More on Grey's Anatomy

I just popped over to the Grey's Anatomy discussion forum thread, and it seems that some people found this episode more offensive than I did.

ABC's Grey's Anatomy thread regarding this episode

I'm going to copy out the three responses that I found most interesting there:

Posted: Oct 03 @ 02:12 PM
by: actual_paramedic (1 Posts in the last 90 days) Registered: Oct 03, 2005
I'm an organ procurement coordinator for the past four years in the Midwest, and organ transplant/donation issues seem to be a recurring theme we might come to expect from Grey's Anatomy in the future.

I'm a fan, and like many on this thread have suggested, I watch Grey's Anatomy for entertainment value only... and because I think Katherine Heigl is hot (much to my wife's dismay)!

I wanted to share a couple of things with all of you who read this thread about donation...

The process to declare brain death is structured and requires that the patient meet certain criteria for brain death testing to even begin. The clinical and confirmatory exams are performed independently of each other to assure that brain death is present. True brain death INCLUDES the death of the brainstem, as well.

There is no national standard for declaring brain death. In some states, declaring brain death requires two physicians (one of whom must be a neurologist or neurosurgeon or neurointensivist) performing brain death exams a certain interval apart, perhaps 6 or 12 hours. Other states may require only that the patient be declared brain dead by a licensed physician.

Brain death is defined as the irreversible cessation of brain and brainstem function. Brain death is permanent: when brain cells die, they are permanently dead and do not regenerate themselves. It is a clinical diagnosis, recognized universally. Many states recognize the time brain death is declared as a person's legal time of death.

In every case, brain death testing must be performed in the absence of known causes that would cause a patient to be totally unresponsive. For example: a brainstem tumor like the one last night's potential donor had would have been a reason not to perform brain death testing: it is a diagnosis which is potentially reversible through surgical intervention.

To find out anything and everything about brain death, I urge anyone who has a minute to visit www.braindeath.org.

The portrayal of transplant recovery teams hovering around the OR is erroneous and inaccurate. Recovery (harvest) teams arrive shortly before the scheduled OR time, and may be late if they are flying in from a distant transplant center. Heck, they're usually a little late even if the transplant center is just across town! If they are late, we often stand around doing a lot of nothing in the OR waiting for them to arrive.

The process surrounding donor families and the donors themselves is one of the utmost respect shown by everyone directly and indirectly involved with a donor case. Abuses of the organ allocation system, like the situation with the liver in California which came to light last week are always uncovered by auditors and the penalties are stiff. The transplant program has been closed, the surgeons and staff have been relieved of their duties. The federal government provides stiff fines and jail time for those who sell, illegally procure, or deliberately abuse the organ allocation system.

Also, in certain cases, you do not have to be brain dead to be an organ donor. This type of donation is called Donation After Cardiac Death (DCD) or Non-Heartbeating Donation (NHBD). It is slowly being implemented across the United States. In other countries, DCD/NHBD is the only type of donation practiced and is their only source for donor organs. Japan only recently began recognizing brain death!
You can learn more about DCD/NHBD organ donation by visiting:
www.organtransplants.org/understanding/death/

Finally, signing your driver's license is a good thing, and so is having a living will or medical power of attorney/durable healthcare power of attorney, etc. The most important thing anyone on these blogs can do to support donation is to tell your family you do or don't want to be an organ and tissue donor. It will relieve them of such a burden, as this is one of the decisions families can be split over when they're trying to guess what you would have wanted. You certainly won't be able to speak for yourself.

OK, off soapbox.
Eric
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Posted: Oct 03 @ 05:43 PM
by: donationprofessional (2 Posts in the last 90 days) Registered: Oct 03, 2005
In their 10/2 episode, Grey's Anatomy did a wonderful job of accurately and yet dramatically depicting an ethical dilemma around living donation. It is our understanding that the writers consulted with an Organ Procurement Organization to receive input on this storyline and we congratulate you on the outcome. The son-to-father liver donation storyline was accurate and powerful in many ways. Specifically the storyline:

• taught the public that you can donate a liver while alive
  
• highlighted that a candidate must stop drinking before getting on the waiting list
  
• ensured that the father was listed with UNOS before transplantation was considered by the surgeons
  
• focused on the fact that the son had been provided with counseling to make this difficult decision
  
• mentioned that the liver can regenerate in a matter of weeks
  
• showed that you must be over 18 to be considered a living donor (this was a change you made to the storyline to assure accuracy)
  

Your episode could have been a potential award winner for the Sentinel for Health Awards if you had requested and received equal input for the deceased donation storyline. Because you did not ask donation professionals to guide your writers on the deceased donation process your depiction of the deceased donor was not only inaccurate, but also extremely harmful to the public's perception of organ donation. Instead of sharing how brain death is diagnosed and assured, your storyline depicted a fictional circumstance that reinforces one of the most prevalent misconceptions surrounding donation: "They won't work as hard to save me if I'm a donor." Specifically the storyline:

