Transcript: Show #7 | Nov 14, 2000

A slate appears with the caption "The advice given in the preceding programmes is of a general nature only viewers should consult their own medical professional for medical advice specific to their circumstances."

(music plays)

The title of the show appears: "Your Health." Clips of the episode are displayed behind the title sequence.

Maureen says THIS WEEK.

An old woman says I CALLED 911.

Maureen says A SUDDEN AND
HEART-WRENCHING DEATH FROM
EPILEPSY.

Pictures of a young woman appear.

A woman in her forties says THEY HAD BEEN WORRIED
ABOUT MAKING PEOPLE ANGRY
AND ANTI-TRANSPLANTATION AND
THEREFORE OVERALL DECREASING
THE NUMBER OF ORGANS.

Maureen says INCREASING OT ORGAN
DONATIONS, THE ETHICAL
IMPLICATIONS.
AND BUGS BUNNY'S SECRET, A
DIET RICH IN BETA CAROTENE.

Joe Schwarcz says SOME STUDIES HAVE SHOWN
THAT PEOPLE WHO HAVE HIGH
LEVELS OF BETA CAROTENE IN
THEIR BLOOD WERE LESS LIKELY
TO BE AFFECTED BY CERTAIN
TYPES OF CANCER, HEART
DISEASE OR STROKE.

(music plays)
The opening sequence begins.

Clips of different people flash against a grey background. A 30-year-old woman with shoulder length black hair looks through a microscope, a 30-year-old with very short black hair holds up her 1-year-old son, a pharmacist counts and organizes red-and-yellow pills, a surgeon cuts into the abdomen of a patient and, finally, a man wearing a ted tank-top lifts weights. An animated microscope, pill bottle, syringe, and small dumbbell fly around the screen.

The title appears: "Your Health."

Maureen stands in a wood-paneled studio with T.V. screens embedded in the walls. She is in her forties, with short wavy red hair. She wears a gray top and a blue blazer.

Maureen says HELLO, I'M
MAUREEN TAYLOR.
SUDDEN, UNEXPLAINED DEATH.
IT HAPPENS TO INFANTS AND WE
CALL IT SIDS.
WHEN IT HAPPENS TO PEOPLE
WITH EPILEPSY IT IS CALLED
SUDEP WHICH STANDS FOR
SUDDEN UNEXPLAINED DEATH IN
EPILEPSY.
LIKE THE PARENTS OF BABIES
WHO DIE OF SIDS IT LEAVES
DOCTORS MYSTIFIED AND
FAMILIES DEVASTATED.

A picture of a baby appears.

Maureen says JUDY FARRELL HAD A
PREMONITION THAT SHE
WOULDN'T LIVE A LONG LIFE,
EVEN BEFORE SHE WAS
DIAGNOSED WITH EPILEPSY AT
THE AGE OF 12.
BUT SHE WAS ALWAYS SPUNKY,
ACCORDING TO HER MOM.

Pictures of Judy at different ages appear.

A caption reads "Ann Farrell. Judy’s mother."

Ann is in her seventies, with short wavy gray hair. She wears glasses, a black and blue sweater and a blue and white neck scarf.

