Year: 2015

Media Bias? Two articles contrast coverage of newest Planned Parenthood video on using fetal body parts

nancyvalko abortion

A new Planned Parenthood video on the use of fetal body parts after abortion was just released. While much of the mainstream media seems to be ignoring the story right now, here are two articles from major media that are radically different in tone and content. One is from the UK’s Daily Mail and titled “New Planned Parenthood video shows doctor haggling over prices for aborted fetuses, talking about ‘crunchy’ methods and her hopes of buying a Lamborghini”. The other is from the US’s Washington Post newspaper and titled “Antiabortion group releases second Planned Parenthood video”.
Please go the links for both articles and let me know what you think.

1. UK’s Daily Mail newspaper
New Planned Parenthood video shows doctor haggling over prices for aborted fetuses, talking about ‘crunchy’ methods and her hopes of buying a Lamborghini

2. Washington Post newspaper
Antiabortion group releases second Planned Parenthood video

Killing to Heal? Ethical Problems with DCD (Donation after Circulatory Death)

nancyvalko organ donation

This first appeared as an item in the Pro-Life Wisconsin Monday Update, 7-13-15. It is a short overview of ethical concerns about DCD (donation after cardiac or circulatory death and formerly called NHBD, non-heart beating donation).

Killing to Heal? Ethical Problems with DCD (Donation after Circulatory Death)

By Nancy Valko, RN, ALNC and Julie Grimstad, Patient Advocate, Prolife Healthcare Alliance

Donation after Circulatory Death (DCD) is ethically controversial because it links the so-called “right to die” with organ donation, opening a terrible Pandora’s Box. In the quest to secure life-saving vital organs, DCD is pushing the boundaries of what constitutes death. Those with the responsibility to determine death are cautioned to take ample time, even in hospice patients, lest death be declared prematurely. When death is hastily declared for the purpose of acquiring organs, as the DCD procedure requires, the paramount ethical principle – the sanctity of human life – can be overridden by utilitarian calculations of whose life is worth more, the organ donor’s or the recipient’s. Consider the following:
1. DCD involves taking organs from patients who have not been determined to be “brain dead” but who are on ventilators and considered hopeless in terms of predicted survival or “quality of life.” U.S. guidelines (from The Organ Procurement and Transplant Network) even allow conscious disabled people on ventilators to agree to the DCD procedure. In spite of the fact that the patient’s or family’s consent to removal of the ventilator must precede consent to organ donation, these guidelines imply that disabled patients’ organs are more valuable than their lives.

2. As noted by reporter David Wahlberg, “…critics, including some Catholic hospitals and the disability rights group Not Dead Yet, say circulatory death donation can pressure families to withdraw life support. Some say drugs given beforehand can hasten death.” [“UW Hospital a leader in alternative to brain death organ donation,” David Wahlberg, Wisconsin State Journal, July 5, 2015]

3. The DCD procedure requires a doctor’s prediction that a person’s heartbeat and breathing will stop within 1-2 hours after the ventilator is removed, but doctors are often wrong. A study presented at the 2015 Transplant Congress by University of Wisconsin doctors stated, “In 46 patients (27.2%) no organs were recovered because the patients did not expire within 2 hours.” Such patients are then just returned to their rooms to die without further treatment. There is something dangerously awry when doctors’ prognoses are so often wrong – fatally wrong.

4. The DCD procedure usually involves moving the patient-donor to an operating room and there removing the ventilator in order to bring about death in a controlled environment. The donor’s organs are taken only 2-5 minutes after breathing and heartbeat stop. Haste saves organs because they rapidly deteriorate without circulation.

5. The basic ethical principle guiding organ donation is the Dead Donor Rule: a person must be dead before the removal of organs for transplantation. Shouldn’t we be absolutely certain a person is dead before organs necessary for life are removed from him/her? What good is the Dead Donor Rule if the “dead” part is fiction?

