is not simply a who has the next number in the queue, but is based heavily on who has the best chances of survival with the transplant.

Where Jesica may have been at the top of the list before her first transplant, once she received the bad organs, her survival chances plummeted. Why she was allowed a second set is everywhere unstated, although its a fair assumption that it was based on public pressure.

It not heartless to thinks she shouldn't get the organs, and its not the way that the doctors or hospital have to "pay" for their mistake. Just consider who it is that "paid" for Jessica's organs. Its not the doctors, the hospitals or even the U.S. system, it was some blood type-A recipient on the waiting list who won't get organs and is now much more likely to die. Just because we don't know that person's name or story doesn't make the results any less tragic than Jesica's fate.
posted by rtimmel at 9:22 AM on February 24, 2003

It has been suggested that I reiterate this MetaTalk comment, and so I do. In my view, no other apology is due, but I won't add more difficulty to this already difficult topic.
posted by MattD at 10:22 AM on February 24, 2003

It has been suggested that I reiterate this MetaTalk comment, and so I do. In my view, no other apology is due, but I won't add more difficulty to this already difficult topic.

Um, that was an apology?

Come on here, after slandering a family based on a single paraphrased quote from a biased source facing litigation you still maintain that there is not the slightest bit of doubt in this matter?
posted by KirkJobSluder at 10:33 AM on February 24, 2003

KIrkJobSluder: That was not an apology. It wasn't an explanation for his actions. It was a defense.

Unmitigated gall. He who claimed he understood a situation based on a single sentence he read in a single news report. The same man who, when presented with the truth, refused to even do an Emily Litella.

One thing, at least, is frightening: I think we can trust John Ashcroft's INS to pin a medal on this patriot for his call to have a paddy wagon waiting for them when they come to the courthouse to try to sue Duke for malpractice.

Will this lead to a bumpy flight in his life? Or will he learn from this? Will he be shackled to the floor of his beliefs -- unable to rise above his present position? Or will he gather a payday at the benefit of all of our comments, concerns, and calls for a more through investigation of the facts?

Evidently he chooses to learn nothing.

MattD: You last lack of a contrite comment speaks even more about your character. Many of the catcalls you ignored now seem well deserved.
posted by ?! at 11:16 AM on February 24, 2003

The new information reframes the debate somewhat. Is it "unmitigated gall" for a family in a deteriorating relationship with medical providers to prohibit the medical center to mess with the body, in the process trying to preserve evidence that may be critical to future legal action? Does the ethical obligation to donate organs always trump the right to a full post-mortem examination?

My opinion is that if I had any doubt about the quality of care my loved ones received, I would be demanding a post-motem over organ donation in a heartbeat.
posted by KirkJobSluder at 11:26 AM on February 24, 2003

I realize I'm jumping here here awfully late, but here goes anyway.

MattD etc. are angry, no self-righteously livid that these parents "wasted" organs by refusing to donate. Well, let me draw a ittle pciture for you. All aspects of race and immigration status aside, these were ordinary people with no grasp of medical procedures beyond the basics and what their doctors were telling them (that the organs were not usable) and heave on top of that the emotional overload of losing a daughter in the natonal spotlight. We can all agree to this basic description, I think.

Contrast this with a nationally known hospital, staffing doctors who spend years learning every nuance and aspect of the human body, who are in the top of their field. They are responsible by the oath they take in medical school to do no harm. These same doctors made a mistake: they took organs from a Type A donor, and gave them to Type O Jesica.

Now, my mother is a materity nurse and she told me that even for the most basic of procedures there are a huge number of steps to get through, double signatures etc etc before blood goes from the anonymous donor to a patient. It is vitally important that blood types are compatible otherwise the body's own immune system reads the cells as invasive and will reject them. I'm an eighteen year old freshman geography student and even I know this.

It boggles my mind that a mistake like this can be made. Even if it WAS a clerical error, the doctors and the nurses and whole levels of personnel should have been double checking things before those organs got anywhere near Jesica, much less inside her body where they would be practically useless.

If anyone is "wasting" organs, that was happening long before Jesica's parents made their decision. It's completely irrelevant (to me) what stastical amount of people could have benefitted from Jesica's organs. If that orginal set of heart and lungs had been transplanted into the right type patient, and Jesica had waited a little longer for the second Type O set, we would have had as many as four, and at least two human beings with new hearts and lungs and a better "statistical" shot at a long, healthy life than they did with their (for whatever reason) inadequate originals.

It wouldn't even be an issue whether or not Jesica's parents chose to donate her organs, because she would have likely lived to see her eighteenth birthday, when such choices would have been her own to make. Oh, and this would have never been on the national news.

But instead we have a young woman dead, a heartbroken family, and knee-jerk "moralists" calling them worthless scum. Wheee!
posted by nelleish at 11:47 AM on February 24, 2003

There is nothing distinctively Republican or upper-middle-class about my views on this issue, as at least one poster above has noted.

I have to agree with this. You're more like a hideous caricature of an upper-middle-class Republican than an actual human being.
posted by Armitage Shanks at 12:24 PM on February 24, 2003

I know this is late but here's a few facts.

Yesica was born with a disorder that caused her heart to loose it's elasticity, it's called Restrictive Cardiomyopathy. Her disease would have probably destroyed a new heart but with a proper diagnosis the process could be slowed. It's now a moot point but I don't think her organs would have been suitable for transplant.

The doctors who botched her transplant (clearly malpractice) are not the doctors who cared for her day to day in the intensive care unit. That is usually done by Intensivists. Most patients and their families can appreciate this. She was probably being seen by Cardiology, Pulmonary, Hematology, Neurology, Renal and of course the transplant folks.

There is a difference between "brain death" and "persistent vegetative state". The family calls the shots with PVS but "brain death" is the end.

I work in a Pediatric Intensive Care Unit and have participated in removing a brain dead child from life support. I can't imagine doing so with a family that does not understand what is happening. It is virtually impossible to discuss organ transplantation with a family that is not in a lot of pain. Organs are not harvested from patients in a persistent vegetative state they are harvested from "brain dead" patients. When a patient is removed from life support the family can gather and be with the patient as they die. With kids we let the parents hold their kids if possible so they can die in their arms. With harvesting, the family says goodbye as the patient is taken, still on life support, to the operating room where the organs are harvested, and what is left is sent to the morgue.

I remember a case where a surgeon messed up big time and a teenager wound up with brain death. His family, still reeling from the shock of the mistake, donated his organs. I'm not going to call anybody nasty names, but I will always remember this family because of their amazing grace and compassion.
posted by whatever at 12:59 PM on February 24, 2003

How dare anyone be critical of a family who just lost their daughter in these most unfortunate of circumstances!

But, if donating her organs could have saved the lives of others, and her parents chose not to, shit on them (the parents, not the organs).

Then again, they probably weren't in the appropriate mindset at the time to make a decision like that.

And so on and so forth ad nauseum...
posted by pemulis at 10:32 PM on February 26, 2003

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