Each year, between 1,000-2,000 anencephalic babies are born in the United States. With this tragic disorder, the baby essentially has no brain – only a brain stem which controls breathing and primitive reflexes. They usually die within days or weeks after birth – they never survive.
In one case in Florida – after discovering that her child was anencephalic in her eighth month of pregnancy – the mother decided to bear the child. She wanted to donate the child's organs to sick babies who needed them. However, when born, the baby girl could not be declared legally "brain dead" so her organs could be donated, because her brain stem was still functioning. When the girl died ten days later, none of her organs were usable.
Should her organs be used or not? Here are the arguments related to this ethical problem.
1. Removing the baby's organs before death would be an active killing of a human being, thus reducing the value of human life.
2. If this organ donation is done, it might be used as a precedent for using organs from infants who might survive – even though the chances might be slim – or from adults who are in seemingly irreversible comas.
3. This practice might lead to having babies or keeping them alive solely to use their organs for donations. There has been a case in which a child was conceived primarily to be a bone marrow donor to save her older sister's life.
1. Anencephalic babies cannot have a meaningful life. The baby will definitely die within weeks. Donating this baby's organs to other infants can give the baby's death some meaning by providing life for other children. This baby's heart, kidneys, lungs and skin could possibly save the lives of six other babies who are in mortal need of these organs.
2. Specific criteria for brain death could be set which apply only to anencephaly. Only this condition would allow the child to be an organ donor. If this condition is viewed as a legal exception to the rule, it would not allow the practice to spread to other babies that might have some chance for life.
3. Every year about 5,000 American children need pediatric organ transplants. Unfortunately, less than 1,300 actually get the needed transplants. About 30-50% of infants registered to get transplants die before an organ becomes available.
4. Because adult organs are too big and diseased children usually have unusable organs, the only source of pediatric transplants is children who die traumatic deaths, usually car accidents. Anencephalic children have organs that are healthy and small enough to help other sick babies. They could provide most of those remaining 3,700 babies with organs to allow them to lead healthy and productive lives.
You have read the arguments. Do you think we should change our laws to allow these donations?
* Adapted from "Should anencephalic babies be used as organ donors?" in Diane Papalia and Sally Wendkos Olds' Human Development Update, McGraw-Hill Publishers, Winter, 1993, pages 7-8.
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