6. Evidence suggests at least some DCD donors would survive and even recover given time and therapy. For example, NBC’s Today show, September 6, 2011, featured an interview with Shelli Eldredge, a young mother who was comatose after a traumatic brain injury from an accident on June 16, 2011. A doctor recommended stopping life support. Although Shelli’s husband, a doctor himself, also believed it was medically impossible for her to recover, he wouldn’t give up. After a month, Mrs. Eldredge woke up and started speaking. Three months later, she was giving this interview – alert, articulate, and working toward a full recovery.

A civilized society must not allow the deaths of some people to be manipulated in order to obtain organs for others.

“What Does the Planned Parenthood Video Show?” and not show

nancyvalko abortion

One of the most compelling articles on the undercover Planned Parenthood video and its’ implications is in the July15, 2015 Atlantic magazine article “What Does the Planned Parenthood Video Show?” by David A. Graham. The article also contains a link to a much longer video of the Planned Parenthood medical director discussing the harvesting of unborn babies’ body parts in abortions.

But I have yet to see the current mainstream media investigate the companies receiving the aborted fetal parts and how such parts are used. For example, in light of Planned Parenthood’s defense stating that they only “donate” fetal tissue from abortions for “lifesaving scientific research”, note that a 2009 Washington Times article “Aborted fetus cells used in beauty creams”  showed that fetal tissues have been used for non-medical and even commercial uses.

Also unmentioned by the media is the controversy about using aborted fetal tissue cell lines to grow vaccines. This is something many people would object to-or even refuse to receive-if they knew about this. (See the article “Human Cell Strains in Vaccine Development’ which also includes the National Catholic Bioethics Center’s evaluation.

Obviously, there seems to be a lot more to this story than just the undercover video.

Wall Street Journal article July 8, 2015: “Brain Stimulation May Give Hope to Coma Patients”

nancyvalko brain injury

Coma is a term unfortunately often misused by the media to also encompass conditions like “persistent vegetative state” or “minimally conscious state” as it is in the title of this article.

The article “Brain Stimulation May Give Hope to Coma Patients” recounts how a 36 year old man, severely brain-injured for 6 years, was selected for a 2007 study of deep brain stimulation using an implantable device improved for 6 months.  According to the article:
“The patient regained voluntary movements of one limb. He also was able to chew, swallow
and speak again, conveying cognitive and perceptual responses.”

The author of the article, Patricia cites this as a potential breakthrough for the severely brain-injured whose

“Annual costs of care are in the double-digit billions.”

However, other measures have already helped such patients to improve or recover over the last two decades.

I first discovered this in the early 1970s, I worked in a top ICU with many people who were in comas from accidents or other brain traumas. I was teased by my colleagues for talking to these people, telling them what day it was, what I was doing to them, etc. “Do you talk to your refrigerator, too?” they laughed.

I told them that if hearing indeed was the last sense to go, perhaps these coma patients would be reassured by, for example, hearing that I was turning them to wash their backs instead of pushing them out of bed. Why not do it?

Then one day a 17 year old young man I will call “Mike” was admitted to our ICU in a coma and on a ventilator after a horrific car accident. The neurosurgeon who examined him predicted he would be dead by morning or become a “vegetable.” The doctor recommended that he not be resuscitated if his heart stopped.

Personally, I was shocked that the doctor said this in front of the patient.

But Mike didn’t die that night and, after a few weeks, he was weaned off the ventilator and could even move a finger on command and eventually he even said “Hi”. However, I was baffled when Mike didn’t respond at all to the neurosurgeon, even with deep pain stimulation.

After a few weeks and with much coaxing Mike finally did say “Hi” to the shocked surgeon. Soon after Mile was transferred out of our ICU to a nursing home where the whole staff assumed he would spend the rest of his life severely impaired.