She says JUDY WAS 3... JUDY
WAS 32 YEARS OLD WHEN SHE
DIED BUT MANAGED TO LIVE 72
YEARS OF LIFE IN THAT SHORT
TIME.
SHE CAME TO ME ONE DAY AND
SHE SAID MUM, I'M GOING TO
APPLY TO WORK WITH THE
POLICE IN HAMILTON.
I THOUGHT WORKING WITH THE
POLICE THIS IS NOT HER BAG.
AND I DON'T KNOW WHERE THE
IDEA CAME FROM, WHICH WE'LL
NEVER KNOW.
SHE OFTEN WORKED NIGHTS
WHICH SHE LOVED WHICH WAS
VERY BAD FOR HER EPILEPSY
BUT SHE WAS TOTALLY HAPPY
WORKING NIGHTS.
AND ON THE DAY THAT SHE DIED,
I FELT VERY, VERY UNEASY ALL
DAY.
AND I SORT OF FIDDLED ABOUT
IN THE APARTMENT, MADE MY
SUPPER.
AND I THOUGHT SOMETHING
DREADFUL HAS HAPPENED.
I HAVE TO GO.
AND I JUST ABOUT RAN FROM MY
PLACE TO HER PLACE KNOWING,
KNOWING THAT I WOULD FIND
HER.
I HAD HER KEY, OF COURSE.
AND I GO INTO HER APARTMENT
AND SHE IS STRETCHED OUT ON
THE CHESTERFIELD AND THE
TELEVISION WAS PLAYING AND
THERE WAS A CHAIR BESIDE THE
CHESTERFIELD AND HAD...
SITTING UP LIKE THIS.
AND I TOUCHED HER AND SHE
WAS STIFF.
BUT STILL YOU DON'T ACCEPT
THIS, YOU KNOW.
I KEPT SAYING HER NAME OVER
AND OVER AGAIN.
AND I WAS GETTING A BIT
HYSTERICAL.
SO I CALLED 911 AND SAID YOU
KNOW, YOU'VE GOT TO COME.
MY DAUGHTER'S DIED.

The caption changes to "Robin Rowe. Epilepsy Association of Toronto."

Robin is in her thirties, with short slightly wavy blond hair. She wears a headband, a white top and a blue blazer.

Maureen says SUDEP IT IS AN ACRONYM
STANDING FOR SUDDEN,
UNEXPLAINED OR UNEXPECTED
DEATH IN EPILEPSY.
SO IT IS WHEN A PERSON WHO
HAS EPILEPSY DIES SUDDENLY.
AND AFTER THE DEATH, THE
CORONER IS UNABLE TO FIND
ANY ANATOMICAL OR
TOXICOLOGICAL, ANY REASON
FOR THAT PERSON DYING.
SUDEP, THIS SUDDEN
UNEXPECTED DEATH IN
EPILEPTICS IS TRULY A
MYSTERY, EVEN TO
NEUROLOGISTS.

The caption changes to "Doctor Joseph Bruni. Neurologist. Saint Michael’s Hospital."

Joseph is in his fifties, clean-shaven and with short receding white hair. He wears glasses, a white shirt, green patterned tie and a white coat.

He says WE ARE NOT EXACTLY SURE
WHAT CAUSES SUDEP WHEN
PATIENTS WITH EPILEPSY DIE,
SOMETIMES IT IS DIFFICULT TO
KNOW WHAT THE MECHANISM OR
WHAT THE CAUSE OF DEATH WAS.

Robin says THE THEORY IS THAT THE
BRAIN IN A PERSON WITH
EPILEPSY HAS UNUSUAL
ELECTRICITY BY SENDS A
MESSAGE TO THE HEART OR TO
THE LUNGS.
AND THE PERSON DIES.

Maureen says WHEN A STRANGE
DEATH OCCURS, THE CORONER IS
CALLED IN.

The caption changes to "Doctor James Young. Chief Coroner for Ontario."

James is in his late forties, clean-shaven and with short wavy gray hair. He wears a blue suit, white shirt and printed tie.

He says DURING THE AUTOPSY, THE
FIRST THING WE DO IS DO AN
EXTENSIVE EXTERNAL
EXAMINATION LOOKING FOR
BRUISES, SIGNS OF... ANY
SIGNS OF VIOLENCE.
SO WE WOULD FIND NONE OF
THOSE.
WE WOULD THEN EXAMINE ALL
ORGANS AND AREAS OF THE BODY
LOOKING FOR A LOGICAL CAUSE
OF DEATH, A CANCER, PROBLEMS
WITH THE LUNGS, A PULMONARY
EMBOLUS, FOR EXAMPLE.
SOME LOGICAL MAJOR HEART
ATTACK.
BUT ESSENTIALLY ALL OF THOSE
EXAMINATIONS AND THE
HISTOLOGY OR MICROSCOPIC
EXAMINATIONS AFTERWARDS
WOULD BE NEGATIVE AS WELL.
SO WHAT WE WOULD THEN LOOK
AT IS TOXICOLOGY.
AND WE WOULD EXPECT IN A
CASE LIKE THIS TO FIND
NEGATIVE TOXICOLOGY OR IN
OTHER WORDS, NO DRUGS OR
ALCOHOL THAT WOULD ACCOUNT
FOR DEATH.
BUT WE MAY OR MAY NOT FIND
ANTI-EPILEPTIC DRUGS.
AND THAT IS A SIGNIFICANT
THING THAT WE WOULD LOOK
FOR.

