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Organ Ambulances Proposed

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The Washington Post

Published: May 24, 2008

In the hope of saving the lives of more people waiting for transplants, New York is working on a plan to deploy a special ambulance to collect the bodies of people who have died suddenly from heart attacks, accidents and other emergencies and try to preserve their organs.

If the rapid-organ-recovery ambulance succeeds, officials would like to expand the pilot program citywide with a fleet of ambulances and eventually duplicate it in other cities.

"We hope this will fulfill the wishes of more potential organ donors and their families in these tragic settings, and provide more organs to save the lives of those who are now dying on the waiting list," said James Burdick of the federal Health Resources and Services Administration, which is funding the project with a $1.5 million, three-year grant.

Some doctors and ethicists, however, say the initiative raises a host of prickly issues, including whether it is ethical to perform procedures on and administer drugs to a body to preserve the organs before getting a loved one's approval, as is expected to happen often.

They also worry about blurring the line between saving lives and removing organs, potentially undermining public trust in emergency medical care and the organ donor system.

"I think it's disgusting," said Michael A. Grodin, director of bioethics at Boston University. "People are going to worry when the ambulance comes out to their house whether they are there to care for them or to take their organs."

The plan comes as transplant advocates have come under criticism for increasingly aggressive efforts to boost the organ supply, including advocating the removal of organs before patients are brain-dead.

"This is another example of overzealous transplant people trying to retrieve organs any way they can," Grodin said.

Proponents defend the plan, saying there would be a clear distinction between the ambulance dispatched to try to save someone and the one standing by if paramedics fail.

The project will proceed only if all ethical issues have been addressed and if a series of meetings with community groups alleviates any public fears, they said.

"We have to make sure people understand our job is to save lives, and we're not going to do anything to compromise that," said Lewis R. Goldfrank, director of emergency medicine at Bellevue Hospital, who is leading the program, which he hopes to launch this year.

Currently, New York paramedics try for about 30 minutes to revive patients whose hearts have stopped before declaring them dead, while a doctor monitors their efforts remotely. The bodies are then taken to a funeral home, morgue or medical examiner's office.

"They could have a donor card. They could have a host of wishes about donation. But they don't have that opportunity because there's no system established for that," Goldfrank said, noting that similar procedures are routine in Spain and some other European countries.

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