However, two years later, a handsome young man strode into our ICU, announced he was Mike, and thanked us for saving his life. We were stunned and overjoyed. Laughing, I told him that he wouldn’t remember this, but he used to respond a little to some of us nurses but didn’t for the neurosurgeon. The laughter stopped when Mike revealed that he purposely hadn’t responded to the doctor because he had heard him call him a vegetable and it made him angry.

After that, every nurse was told to treat all our coma patients as if they were fully awake. We were rewarded when several other coma patients woke up and some even recovered.

Today, Mike would probably be dead because of his refusal to respond to a doctor because withdrawal of ventilators, food and water and basic medications have become almost routine when a patient is severely brain-injured unless the family objects. I have seen many people like this called “hopeless” and eventually warehoused in nursing homes to be forgotten.

Over the years, I’ve written about many other patients in comas, “persistent vegetative states”, etc. who improved or even woke up with verbal and physical stimulation instead of the brain stimulation explained in this article.

For example, doctors like Dr. Keith Andrews of the UK and US doctor Mihai Dimancescu did studies years ago that showed around 43% of patients in a so-called “persistent vegetative state” were misdiagnosed. In 1988, Britain’s Royal Hospital for Neuro-Disability developed the “Sensory Modality Assessment and Rehabilitation Technique (SMART) is a clinical tool for the assessment and rehabilitation of people with disorders of consciousness following severe brain injury.” For decades, I’ve also recommended Jane Hoyt’s wonderful pamphlet “A Gentle Approach-Interacting with a Person who is Semi-Conscious or Presumed in Coma”.

People do need to know that there is ongoing research and hope for the severely brain-injured.
As Pope John Paul II wrote in his historic 2004 address to the participants in the International Congress on “Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas” :
“The sick person in a vegetative state, awaiting recovery or a natural end, still has the right   to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention  of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of eventual recovery.” (Emphasis added)

Here’s What Happened when Colorado Offered Free Birth Control

nancyvalko family planning

I came of age during the era of the Pill and the sexual revolution.

At first, we were told that this hormonal contraception would be the liberator of both married and unmarried women, freeing the unmarried from the stigma of unwed motherhood and freeing the married from the burden of too many children. We were told that the Pill was absolutely reliable and safe. All we had to do was take one pill every day until we wanted a baby.

Fast forward 40 years.

On July 6, 2015, Business Insider published the article “Here’s What Happened when Colorado Offered Free Birth Control“ touting the success of newer, long-acting birth control methods that are implanted or inserted into women to prevent pregnancy even for years and are claimed to be more effective.

It turns out that the Pill was not so reliable. Note this quote from the article:

“According to a study in the New England Journal of Medicine, about 9% of women using the pill, patch, or ring for three years will get pregnant.” emphasis added)

But if you read the actual NEJM study, the study’s actual statistics for the Pill are even worse:
“Annual failure rates with typical use of oral contraceptive pills are estimated at 9% for the general population, 13% for teenagers, and 30% or higher for some high-risk subgroups>.” (emphasis added)

With these rates and school sex education programs promoting contraception, no wonder Planned Parenthood becomes a self-perpetuating abortion/contraception industry.

The article also states that:

“The emphasis on long-acting contraception, like intrauterine devices (IUDs) and implants, is important because the devices are permanent and last for years”. (emphasis added)

Unmentioned is that the problems with the longer-acting contraceptives like the IUDs and implants, problems like cost and side effects such as pain, bleeding, etc. have led almost 1 out of 4 women to stop using them according to a 2013 Family Medicine article.

Also unmentioned is the potential for the longer-acting contraceptive to mask an infertility issue when such contraceptives are used for years.

But this might be the real rationale behind this article publicizing the need for funding of free long-acting contraception in Colorado (and possibly elsewhere):

Between 2009 and 2015, “teen births dropped 40 percent, abortions fell 35 percent and the state avoided more than $80 million in Medicaid costs” according to the Colorado Department of Public Health and Environment’s website.

