Ethicists Debate Ambulance for Organs

"How well it will work out remains to be seen."

Several Ethical Concerns

Maxwell J. Mehlman, director of the Law-Medicine Center at Case Western Reserve University in Cleveland, says he worries the process could cause distress for family members of decedents if it interferes with their grieving process.

"Would it delay family access to the decedent?" Mehlman said. "Would it physically alter the body in ways that were apparent during the funeral -- [for example, during an] open casket? If so, then some families might object, and some courts might regard the program as violating the family's rights."

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The issue of how family members react to the service might even begin well before the funeral.

"I can also easily imagine confusion during which a corpse that is dead has procedures done for preservation of the organs and is whisked away, leaving onlookers and family thinking that the person is still alive, when the EMTs know they are dead," said Bill Allen, associate professor of the Bioethics Program at the University of Florida College of Medicine in Gainesville. "What will they tell bystanders?"

Far more troubling is the idea that emergency medical personnel staffing the ambulances could be faced with a dilemma of either doing everything possible to save a patient, or acting with the chief interest of saving organs.

"If it is an ambulance for the living or the dead, you run into an ethical dilemma," O'Brien said. "The ambulance has an obligation to the people of their service area to go back into service after a call, as soon as possible. This sounds like they may be tied up transporting and working on literally a deceased person, and not be available for others."

"Unless there is a plethora of EMS vehicles available where this ambulance serves, which is not the case in many areas, they still should concentrate on treating and transporting patients who have a chance at survival first."

Mehlman adds that some may worry whether the responders on such an ambulance would be under any pressure to stop trying to revive a patient in order to begin saving his or her organs. And at a time when the growing need for transplant organs is met by public concern over how these organs are obtained, such considerations become especially crucial, Allen says.