USVI: Brain dead for organ donation?

ST. CROIX - Doctors at Luis and Schneider hospitals on Wednesday called for new legislation that would allow the territory's physicians to declare a patient brain dead.

Three physicians testified at a public hearing Wednesday before the Senate Health, Hospitals and Human Services Committee in support of proposed legislation that would amend the Uniform Determination of Death Act to give V.I. doctors the ability to ascertain brain death using the resources available to them.

Dr. Kendall Griffith, Luis Hospital medical director, said doctors in the territory currently lack the resources to declare a patient brain dead. On St. Croix, the hospital does not have an electroencephalogram machine, and there is only one neurologist on staff. Schneider Hospital has an EEG machine, but it has only one neurologist.

"This complicated, confusing medical dilemma merits your concern because it causes prolonged family suffering, frustration and pain of the nursing staff, frustration of the physician staff, misuse of limited ICU beds and financial drain on limited hospital resources," Griffith said.

The act, adopted in the Virgin Islands in 1993, states that to declare a patient brain dead, the individual must have a total failure of circulatory and respiratory functions, and the irreversible loss of all brain functions must be determined "in accordance with the accepted medical standards."

The law was amended to include medical standards established under the 1993 Fredella v. Farrelly Territorial Court decision requiring that two EEG tests be performed within a 24-hour period to confirm absence of brain activity and that neurological tests be performed by two neurologists.

The proposed bill would require each hospital to establish its own written policy and procedures for tests to determine brain death that would fit the hospital's individual needs and abilities.

Another issue raised is the wasted potential for donating organs.

This legislation is suspect simply because hospitals which lack the requisite technology have no means of determining lack of brain activity in the comatose.

Absent such means of brain activity verification, patients with brain function may be declared brain dead for the purposes of organ donation and for the utilitarian reasons indicated by Griffith, such as the avoidance of pain and suffering to the family, of emotional angst of the medical staff, and of wastage of hospital resources. Thus, patients will be declared brain dead because they are a bother to others.

So, what if the person isn't brain dead? Should he be deprived of life to spare others pain and frustration, to make bed space available, and to halt the "financial drain" on hospitals? How much is a human life worth in the USVI?