Years ago, I made sure my minor daughters were aware of the physical, emotional and spiritual problems with artificial contraception and sex outside of marriage. However, they were both pressured-without my knowledge-by doctors about using artificial contraceptives. One refused and is now glad she did but my other daughter gave in and went to Planned Parenthood. She subsequently became pregnant at age 18 and later had to have surgery for a HPV (Human Papillomavirus Virus) infection.

With supportive articles like the one here and the legal confidentiality requirement that excludes parents, are we running the risk that long-acting contraception might be imposed on our minor children in the future supposedly for their own good and the good of society?

Now I fear it might be inevitable.

Welcome!

nancyvalko about me

Welcome to my blog!

I hope you will find it worthwhile and enlightening. These are my own personal observations and I encourage you to share yours.

Links to sources are underlined. Just click to see the referenced citation.

I also have an archive of older articles, etc. from Voices magazine at my other blog “Nancy Valko, RN ALNC”.

I am glad you came!

Nancy Valko, RN ALNC

Our Grandson Was Saved By An Adult Stem Cell Transplant

nancyvalko abortion, organ donation

Wednesday, July 1, 2015, our 2 year old grandson Liam and his family were featured on the local news by the St. Louis NBC affiliate. The video segment titled “St. Louis family meets life-saving bone marrow donor” is now online at:
http://www.ksdk.com/story/news/local/outreach/2015/06/30/bone-marrow-transplant-donor-reunion/29537057/ and it is wonderful.

It told the basic story about how our 2 year old grandson Liam Bryant, who like his deceased older brother Noah, had a bone marrow transplant for a rare autoimmune disease called HLH and is doing well thanks to the generosity of a stranger named Kevin who donated his bone marrow. There were many tears of joy when Liam and the family were able to meet Kevin in person.

But there is much more to the story.

There are two types of stem cell procedures. Ethically controversial embryonic stem cell (ESC) procedures and non-controversial adult stem cell procedures. ESC procedures are controversial because the cells used are derived from human embryos – babies at a very early stage of development – who are killed in the process. ESC procedures, so far, have not proved to be the breakthrough they were expected to be.

Liam’s transplant came from adult stem cells. Adult stems cells are now proving very useful in the treatment of many diseases thanks to ongoing research, but bone marrow transplants using adult stem cells have been successful for decades.

Liam’s Parents Also Chose Life

The autoimmune disease HLH is notoriously difficult to diagnose and there is only a short window of opportunity to successfully treat the disease with a bone marrow transplant. Liam’s 6 year old brother Noah’s HLH was not diagnosed early and although he fought hard for many months, complications of his bone marrow transplant took his life in October 2012.

While we were all standing vigil for Noah two days before he finally died, Noah’s parents received the difficult news that a special prenatal test showed that Liam, Noah’s unborn brother, also had HLH. The abortion option was brought up. This happened even though little Liam himself would have an excellent chance for a bone marrow transplant cure, especially since his bone marrow transplant could be planned before he showed any sign of the disease.

I was so proud of my stepdaughter when she instantly replied to the abortion “option” with outrage. She told the doctor that it was unthinkable that she would be offered the “choice” of killing one of her children while watching another one of her children die!

The “helpful” doctor who suggested abortion probably thought that she was only being sympathetic, but, like too many people in our society, she saw abortion as an acceptable solution to a tough situation. My stepdaughter enlightened the doctor not only about the truth of abortion as killing but also about the effects on the family. So-called “therapeutic” abortion is never therapeutic for either the child or the family. How can killing a child ever prevent grief and guilt? How can anyone rationalize the very real difference between dying and being killed?

BONE MARROW AND ORGAN DONATION

As I have previously written (see my previous blogs on Non-brain Death Organ donation, Parts one and two), many people are understandably concerned about signing an organ donation card because of the controversies surrounding brain death organ donation and DCD (donation after circulatory death).