• utilized antiquated and objectionable terminology, "harvested¨, rather than the correct terminology, "recovered"
  
• implied that care and diagnosis of a potential donor is secondary to getting their organs
  
• inaccurately said that people are called to receive organs before a patient is confirmed to be brain dead
  
• implied that MRI's and brain scans are not part of determining brain death
  
• implied that a neurosurgeon would not normally be part of the pronouncement of brain death
  
• gave the impression that the six people who were to receive the organs were a priority over the care of the brain damaged patient
  
• provided the improbable situation of a patient recovering fully from a brain tumor on the brain stem
  

This conflict between the powerful, accurate and dramatic living donation storyline and the harmful, weak and inaccurate deceased donation storyline underscores the need for your writers to continue to work with donation professionals to receive information about the donation process. As we work daily to inspire people to donate life through organ and tissue donation we need hit shows like Grey's Anatomy to find and tell the truth and not perpetuate myths and misconceptions that keep people from saying yes to donation.

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And, finally, an observation that I found to be an astute statement of the "chill-out" faction:

Posted: Oct 04 @ 08:17 AM
by: _Neenie_ (1 Posts in the last 90 days) Registered: Oct 04, 2005
I think the idea that television has turned us all into zombies who immediately imitate/believe everything we see on tv is a really basic, naive media theory. Its like saying "TV makes us violent, and gives us all anorexia". We are not all the cultural dupes some of you want to make us out to be. I truly feel sorry for anyone who believes a passing reference to organ donation in a soap opera style television show is enough information for them to decide whether or not to donate. If there really are people who would do this, we as a culture have a much bigger problem than an insensitive writing team on grey's anatomy. Television is not for learning, it is for entertainment. If you want to know about something, read about it. Read Neil Postman's "Amusing ourselves to Death

It seems like the only people who are concerned with this issue are a) those who work in a hospital, and b) those who are waiting for, have received, or has a relative who is waiting for or has received an organ donation. Keep in mind that you have a special interest in the issue of organ donation, therefore any reference to it going to be more salient to you than to others. I have a feeling that most people watching the show, like me, who are potential donors, were really more interested in the drama, the entertainment value of the show. I don't watch medical dramas to learn about medicine or medical terms, In fact I assume they will not be one hundred percent accurate, I watch them to see if one hot doctor will get together with another hot doctor . The medical stuff is just background, and I suspect this is the same for most people. I don't work in a hospital, but I have been in one, and I assure you, as much as everyone seems to love dissecting the "reality of the show, if there was a show that portrayed a hospital exactly like it is in reality, no one would watch it.

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I think the most interesting point made by the last contributor is that it is primarily people intimately connected with organ donation that find these episodes concerning. I certainly know that my reaction is colored by my own experiences, and I suppose also by my need to see donors and the donation process presented in a positive light to assuage the guilt that seems common to many transplant recipients and their families. And, of course, I hope that the number of organ donors increases, and it seems that presenting positive instances of organ donation would contribute to that effort.

As much as I appreciate the "chill out, it's only entertainment" argument, I do wonder about its accuracy in this case. Certainly there have been many cases in which misconceptions on some issue are rampant, and TV was used effectively to combat these myths. In particular, I'm thinking of the panic surrounding the transmission of HIV in the '80s that had people thinking, wrongly, that the virus could be spread by normal social contact, such as hand-shaking. The entertainment industry was used very effectively as an educational tool to debunk these myths, and the industry was soundly criticized when it strayed into areas that perpetuated misinformation. So I do think that, in cases where misapprehensions are informing people's actions, TV and movies should be careful not to reinforce those fears.

Comments

[Running2Ks]

I agree that telling everyone about your organ donation intentions is critical. Many people don't know about the drivers' license option--or think it means people won't make efforts to save them if they list themselves as organ donors. Not true! A living will is also an excellent idea. People should consult attorneys and update them for every state they move to.

[Rowan]

Wow. That was a lot of information. Some great posts and info on that board.I gently push donation status with everyone I know. it's just become second nature.

[Sarahlynn]

"So I do think that, in cases where misapprehensions are informing people's actions, TV and movies should be careful not to reinforce those fears."Bingo. I agree 100% and feel strongly about it, as someone who has never been directly or personally effected by need of an organ transplant for myself, a close friend, or a member of my family.In a recent discussion with my book club, I was *stunned* that there are people who refuse to donate - after they're dead! - because it's "gross". Unbelievable.

[Becca]

Do we know "Eric" the writter of the first post? Thanks for taking the time to post some of the comments about the show here. I appreciate it.