Joseph says A NUMBER OF PATIENTS MAY
HAVE LOW BLOOD LEVELS.
I SUGGEST THAT THEY DID NOT
TAKE THE MEDICATIONS
PROPERLY.
THERE ARE SOME STUDIES THAT
WOULD SUGGEST IT IS MORE
COMMON IN MEN, YOUNGER
PEOPLE.
PEOPLE WHO HAVE SEVERE
EPILEPSY.
PATIENTS WHO HAVE HAD
EPILEPSY FOR A VERY LONG
TIME.
THE INGESTION OF ALCOHOL MAY
BE A FACTOR.
BUT IN SOME PATIENTS IT IS
TOTALLY UNEXPLAINED.

A black slate appears with the caption "SUDEP."

Maureen says DOCTORS MAY NOT
KNOW WHAT CAUSED SUDEP BUT
THEY'VE KNOWN ABOUT THE
MYSTERIOUS CONDITION FOR
OVER A HUNDRED YEARS.
YOUNG PRINCE JOHN, SON OF
GEORGE V HAD EPILEPSY AND
DIED QUIETLY IN HIS SLEEP.
AND EMILY DION OF THE FAMOUS
QUINN IT UP HELPS MAY HAVE
DIED FROM SUDEP.

Robin says BECAUSE RESEARCHERS
DIDN'T RECOGNIZE IT,
CORONERS AND PATHOLOGISTS
WEREN'T CATEGORIZING THE
DEATHS THAT WAY.
SO WE DON'T HAVE ENOUGH
DIAGNOSES OF SUDEP.

James says IN SUDEP WE ARE BEGINNING
TO KEEP THAT KIND OF
STATISTIC.
SO WE WENT THROUGH OUR FILES
RECENTLY, FOR EXAMPLE, AND
WE FOUND SOMEWHERE IN THE
ORDER OF ABOUT 90 CASES OVER
A TWO-YEAR PERIOD.
SO WE ARE LOOKING AT A
SIGNIFICANT NUMBER OF DEATHS
THAT WHEN ALL IS SAID AND
DONE ARE ATTRIBUTED TO
EPILEPSY IN THE PROVINCE OF
ONTARIO.

Ann says WHEN I HEARD ABOUT
SUDEP... FIRST OF ALL IT
MADE ME FEEL MYSTIFIED, WHAT
THE HELL IS THIS.
THAN I FELT ANGRY.
WHY HAD THE DOCTORS NOT TOLD
ME THIS.
YOU FELT PARTICULARLY
BETRAYED BECAUSE MOST
DOCTORS WHEN YOU FIRST GO
WITH A PERSON WHO HAS
EPILEPSY WILL TELL YOU WELL,
THEY MIGHT DROWN OR THEY
MIGHT HAVE A SEIZURE
CROSSING THE ROAD AND BE
KILLED IN A MOTOR ACCIDENT.
BUT YOU DON'T DIE OF SUDEP.

Joseph says I SUSPECT THAT SUDEP IS
NOT SOMETHING THAT IS
DISCUSSED WITH MOST PATIENTS
WITH EPILEPSY IN THEIR FIRST
ENCOUNTER WITH A
NEUROLOGIST.