However, there are alternatives such as the donation of bone marrow, blood or even a kidney or part of a liver while still alive and healthy. In addition, after death, tissues like bone or corneas can be taken even hours after death is certain.

HOW TO BECOME A BONE MARROW DONOR FOR SOMEONE LIKE OUR GRANDSON

If you or someone you know is between the ages of 18 and 44 and wants to consider being tested for bone marrow donation, you can get more information and join the bone marrow registry at Be The Match at https://bethematch.org/Support-the-Cause/Donate-bone-marrow/Join-the-marrow-registry/

Bone marrow donation can be done by a technique that collects peripheral blood stem cells (PBSC) from the donor’s blood as well as by having bone marrow taken from the hip as Liam’s donor did. An explanation of both donation methods can be found at >https://bethematch.org/transplant-basics/how-marrow-donation-works/steps-of-bone-marrow-or-pbsc-donation/

We will continue to be eternally grateful to Liam’s donor for a true gift of life.

Addendum from the Pro-Life Healthcare Alliance Newsletter July 23, 2015 :

There is a third designation of stem cells that is little known but is gaining momentum: the fetal stem cell. Human beings are called embryos for the first eight weeks after fertilization. After that, we enter the fetal stage, which is from nine weeks post-fertilization until birth. Fetal stem cells are stem cells harvested during the fetal stage of development. Fetal stem cells, often procured from elective abortions, are disingenuously classified as “adult” stem cells simply because they do not come from embryos. Needless to say, this creates great confusion. Be wary. See: https://www.ncregister.com/daily-news/stem-cell-stealth-mode-when-terminology-masks-immorality/

Compassion and Choice’s lethal game plan: California Mom Christy O’Donnell Fights to Die on Her Own Terms by Katie Couric

nancyvalko assisted suicide

A July 1, 2015 Yahoo News article titled “California Mom Christy O’Donnell Fights to Die on Her Own Terms” by Katie Couric (https://www.yahoo.com/health/california-mom-christy-odonnell-fights-to-die-on-122937321077.html) shows that Compassion and Choices has a lethal game plan for forcing assisted suicide on the nation. Note this quote:

“Despite the growing death-with-dignity fight in various states, Coombs Lee doesn’t expect that it will find itself in front of the Supreme Court anytime soon: “I don’t think it’s reasonable to think the Supreme Court will act before the majority of states.” But Coombs Lee is hopeful that the End of Life Option Act will pass in California within three years. “It will definitely pass,” she says. “And if this legislature doesn’t pass it, there are two lawsuits working their way up.” (emphasis added)

As a nurse, I am also appalled by the implications of this quote:

“Attorney Barbara Coombs Lee, president of nonprofit death-with-dignity organization Compassion & Choices and co-author of Oregon’s Death With Dignity Act, tells Yahoo Health that those safeguards include extensive evaluations by two physicians, as well as several waiting periods, before a patient can fill a prescription for life-ending medication. Even then, Coombs Lee points out, not everyone actually takes the medication. “Every year between 30 to 51 percent of the people who have the prescriptions do not administer them,” she says, adding that many feel that the quality of their lives improves just by having the option.” (emphasis added)

So these suicidal people not only have deadly drugs themselves but also drugs potentially accessible to anyone else in their household like a grandchild whether or not these people eventually use them to kill themselves. When I was a hospice nurse, we had strict rules for accounting for and safely disposing unused drugs- especially controlled drugs. Apparently such standards are ignored in legalized assisted suicide.

