Doctors in India have apparently not reached the stage of killing their patients to have quick access to their key organs such as kidneys and livers etc.
Believe it or not, such is not the case with the medical fraternity in the United States. In a bizarre case, a California-based surgeon, Dr. Hootan C. Roozrokh, has been charged with prescribing excessive and improper doses of drugs to hasten the death of one of his patients, Ruben Navarro, to retrieve his organs sooner.
A court is expected to begin a preliminary hearing of three felony counts against Dr. Roozrokh today in relation to Mr. Navarro's treatment as a donor.
At the heart of the case is whether Dr. Roozrokh, who studied at a transplant fellowship program at the Stanford University School of Medicine, was pursuing organs at any cost or had become entangled in a web of misunderstanding about a lesser-used harvesting technique known as "donation after cardiac death."
Several days after Navarro was hospitalized at California's Sierra Vista Regional Medical Center, a decision was made to remove his ventilator.
According to the criminal complaint, Dr. Roozrokh ordered excessive doses of morphine and Ativan, an anti-anxiety medicine, both of which are used to comfort dying patients. In the most shocking accusation, the complaint said Dr. Roozrokh introduced Betadine, a topical antiseptic, into Navarro's system; Betadine, the complaint said, is "a harmful substance that may cause death if ingested."
Navarro died about eight hours later of what the coroner ruled was natural causes. In the end, however, because his death was not more immediate, his organs had deteriorated too much to be usable for transplant.
Prosecutors have charged Dr. Roozrokh with felony counts of dependent adult abuse, mingling a harmful substance (Betadine) and prescribing a controlled substance (morphine and Ativan) without medical purpose.
Dr. Roozrokh has pleaded not guilty, and his lawyer said the charges were the result of overzealous prosecutors. But the case has sent a shudder through the tight-knit field of transplant surgeons.
If convicted on all counts, Dr. Roozrokh could face eight years in prison — while also worrying donation advocacy groups that organ donors could be frightened away.
David Fleming, the executive director of Donate Life America, a nonprofit group that promotes donations, said the case had "given some support to the myths and misperceptions we spend an inordinate amount of time telling people won't happen."
The New York Times quoted Fleming as saying that about 18 people a day die in the United States waiting for transplants, and this has created a tremendous demand for donor organs.
However, over the years the medical community has established strict protocols to govern organ harvesting. Transplanting organs from patients whose hearts have stopped, or cardiac-death donations, began to go out of vogue in the late 1960s and early '70s after medical advances like life support and subsequent changes in the legal definition of death made donations from those declared brain dead more efficient.
But health officials have encouraged cardiac-death donations in recent years.
There were 670 cardiac-death donations through the first nine months of 2007, the most in any year this decade, according to the United Network for Organ Sharing, which oversees organ allocation. Over the same period, there were 12,553 brain-dead donations, according to the network.
In brain-death donations, the donor is legally dead, but machines keep the organs viable by machines. In cardiac-death donations, after the patient's ventilator is removed, the heart slows. Once it stops, brain function ceases. Most donor protocols call for a five-minute delay before the patient is declared dead. Transplant teams are not allowed in the room of the potential donor before that.