Winnipeg Free Press

Winnipeg Free Press (Newspaper) - November 6, 1987, Winnipeg, Manitoba Winnipeg free press november 1987 Page 7 focus a Triumph for Mit life and ethics by Benjamin Freedman special to the free press baby Pauls heart transplant making him the youngest heart recipient in was a bold clinical move on the part of Leonard whatever happens Over the longer for the pres ent Bailey has achieved a spectacular medical for the medical team in that managed the heart baby it represented a More quiet kind of Triumph a Triumph of caution and ethical con before the medical drama was played out a drama of medical ethics was played out in the Issue raised what do we value about human life Leonard of Loma is a surgeon who has trailblazer the area of Rediat Ric cardiac while he has had several noteworthy Suc he was probably Best known until now for a failure the trans Plantation of a Baboon heart into baby the failure of that Effort pointed up the shortage of suitable sources for infant Organ infants can Only receive transplants from other infants who have died in ways that left their organs massive often caused by a traffic is the most common form of death resulting in a cadaver with organs suitable for traffic accidents of a rare cause of death for added interest upon an alternative those infants fated to die due to Nence Anen Cephal is a birth defect characterized by a Complete absence of an functional that major portion of the brain responsible for conscious sen and the condition May be diagnosed before Anen Cephal occurs about once in every to and is incompatible with an estimated half to three fourths of Ane Cephalic infants Are those who Are not stillborn have some function in the brain that portion of the brain which controls such reflexes As tempera Ture regulation and within a Short even this minimal ability to breathe gradually babies born with Anen Cephal uniformly die within two weeks of a condition which is utterly beyond the Power of Medicine to Correct or it was known that parents of affected children had often sought to retrieve meaning from their baby tragedy through Organ scattered reports have appeared in the medical literature since the late 1970s of the use of Ane Cephalic infants As donors for kidney trans the Ane Cephalic donor could be consid ered for a Broad Range of trans the Only basis upon which any such transplant could proceed is following the death of the infant whose Organ is being yet the previous reports had never explained the basis upon which the infants used were deter mined to be Organ transplant practice has re lied upon what is known As the whole brain death in this a person cannot be considered As an Organ donor until he has suffered death of the entire including the brain one who has suffered whole brain has lost much More than the capacity to think or As is the ability to breathe independently or other Wise to self regulate Basic bodily in such a it is deceptive to As is that his life is being sustained by artificial some functions Are being sustained by tech but the person has nonetheless he is not breathing on the he is being breathed by the the concept of whole brain death therefore satisfies those who feel that Independent breath ing or the ability to centrally Inte grate and coordinate body functioning Are themselves signs of heart functioning itself depends upon the hearts receiving a continuous fresh Supply of oxygen through if a persons breathing is being artificially sus his heart function too is the whole brain death definition therefore satisfied a Broad spec Trum of which values human life Over and above the ability to or consciously As it has been adopted As the Standard for Organ and has been widely adopted As a Legal doctors face an urgent need for organs to save the lives of definition of death in the United in brain death statute has been adopted in Manitoba and has been recommended in a report of the Law Reform commission of this approach has not served for transplantation of organs from an a Cephalic if organs from these babies Are not in a usable condition for transplant if born these infants Are not dead according to whole brain death the fact that they Are breathing independently itself indicates that there is a portion of the brain the brain Stem that is the manner of death to which these infants will typically succumb gradual loss of breath ing ability deprives their organs of rendering them unsuitable for american paediatric notably including Michael Harri son of the University of California in san As Well As Leon Ard have argued that the approaches of Law and ethics to transplantation need to be changed to allow for the use of donation from Ane Cephalic although not quite brain they have a these infants Are brain a a condition which should have the same ethical and Legal consequences As should this approach be adopted in Canada on january a conference was held in to consider ethical and As Well As aspects of Ane Cephalic the conference was of practical As Well As intellectual since the very Active transplant team in London was itself in the process of determining under which conditions it would participate in Anen Cephalic american speakers strongly encouraged the canadians to adopt their View of Anen Cephal As a brain absent exception to the definition of it was is different in that its diagnosis is simple and its Progno the advocates of the brain absence View further claimed that any qualities that Are associated with person Hood or personality could never conceivably develop in the Ane Cephalic and there were the compelling medical arguments on the one the great need for Small organs