Over 8,000 people in Germany are currently waiting for an organ donation. The FDP wants to ensure more donations – and to do so expand the definition of death.
Munich – The FDP parliamentary group wants to lower the medical hurdles for organ donations in order to increase the number of available donor organs. Up to now, brain death has to be proven before an organ is removed – in the future, the determination of cardiovascular arrest should also be sufficient: This is stipulated in a motion that the FDP parliamentary group should pass on Tuesday. Such a change in the definition of death could save lives, said the initiator of the application, FDP member of the Bundestag Andrew Ullmann. The most important questions and answers.
The FDP parliamentary group wants to redefine death – recognize “scientific reality”.
When does a person become brain dead?
In 1968, a Harvard Medical School commission published a precise definition of the irretrievably lost overall function of the brain and proposed that the corresponding condition be recognized as a sure sign of death. Its characteristics were established in 1981: no receptivity to sensory impressions and stimuli, no spontaneous movements and breathing, no reflexes and the electroencephalogram (EEG) shows no electrical activity in the brain.
What does the FDP parliamentary group want to change?
Only a few patients suffer brain death in the intensive care unit, i.e. the irreversible loss of all brain functions. Most die from cardiovascular failure. “The effort involved in determining brain death is immense and this limits the number of potential donors from the outset,” explains Ullmann, who is also a doctor. Death after a prolonged cardiac arrest is medically equivalent to brain death. “As legislators, I see it as our duty to recognize the scientific reality, especially since it is a fundamental prerequisite for enabling more people to have an organ transplant and thus saving lives,” emphasized Ullmann.
Organ donations in Germany: Over 8,000 people are waiting to be rescued
Why is there a need for action?
“The number of organ donors is still many times higher than the number of people on the waiting list: at the end of 2023, 8,716 people were waiting for a saving donor organ,” said FDP right-wing politician Katrin Helling-Plahr. Many of those waiting would die without ever receiving a donor organ.
What is cardiovascular death?
Cardiac arrest is easier to detect than brain death. In Germany, doctors have said in the past that determining death from cardiovascular disease carries a higher risk of misdiagnosis. Many scientists consider this assessment to be outdated. “From a medical perspective, there is no gold standard for explaining death,” said FDP expert Ullmann.
How do other countries do it?
In Great Britain, Spain, the Netherlands, Belgium, Switzerland and the USA, organ donations after cardiac arrest are already permitted and have led to a significant increase in organ donations.
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How does organ donation work?
The body of a brain-dead person can be artificially ventilated and cardiac and circulatory function can be maintained artificially. This procedure is necessary because as soon as organs are no longer supplied with blood, they slowly lose their functionality and therefore their ability to be transplanted. This means that an organ must be removed from the donor and transplanted within a certain period of time, otherwise it becomes unusable. This period is around four hours for the heart, twelve hours for the liver and 24 hours for the kidneys.
What is the current legal situation?
The regulation applies in Germany, Switzerland, Great Britain, Denmark and the Netherlands “extended consent for organ donation”. Every citizen can give their consent to organ donation on their own initiative. If there is no specification, the relatives must decide.
What is the contradiction solution?
In countries such as Austria and Spain, fundamental consent to organ donation is assumed unless the person concerned has expressly objected during their lifetime. Criticism of this solution is the interference with personal rights. Other states practice the so-called extended objection solution, in which an objection by relatives to organ removal is also decisive (Finland, France, Italy, Norway and Sweden). Countries with opt-out solutions have a higher rate of organ donors. In Spain, 46 people per million inhabitants donate at least one organ after their death, whereas in Germany the figure is only 10.3.
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