Ruben Navarro’s death is “old news” by internet standards. He was a man with adrenal leukodystrophy whose path to death included an alleged attempt to kill him by a transplant surgeon. Five medical professionals stood by while transplant physician Hootan Roozrokh ordered massive doses of ativan and morphine for Navarro. One of those physicians was Navarro’s attending physician. A sixth medical professional, a nurse, administered the injections that Roozrokh ordered. Roozrokh is now facing felony charges of dependent adult abuse, administering a harmful substance and prescribing controlled substances without a legitimate medical purpose.
For the full story of Navarro’s life and death, please read Diagnosis: Murder by Cilla Sluga for the most comprehensive investigative reporting on the life and death of Ruben Navarro.
Ruben Navarro’s “medical lynching” occurred under the heart beating cadaver donor protocols. Unlike the more common organ harvesting done when someone is declared “brain dead,” the organs are removed shortly after a person undergoes cardiac arrest. This protocol is somewhat controversial, but many thoughtful people support it as ethical if it is done properly. Wesley Smith, for example, laid out his reasoning about the practice in this essay.
Whether it’s ethical or not, the practice has at least two big problems that don’t exist within the more common practice of harvesting after pronouncement of brain death:
- In the case of brain death, physical functions can be maintained while arrangements are made to harvest organs after removal of artificial ventilation, minimizing time pressure;
- The new protocol opens up potential “candidates” for organ harvesting who are not dead or dying at all. Ruben Navarro, for example, could have gone on indefinitely on a ventilator and may even have achieved some level of recovery if he had not been disconnected from his ventilator.
Meanwhile, there are several important issues demanding discussion, but no bioethicist or journalist we can find is discussing them (thanks to Cilla Sluga as a source for more than one of these important questions):
- Was Ruben Navarro really dying? In the wrongful death complaint brought by Navarro’s mother, she claims the hospital told her that the hospital had a limit of five days for coma patients being on a ventilator? Could Ruben Navarro have experienced some level of recovery if he’d been given longer than five days? Is this claim true? How did she come to believe that? What does that mean about her “consent” to having his ventilator removed?
- Can we trust the coroner’s report? Cilla Sluga reports that a betadine solution administered into Navarro’s intestines is toxic when taken internally. Navarro lived for hours after the alleged overdoses of ativan and morphine. Did the betadine kill him?
- Why was no one else in the room charged with a crime? The medical professionals in that room all had a duty to prevent harm from being done to a patient. How did the medical review boards come to a decision that neither the attending physician nor the nurse who administered the injections did nothing wrong? Could they tell us what the heck they did right? What does this tell us about the medical profession’s ability to police itself and discipline its members for misconduct?
Right now, the news coverage has died down on Navarro, but it will flare up again, and more than once. Look for it to flare up again around September 12, when transplant surgeon Hootan Roozrokh will be arraigned.
So far, transplant advocacy organizations, bioethicists, and transplant recipients have made themselves heard in the coverage. That’s exactly what they should be doing in terms of advancing their respective interests.
Ruben Navarro, though, was a member of the disability community, and our voices have been absent. We need to claim our place in this story. The nightmarish treatment of Ruben Navarro resonates with some of the worst nightmares that many of our brothers and sisters talk quietly about.
To put it bluntly, Ruben Navarro would probably have been rejected out of hand as eligible for being a recipient if he had needed a transplant. It makes the circus of horrors accompanying the rush to make him a donor all the more appalling.
It’s time to get louder.
It’s especially important in California where legalization of assisted suicide is being pushed. Part of the “push” includes glowing promises about “safeguards” and “oversight” – the same kinds of safeguards and oversight that “protected” Ruben Navarro.
For some ideas on what to get loud about, check out this archived episode of WBAI’s “The Largest Minority.” Cilla Sluga and I discuss the Navarro case. –Stephen Drake
Addendum: I was just alerted that the archived audio of a show I did last week is now available. Thanks to host Geoff Langhorne of “disRespect disability awareness radio.” Disabled Los Angeles Man Put Down for Organs ? can be now be heard online or downloaded.