My letter on ethical palliative care published in National Catholic Register 6/14/15

nancyvalko palliative care

http://www.ncregister.com/site/article/letters-06.14.15

Regarding “Pope Francis: Abandonment Does Greatest Injustice to the Elderly” (NCRegister.com, March 6):
As an R.N. with 45 years of nursing experience, including many end-of-life situations, I’m sure the Pope meant “ethical” palliative care, which is indeed wonderful for both patients of any age and their families. Unfortunately, there is a growing trend towards calling unethical practices “palliative care.”
For example, just last year, I saw a middle-aged nurse/friend’s life deliberately ended due to so-called palliative care labeled “comfort care.” She had recently suffered a severe brain injury and was declared hopeless after a couple of weeks. The family was strongly encouraged to switch to “comfort care.” She was taken off a ventilator, had her feeding tube removed (against family wishes), and the sedation medications used when she was on the ventilator were continued and even increased when she continued to breathe on her own, until she died a few days later.
The public needs to be aware of such practices and what the Church teaches so that they can make informed decisions if they find themselves or a loved one in a difficult situation.
Nancy Valko
St. Louis, Missouri

Non-Brain Death Organ Donation, Part Two

nancyvalko organ donation

Non-Brain Death Organ Donation Part Two

By Nancy Valko, RN, ALNC

February 20, 2015

(This is an updated version of an article originally published in the February newsletter of the Pro-Life Healthcare Alliance .

Although non-brain death organ donation started over 20 years ago, it is mostly unknown to the  general public who sign organ donor cards assuming that they will be carefully diagnosed as  “brain dead” before their organs are harvested. (See “Non-Brain Death Organ Donation, Part  One,” )

Originally called non-heart beating organ donation (NHBD), and later DCD (donation after cardiac death), it is now called donation after circulatory death (also DCD) because donor hearts can sometimes be restarted for transplantation. I call it non-brain death organ donation because “brain death” criteria are not used.

In March, 2011, the Organ Procurement and Transplantation Network (OPTN) published proposed policy rules on non-brain death organ donation and opened its website for public comments. Despite many critical comments and an article in the Washington Post titled “Changes in controversial organ donation method stir fears” [1], the OPTN has now finalized some very dismaying standards.[2]

In one of the most disturbing sections, “Consent for DCD”, the OPTN states that “Conditions involving a potential DCD donor being medically treated/supported in a conscious mental state will require that the OPO (organ procurement organization) confirms that the healthcare team has assessed the patient’s competency and capacity to make withdrawal/support and other medical decisions.” [Emphasis added.] There is no mention of evaluation for depression or other difficulties that may influence the person’s decision, which omission obviously could lead to a new form of assisted suicide.

The OPTN policies also state that “Any planned withdrawal of life sustaining medical treatment/support will be carried out in accordance with hospital policy.” Even the guidelines suggested in the two Institutes of Medicine reports on non-brain death organ donation, like waiting a minimum 5 minutes (after cessation of the donor’s breathing and heartbeat) before harvesting, have been generally jettisoned in favor of locally decided rules. As the OPTN admits, its policies “…set the minimum requirements for DCD recovery but do not address local practices, cultural and resource issues…” Thus, like brain death criteria, the rules surrounding non-brain death donation can potentially vary even from hospital to hospital without the patient or family even being aware. And as one of the inventors of the NHBD protocol, Dr. Michael DeVita, has admitted, “the possibility of [brain function] recovery exists for at least 15 minutes.”[3]

Another major problem is that, even though doctors screen such patients for a rapid inability to continue breathing without a ventilator, at least an estimated 20 per cent of non-brain death donors do not stop breathing and heartbeat fast enough after withdrawal of a ventilator to have usable organs. These patients are then just returned to their rooms to die without further treatment.[4]

How can doctors be so wrong in some cases? Could such patients potentially improve? A 2003 article in the New England Journal of Medicine illustrated a disturbing lack of objective medical standards for withdrawal of ventilators even outside an organ donation decision. This article admitted that no study was done to “validate physician predictions of patients’ future functional status and cognitive function” and the researchers did not ask doctors to ”justify their predictions of the likelihood of death or future function.”[5]

These are just a few of the criticisms of non-brain death organ donation that have been raised by ethicists, doctors and other concerned people.