on behalf of other infants who could otherwise Lead Normal lives on the the impossibility of retrieving usable organs from Ane Cephalic infants if traditional brain death criteria were their recommendation was that new Law and ethics should be developed to accommodate the medical really of Nence Phaly and need for Nence Phalis should be treated As an and in their Case inde pendent breathing should not be considered a sign of in the the Consen sus View rejected that which would Purchase medical efficiency at the expense of settled ethical and Legal such an exception on behalf of Nence Phaly might set an unwelcome precedent on behalf of other patients with poor impaired cognitive functioning and who Are Respirator it could narrow the Broad sup port transplantation had by repudiating any connection be tween Independent heart and lung functioning and the presence of if brain absence itself is a valid criterion of an Ane Cephalic child who is still breathing independently in be treated in All ways including trans Plantation and preparation for burial As already this ethical and Legal innovation would ratify a judgment which society May not be prepared to that human value is found exclusively in mental if Nence Phalis Are morally and then respect will Only be granted to those demonstrating human it will have been withdrawn from human pres ence and the Canadian con Ference consequently rejected the proposed ethical land ing right Back at the dilemma How can usable organs be retrieved from Ane Cephalic infants the suggested Resolution treat Ane Cephalic infants precisely As you would any other prospective Organ the same criteria of death ought to including an absence of brain Stem function As expressed in the Independent capacity to to maintain the organs in a usable the infants breathing would need to be artificially supported when it began to and other forms of support May also need to be provid the infants condition would need to be and when All brain functions had been the infant could be declared dead in this Equality of persons would be and there would be no need to change the settled ethical View on the definition of death and this solution preserved ethics but it rested upon a medical was the degenerative process observed in infants without technological support caused by a shortage of oxygen Supply would an Nence phallic infants minimal brain function be preserved indefinitely by artificial support in that the infants organs could never be the result would be that some other infants Hope for life would be there was no Way of knowing in Advance what the result would it was nonetheless Felt in this medical practice should attempt to accommodate the fundamental ethical values at from All published this was the approach followed by the London team that managed baby Pauls Organ baby Michael Harrison has accused them of playing a Shell game to get around the ethical he supports an immediate declaration of death upon the birth of a breath ing Ane Cephalic this was no the Gamble appears to have been Suc and it now seems possible to retrieve organs from an Nence phallic child while following the same safeguards and conditions applied to other that is Triumph for and for baby at the same ethics and social attitudes were not put at risk in this Organ retrieval that is a Triumph for the careful approach taken by the med ical but for baby Gabriel above All a silent child whose dying confirmed that prudent ethics and medical practice can co Benjamin Freedman is associate professor at the Mcgill Centre for ethics and soviet press begins to print stories about War in Afghanistan j if non Curac in of Mininc a killing eve Cervoni by Alexander Gelvan special to the free press an unusually detailed account of a soviet search and destroy Mission has been published in the soviet daily the report covers a three Day period during which a group of soviet soldiers searched deep in Dushman rebel territory for a weapons the caravan missions Are a regular part of carried out by special groups of handpicked volunteers in an attempt to choke the continuous Supply of new weapons to the it is not unusual for Dushman to declare blood oaths against some of the better known Sovie pres who have led numerous soviet missions against the Cara the groups Are taken by helicopter behind the enemy travelling Only at they must endure 45 degrees celsius during the Day while hiding in the desert under camouflaged their Only Contact with Home base is the if it becomes they Are trapped and it is Only a matter of time before the rebels find when captured by the so Viet officers Are rarely More often they Are traded Back for it is reported that a soviet Pilot brings Afghani a Colo Nel Afghani a Lieutenan Colo Nel it would seem that the political situation in Afghanistan is not what the soviet Media portrayed it before the Days of in an interview with Izvestia one soviet officer openly stated there is no evidence of lasting no one will give a pins head for your life if you decide to take a walk without your the afghan resistance is especially Strong around the City of Kanda All around the City the soviet correspondent observed traces of destroyed soviet Afghanistan has often been called the soviet and indeed there Are Many soviets find it difficult to fight the there Are no attempts to capture they Are not afraid of they do not surrender if there is no Chance to they blow them selves explains a the Mission witnessed by the so Viet reporter was Howe he was not allowed to take any pictures of the men before going this was not because of any official military years of conflict in Afghanistan have established