Voices Online Edition
Vol. XXIII, No. 2
As Easter arrived, NBC’s news show Dateline breathlessly ran a story1 about a teenage boy declared “brain dead” who nevertheless began to recover just hours before his organs were scheduled to be harvested.
Last November, 21-year-old Zack Dunlap was declared dead 36 hours after flipping his 4-wheeler ATV. Official word of his death was even reported to Oklahoma authorities. The parents were told that their son was brain dead and they knew he had signed an organ donor card. After seeing a brain scan apparently showing no blood flow to his brain, the parents agreed to donate his organs.
However, Zack jerked his foot when a nurse ran a sharp object up the bottom of his foot. Although skeptical at first, soon even the doctors agreed that he was showing purposeful movement and the organ removal was cancelled. Five weeks later, Zack was transferred to the Jim Thorpe Rehabilitation Hospital in Oklahoma City.
Today, just four months later, it is almost impossible to tell that Zack ever had an accident, much less a catastrophic one. He speaks clearly, walks without assistance and is planning to go back to work. He now insists that that he heard a doctor say he was dead and that this “just made me mad inside”.
During the broadcast of this amazing story, much was made of Zack’s grandmother’s prayer for a miracle. Zack’s doctors continue to insist that no mistakes were made in Zack’s diagnosis of brain death and the parents agreed, saying “There’s no blame in a miracle.”
So have we indeed witnessed a replay of the Lazarus miracle? Probably not.
THE TRUTH BEHIND MOST MIRACLES
I fervently believe in the enormous power of prayer. I believe that God can and still does perform miracles but even when recovery doesn’t happen or is less than desired, prayer always helps.
As a nurse, I have seen many amazing recoveries over the years, ranging from the purely physical to the deeply spiritual. Intense prayer has accompanied many of these recoveries, but some, to my knowledge, have not. Of course, people like my paternal grandmother have made a habit of praying for anyone who most needed prayer, but I know from personal experience that there are no special words or prayers guaranteed to make a recovery happen. In the end, we always have to trust God.
But there is a larger issue: Are we conferring too much similar trust in the wisdom of the medical and ethical establishments?
It is ironic that true miracles such as the Resurrection and those verified at Lourdes are often dismissed as fake by the scientific establishment, but recoveries such as Zack’s are routinely seen as “miraculous” rather than as problems that need rigorous scrutiny or even opportunities to learn more.
Countless times over the years, I have seen doctors turn out to be wrong when they have given families a dire prognosis about their loved one. Honest mistakes do happen but with time and care, a surprising number of such patients survived and some even fully recovered. In the past, however, we weren’t in such a rush to withdraw treatment or donate organs. Today, a dire prognosis can be a death sentence.
In Zack’s case, barring a true miracle, it seems most likely that the doctors were well-intentioned but frighteningly wrong.
The diagnosis of brain death itself can be problematic and is still being debated even in Catholic circles.2 But while debate will continue over the validity of brain death, it seems obvious that we also need much more scrutiny of the ethics and practicality of applying that theory. At the very least, brain death is not a term to be used lightly.
For example, despite claims that brain death soon results in the end of all bodily function, we now have cases of pregnant “brain dead” women able to live for even months until their babies could be delivered. At the present time, the tests required to diagnose brain death can vary widely from hospital to hospital. When I personally served on an ethics committee at a local hospital years ago, I was appalled when one young doctor proposed that our hospital adopt the least strict brain death tests so that we could obtain more organs. This can have lethal repercussions even outside the context of organ donation.
For example, recently an elderly Minnesota woman’s family was told that she was brain dead after a massive stroke. No organ donation was planned and the family decided to take the 65-year-old woman home to die. Less than a month later, she was awake, talking and the doctors now say there is a possibility of a full recovery.3
And, as I have written before, there is now a big push for organ donation policies to include taking organs from people who are not brain dead, but whose families or guardians agree to withdraw life support and donate the organs when (or if) the heart stops within about an hour.4 This kind of organ donation is called non-heartbeating organ donation (NHBD) or donation after cardiac death (DCD). Currently, a California surgeon is fighting charges that he used drugs to hasten a disabled man’s death in order to obtain his organs using this kind of organ donation.5
Scientists do agree on at least one thing. There’s a lot we don’t know about the human body, especially the brain. In the meantime, we have become used to the term “medical miracles” when new discoveries are made.
In the past, for example, we have had the development of CPR (cardiopulmonary resuscitation), which literally changed our legal definition of death from the cessation of heartbeat and breathing to the irreversible cessation of heartbeat and breathing. Countless lives that could have ended prematurely are now being saved. And just by not giving up, we have discovered that drowning victims can sometimes recover full brain function after being submerged in cold water for a prolonged period of time.
