The below are quotes from the article ‘”Are You Sure He is Dead?”: Doctors Struggle with Families’ Lack of Understanding of HOTA’ featured on 5 May 2019 at https://www.channelnewsasia.com/news/singapore/human-organ-transplant-act-doctors-families-understanding-11459284 with notes on them.
‘Singaporeans and Permanent Residents aged 21 and above are deemed donors, unless they chose to opt out. It allows for their heart, kidneys, liver and corneas to be harvested for transplantation when they are declared brain dead.’
Note 1: If choosing to opting out, use this form: https://www.moh.gov.sg/policies-and-legislation/human-organ-transplant-act
‘They [i.e. family members] either cannot come to terms with the death of the family member or doubt that their family member is really brain dead.’
Note 2: There is no worldwide agreement on what brain death really is, and that being brain dead is being completely dead. This 3 Jan 2019 article shows that the definition of brain death is not even agreed upon yet, in all the states of USA: https://www.medscape.com/viewarticle/907210
‘Are you sure he is dead? See, he is still breathing (supported by ventilator).’
Note 3: Organs are harvested from the brain dead with the ventilator still operating, which means there is still breathing, although via life-support.
Note 4: The Buddhist definition of death is when there is no more breathing AND when the consciousness is detachable from the body, although the consciousnesses of many of the deceased tend to stay habitually attached to the body for some time, thus feeling magnified pain when touched, moved or cut, due to greatly magnified sensitivity then.
Note 5: The above in Note 4 means that if there is still breathing, even if with a ventilator, this is not considered death. When there is actual death, with departure of the consciousness, even a ventilator will not be able to sustain the body’s vital functions. With death being eventual, no one can be kept alive forever via a ventilator.
Note 6: As there are some cases of those ‘reviving’ even after breathing had stopped for some time, such as that in Note 7 below, the end of breathing alone is still not conclusive as death. Thus, as above in Note 4, the consciousness must also be detachable to be considered as death. As such, before and after death, there should be ample guidance offered with support-chanting, to urge the consciousness to swiftly part from the body, to avoid suffering needlessly.
‘Can we wait another day? I heard there are miracles that happen sometimes.’
Note 7: Yes, ‘miracles’ sometimes do happen, as can be seen in cases worldwide like this recent one (circa 4 May 2018), of a boy whose heart stopped for 15 minutes, and with brain death being declared, about to be harvested for organs before ‘reviving’ in time: https://www.youtube.com/watch?v=Krpdx6YyCTA
‘They [i.e. family members] do not want organ donation and cannot accept the presumed consent provided under HOTA [Human Organ Transplant Act] and feel that their loved one would not have wanted to.’
Note 8: Even if organ donation for family members is not wanted, if there was no personal opting out, it can still proceed.
‘This discord arises when patients do not discuss it with their loved ones due to its “taboo” nature.’
Note 9: As part of reality to be eventually faced, dying, death and expected procedures after should be swiftly, openly and clearly discussed, so as to know each other’s expectations on what to be done, and to carry them out accordingly.
‘Objections could also come about for cultural or religious reason.’
Note 10: Such reasons are not necessarily unscientific, even if difficult to be verified by science. Anyway, science still cannot measure post-death consciousness’ activities or explain ‘miracles’ such as the above.
Avoid Touching Of Body (When Dying & Dead)
HOTA (Human Organ Transplant Act): Opt-In Or Opt-Out?