a tradition that soldiers do not take pictures of each other before the do not write Home and do not after two Days of travelling at night they took their position on a narrow strip of the they waited until the whole caravan was in View and within minutes the time on for those who were on that Road came to a one of the trucks killing everyone the other cars were riddled with soviet bullets and looked like a there were no soviet such reports Are a new trend in the soviet it is not common for the soviet press to report catastrophes or details of military opera in the past several reports of soviet casualties in Afghanistan have become More full details of five trans port air planes having been shot Down by the afghan rebels since january have appeared in pravda and Ives Alexander Gelvan is a Winnipeg graduate student and Cost of buying Gas firm will eat up any savings maybe its All those incredibly complicated perhaps the Japa Nese Are putting the chips in Why would responsible people go around making those really dumb state ments based on really bad Jay that Whiz kid of the Treasury has Given us the latest Jay and his Cabinet colleagues have been telling us that they will save us Money on our heating Bills this jays Howard said we would save this after the National Energy Board would not let Manitoba play Jast and Loose with existing the savings shrunk to then the Public utilities Board got out its calculators and reported that the actual savings this Winter would not be but Only Jay Cowan now pipes up to Tell us that the saving is exactly the same As it always but it depends on How the amount is the pub figure of is the same As the talked about which is the same As the first what does Cowan take us for either we Are going to save or or maybe Only saving is not the same As saving or saving no matter How the figure is the common who is not As accustomed As Cowan is to juggling millions of dollars on a knows exactly the difference tween and it is enough to buy three quarters of a thankful of gasoline but not enough to buy a 26 at the local liquor the difference Between and is a sizeable sum to most not too Many will need their calculators to figure out that would fill up a couple of Small bags at a grocery pay for some minor repair to the family automobile or even finance a Fred Cleverley dinner for two at one of Winnipeg respect Able no calculator could per Suade an average Manitoban that a saving of is the same As a saving of that strictly government the average Manitoban will have More need for his calculator to make ends meet after Cowans Eugene finishes picking every pocket in the province with his new he wont need a calculator to figure out what he is saving on his Gas he wont need a calculator mainly if Cowan and Kostyra carry out their takeover of the Gas there wont be any savings to we know what the savings will be in our Gas Pawley says Cowan says the Public Utility Board says so far so where things get off the and where a calculator might be a Handy is what it is going to Cost each Gas customer to have the government buy the Gas distribution this Cost is made up of two the first is a figure that is generally accepted As the amount of Money that must change hands before the Pawley posse gets the key to the the province does not have million with which to buy the Gas like a teenager with dads credit it will go ahead just As if it did have the once it we will every about million in interest to keep the debt to this must be added the million a year the government lost by re pealing its motive fuels in Manitoba will be looking at an extra expenditure of million a year for the privilege of painting the provincial logo on the Gas where is this Money coming from per if Jay Cowan thinks that is the same As he also believes in the tooth the Money will come from the Gas there Are about of How much will every customer have to be charged each year to produce almost lets use a the answer is a perhaps that is what Jay Cowan was talking about when he said and were the added they Are almost the same As the Cost of Public what is perfectly Clear is that there was Money to be saved in the Price of natural Gas All the amount was not identified when Premier Pawley announced that he was about to Rescue the poor Consumers from the clutches of intercity the amount was identified when the Public Utility Long before the premiers ordered ice to renegotiate its these negotiations hit a the Snag was the Manitoba motive fuels this tax was designed to Siphon in part of the Cost of pumping Gas to the really big Market in the provincial government got into the negotiations Only after it started making noises about removing this natural Gas distribution is currently the responsibility of a private but that company is regulated by the Public Utility Board so closely that its profit is determined to the second Decimal the Public is fully protected under the current there is no heaping pile of complaints about the Gas its especially during the Winter is Why do we need to buy it we Are getting the cheaper Gas our savings Are not what were promised by the politicians but neither is what we pay for Hydro the full Cost of producing at while the Gas company is we will know that what we pay represents the whole Cost of the put the government in charge and it will be no time before Gas rates but taxes and the deficit go there May be funny but there is no tooth doonesbury by Garry Trudeau jell him Peman 05tter markets is want four workstations per not commit say5 he wants to work out a settlement my win he says oh7hohipoes he propose talking to we talk Pamn i pull that sooner later it i ;