Organ donation: Doctors with brain death diagnoses often overwhelmed?
In German clinics, brain death diagnoses are not always made according to the guidelines. The "Süddeutsche Zeitung" (SZ) reports with reference to the documents available to it. The German Organ Transplantation Foundation (DOS) warns of the consequences. Potential donors could raise further doubts about organ donation. There have been repeated transplant scandals in the past. The number of donors then reached its lowest point. Until now, brain death diagnostics has been considered safe. According to the SZ, even death certificates had to be subsequently corrected due to incorrect diagnoses.
Disagreement among doctors about the type of diagnosis of brain death In the past three years, doctors have diagnosed brain death in ten patients in total without following the guidelines. Under no circumstances did organs be removed from a living organ, reports Rainer Hess, DOS board member, to the news agency "dpa". With this, Hess confirms a SZ report that even death certificates had to be corrected afterwards. The reason is inadequate training of doctors in the field of brain death diagnostics, the newspaper writes. Hess also confirms that doctors are sometimes at odds over how exactly brain death can be determined.
There are clear guidelines for diagnosing brain death in Germany. This includes, among other things, that two qualified doctors make the diagnosis independently of each other and have to agree, the paper reports. In addition, all circumstances that only numb the brain, such as medication, coma, a too low body temperature or poisoning, would have to be excluded. According to the report, brain death diagnoses were also made, although the patient had recently been anesthetized with strong pain relievers. A breathlessness test was also not carried out correctly.
The neurologist Hermann Deutschmann from the Nordstadtkrankenhaus in Hanover is committed to improved brain death diagnostics. "Brain death diagnosis is one of the safest methods of all if you follow the guidelines and have experience in this area," he explains to the SZ. In 30 percent of the cases in which he was consulted as a second assessor for brain death diagnosis , but he was unable to confirm the diagnosis.
Training of doctors to improve brain death diagnoses Eugen Brysch, board member of the German Foundation for Patient Protection, calls for a "Brain Diagnostics Competence Team" to be located at the Robert Koch Institute. The removal hospitals could then request the specialists. It is now "consistent action required, because the question of whether living or dead organs are removed, the core concerns of the population about organ donation," said Brysch the news agency.
Hess from the DOS considers the presentation of the incorrect brain death diagnoses to be exaggerated and sees above all the consequences of such scandals. "I strongly reject the general suspicion of false death determinations." It had been ten cases in three years. Mistakes would be made everywhere, unfortunately also with transplants. “There were only two organs removed. In the other cases, the control system worked. However, there was never an organ removal from the living, ”emphasizes Hess. “You cannot say that the overall system fails. The cases described are cleared up. "
Last year the number of organ donors dropped to 876. This corresponds to a decrease of 16 percent compared to 2012. The main reasons are the transplant scandals. Reports of incorrect brain death diagnoses should not improve the situation. Nevertheless, it is important to draw attention to such serious grievances. It remains to be hoped that public pressure will help to improve the training of doctors in diagnosing brain death. (ag)
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