In recent years, careful observation and new technology is showing us that many people thought to be in a coma or the so-called “vegetative state” can indeed think and feel.6 Unfortunately, and despite numerous cases of people waking up even years after being diagnosed as comatose or “vegetative”, many doctors and ethicists continue to insist that such people are hopeless and better off dead.
Death penalty opponents hold that it is better for ten guilty men to live than for one innocent man to die. Ironically, that same rationale is seldom applied to such patients.
LESSONS TO BE LEARNED
In the past generation, we have seen a societal U-turn from “sanctity of life” to “quality of life”. Thousands of people sign “living wills” and other advance directives stating that they don’t want even simple measures such as food and water or antibiotics in the event that they do not have full mental function. Futility policies to allow the removal of basic medical care even against the patients’ or families’ wishes are becoming increasingly common, even in Catholic hospitals.7 More and more countries are legalizing assisted suicide and even outright euthanasia.
Terminal sedation, when used to make a person unconscious until he or she dies from dehydration, is now viewed by many as an ethical and legal substitute for euthanasia.8 Some ethicists, like Peter Singer of Princeton University,9 insist that human beings actually lack “personhood” when diagnosed as “vegetative” or severely brain-impaired and that caring for such people is a waste of health care resources.
In light of this new view of human worth, it is disappointing but not surprising that Zack’s dad, like many other well-meaning but misguided people, would say, “He lived life to the fullest. And laying in bed the rest of his life? That wasn’t an option.” This same rationale is used every day to deny basic care to even conscious people like the frail elderly, people with severe disabilities, patients with Alzheimer’s, etc. Society seems to be quickly forgetting that there is a very real difference between withdrawing futile and/or burdensome treatment from someone near death and actually causing or hastening the death of a vulnerable person.
In the final analysis, it seems that the story of Zack Dunlap’s recovery is less a story about a miracle than a cautionary tale about a close call. If Zack indeed had his organs harvested, this whole incident would be seen as just another successful case of organ donation. If Zack had survived with severe brain damage, we probably would have never heard about him at all.
While the media may treat Zack’s recovery as a feel-good human interest story, I believe that we should instead consider Zack’s case as both a wake-up call and an opportunity: We desperately need reform of some of our questionable medical and ethical policies as well as some of our own attitudes toward the sick and disabled. And we need to scientifically examine medical mysteries like Zack’s recovery so that possibly even more people can benefit from such medical marvels.
As far as miracles go, perhaps Zack Dunlap’s recovery was God’s way of reminding us that we still don’t know as much as we think we do and that we still need to take good care of each other.
1 “‘Dead’ man recovering after ATV accident”, March 23, 2008. available online at: http://www.msnbc.msn.com/id/23768436/
2 “Vatican resuscitates issue of whether brain death means total death” by Carol Glatz. Catholic News Service. September 15, 2006. Available online at: http://www.catholicnews.com/data/stories/cns/0605285.htm.
3 “Lake Elmo woman makes miracle recovery from ‘brain dead’” by Allen Costantini, KARE 11 News. Feb 13, 2008. Available online at: http://www.kare11.com/news/news_article.aspx?storyid= 498009.
4 “Ethical Implications of Non-Heart-Beating Organ Donation” by Nancy Valko. Voices, Michaelmas 2002, Volume XVII, No. 3. Available online at: http://www.wf-f.org/02-3-OrganDonation.html.
5 “Surgeon Accused of Speeding a Death to Get Organs” by Jesse McKinley. New York Times. February 27. 2008. Available online at: http://www.nytimes.com/2008/02/27/us/27transplant.html?_r=1 &oref=slogin&ref=us&pagewanted=print.
6 “What if There Is Something Going On in There?” by Carl Zimmer. New York Times. September 28, 2003. Online at: http://www.nytimes.com/2003/09/28/magazine/28VEGETAT.html? pagewanted=print&position=.
7 “The Duty to Die: Scouting the Next Pro-Life Battlefield” by Deborah Sturm. insidecatholic.com. March 24, 2008. Available online at: insidecatholic.com/Joomla/index.php?option=com_content&task=view&id=3150&Itemid=48.
8 “When Is Sedation Really Euthanasia?” by Kathleen Kingsbury. Time. March 21, 2008. Available online at: http://www.time.com/ time/health/article/0,8599,1724911,00.html. See also my article “Sedated to Death? When ‘comfort care’ becomes dangerous” (written in 2002) at http://www.wf-f.org/02-2-terminalsedation.html.
9 “Taking Life” by Peter Singer. Excerpted from the book Practical Ethics, 2nd edition, Cambridge, 1993, pp. 175-217. Available online at: http://www.utilitarian.net/singer/by/1993—-.htm.
Nancy Valko, a registered nurse from St. Louis, is president of Missouri Nurses for Life, a spokesperson for the National Association of Pro-Life Nurses and a Voices contributing editor.
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