Letter: Transplant ethics

Sir: As a staff nurse on a paediatric intensive care unit I was very disturbed by Esme Thompson's letter (8 March) about organ donation.

It is now possible to keep a patient's body alive when they are actually "brain dead" and it is these patients who are considered for organ donation. Very strict tests are performed which establish, without a doubt, that the brain stem has been irretrievably destroyed and the patient's body would not function any more without the assistance of machinery. These tests are performed twice and the patient has to fail them both times to go for organ donation. If there is any doubt at all then the patient's treatment continues as aggressively as before. Families can, and often do, choose to be present when the tests are performed, and they are explained in detail.

It is very important to keep the organs in as good condition as possible to give the recipients the best chance, and to deprive them of oxygen would damage them; so all support to maintain the organs is continued until organ retrieval is completed.

The time of death is registered as at completion of the first set of tests. The families of patients who donate organs are fully aware of all the implications of organ donation and receive objective advice and full support from nursing and medical staff at what is an incredibly difficult time. Comments such as Esme Thompson's are very damaging indeed.

ANN SKELHORN

Warrington, Cheshire