Informed Consent

 How many people know the Uniform Anatomical Gift Act was revised in 2006 to include “first person” authorization when a person signs an organ donor card or other legal donation document that “not only continues the policy of making lifetime donations irrevocable but also is restated to take away from families the power, right, or authority to consent to, amend, or revoke donations made by donors during their lifetimes.”[6]?

With the discussion about problems with non-brain death organ donation absent in mainstream media, what can you do to protect yourself from a potentially unwanted organ donation?

First of all, know the facts. It is necessary to do your own research since fact sheets often provide only minimal information when you sign an organ donor card while you are renewing your driver’s license or checking off a box in your advance directive. Therefore, you may not be giving the truly informed consent such a momentous decision requires.

Keep informed about new strategies being proposed such as “presumed consent” which is the assumption that everyone is willing to donate his/her organs unless there is evidence that they would not want to donate. Illinois narrowly avoided a “presumed consent” statute a few years ago.

However, there are alternative ways to donate that people who are uncomfortable with brain death and/or non-brain death donation might consider. For example, people can become a living organ donor for a kidney. Such kidneys also have many advantages over both brain dead and non-brain dead kidneys such as usually lasting twice as long. (See: “The Benefits of Living Donation”) While there are risks to such a surgery for the donor, living organ donation avoids the ethical concerns about determining death.

Other alternatives are the donation of blood or bone marrow donor while living or, after death, the donation of tissues like bone or corneas that can be taken even hours after death is certain.

In addition, there is hopeful medical research involving adult stem cells to repair organs and building artificial organs that may someday replace the organ donation we have now.

Having a daughter-in-law who currently needs a living donor kidney transplant, I am aware of how much such a “gift of life” can mean, but I believe it should not be at the expense of ethics or informed consent.

About the author: Nancy Valko, RN, ALNC, has been a registered nurse for 45 years and is a spokesperson for the National Association of Prolife Nurses . A long-time speaker and writer on medical ethics and other health issues, she has a blog “A Nurse’s Perspective on Life, Healthcare and Ethics” and an archive of her articles from 1988-2014 titled “Nancy Valko, RN ALNC”.  She is also now a legal nurse consultant.

FOOTNOTES

[1] “Changes in controversial organ donation method stir fears” by Rob Stein. Washington Post, September 19, 2011. Online at:  http://www.washingtonpost.com/national/health-science/changes-in-controversial-organ-donation-methodstir-fears/2011/09/15/gIQAlY9agK_story.html

[2] Organ Procurement and Transplantation Network Policies. U.S. Department of Health & Human Services. Current as of 2/1/2015. Online at http://optn.transplant.hrsa.gov/ContentDocuments/OPTN_Policies.pdf

[3]”The Death Watch: Certifying Death Using Cardiac Criteria,” Michael A. DeVita, MD, University of Pittsburgh Medical Center, Pittsburgh, Pa., Prog. Transplant 2001; 11(1):58-66, © 2001 North American Transplant Coordinators Organization

[4] “Organ Procurement after Cardiocirculatory Death: A Critical Analysis”, Mohamed Y. Rady, MD, PhD, Joseph L. Verheijde, PhD, MBA, and Joan McGregor, PhD. Journal of Intensive Care Medicine. September/October 2008, available online at http://jic.sagepub.com/cgi/reprint/23/5/303.pdf

[5] Withdrawal of Mechanical Ventilation in Anticipation of Death in the Intensive Care Unit” by Deborah Cook, M.D., et al. New England Journal of Medicine, Volume 349:1123-1132, September 18, 2003, Number 12. Abstract available online at: http://content.nejm.org/cgi/content/short/349/12/1123

[6] REVISED UNIFORM ANATOMICAL GIFT ACT (2006), page 30. Online at: http://www.uniformlaws.org/shared/docs/anatomical_gift/uaga_final_aug09.pdf