True, the "semblance" of life remains, but the diagnosis of brain-stem death excludes the possibility of any form of conscious survival or an existence without life-support. A few minutes after disconnection from the ventilator the donor would cease to "be warm and pink ... have a heartbeat and pulse" because the areas of the brain which regulate this activity are dead. Even ventilated, the donor requires increasing intervention from medical staff to regulate the metabolic and cardiovascular instabilities which occur following brain-stem death and the consequent lack of autonomic control from higher centres. The time from the diagnosis of brain-stem death to life being declared extinct by the more traditional clinical markers can only be counted in days.
Taking organs for transplant is never going to be pleasant for any concerned, but the thousands requiring organs are alive in the full sense of the word and can go on to live productive lives. Organs are removed only after we are sure that there is no hope left for the donor, and consent is obtained from next of kin.
Dr ANDREW ROBINSON
Forest of Dean, Gloucestershire