Robin says NOW THERE ARE
PEOPLE THAT THINK IT IS
IRRESPONSIBLE TO TELL THEM
ABOUT SOMETHING WHEN THE
RISK IS SO LOW.
AND WE HAVE WRESTLED WITH
THIS.
IS THIS SOMETHING THAT IS
MORE IRRESPONSIBLE TO BE
ADVISING THE PATIENT THAN IT
IS NOT.
AND WE'VE COME TO THE
CONCLUSION, ESPECIALLY WHEN
WE HEAR FROM PEOPLE WHO HAVE
LOST SOMEONE TO SUDEP AND
WERE NEVER TOLD AND FEEL SO
BETRAYED, AND WERE GIVEN THE
IMPRESSION VERY CLEARLY THAT
THEIR LOVED ONE CAN'T DIE OF
EPILEPSY, THAT NO, WE NEED
TO TRY TO GET THE WORD OUT
BUT TO PUT IT IN ITS PROPER
CONTEXT, THAT THE RISK IS
LOW.
IT'S THERE BUT IT'S LOW.

Maureen says AFTER JUDY'S
TRAGIC DEATH ANN FARRELL
BEGAN HER OWN CAMPAIGN TO
GET THE WORD OUT ABOUT
SUDEP.

Ann says WITH THE EPILEPSY
ASSOCIATION THERE IS PEOPLE
WE HAD GOT THE SUDEP SUPPORT
GROUP GOING.
AND WE BECAME AWARE THAT NOT
ONLY WERE DOCTORS NOT
TELLING PATIENTS OR PATIENTS
FAMILIES ABOUT SUDEP, BUT IT
WAS BEING INACCURATELY
RECORDED AS A DEATH.

James says WELL, I THINK CORONERS
NEED TO KNOW OF THE
EXISTENCE AND ALSO LOOK FOR
THE SPECIFIC CIRCUMSTANCES
OF THE SUDEP SO THAT WE, IN
FACT, CAN GET ACCURATE IDEAS
OF HOW MANY CASES.
WE CAN THEN LOOK AT THOSE
CASES AND STUDY THEM AND
HOPEFULLY LEARN PATTERNS AND
GET AN IDEA WHAT MIGHT BE
DONE TO HELP PREVENT IT.

Joseph says IT IS A VERY ACTIVE AREA
OF RESEARCH AND I THINK THAT
ONCE WE HAVE A BETTER
UNDERSTANDING OF WHAT THE
UNDERLYING MECHANISM IS THAN
WE HAVE A BETTER WAY OF
DEALING WITH THE FEELING OF
IT.

Robin says SO WHAT WE TELL PEOPLE
WHO HAVE EPILEPSY, WHO ARE
CONCERNED ABOUT SUDEP AND
WANT TO LOWER THEIR RISK IS
TAKE YOUR MEDICATION, GET
ENOUGH SLEEP, GET ENOUGH
EXERCISE.
LIVE A REASONABLY
RESPONSIBLE LIFE AND ONCE
YOU'VE TAKEN THOSE FEW
PRECAUTIONS DOING WHAT YOUR
MOTHER ALWAYS TOLD YOU TO DO,
EAT RIGHT AND GET ENOUGH
SLEEP, JUST GO OUT THERE AND
LIVE YOUR LIFE NORMALLY.

Ann says NO DOCTOR WHO HAD SEEN
JUDY HAD EVER MENTIONED THE
POSSIBILITY THAT THIS COULD
OCCUR.
AND WHEN I WENT AROUND TO
SEE HER FAMILY DOCTOR IN
HAMILTON WHO HAD WRITTEN
THAT SHE DIED OF NATURAL
CAUSES ON THE DEATH
CERTIFICATE, I SAID DID YOU
KNOW ABOUT SUDEP.
HE SAID OH, YES.
I SAID WELL, WHY DIDN'T YOU
SAY ANYTHING.
I THINK THEY THINK THEY ARE
HELPING FAMILIES BY
PROTECTING THEM FROM
WORRYING THE WHOLE TIME.
BUT THERE IS A TREMENDOUS
SENSE OF BETRAYAL WHEN YOU
HAVEN'T BEEN TOLD.
IT'S BAD ENOUGH TO... YOU
KNOW, YOU CAN'T REALLY DEAL
WITH THE DEATH WHEN IT COMES
AS SUCH A SHOCK.
YOU HAD NO TIME TO THINK
ABOUT THIS POSSIBILITY.

A slate appears with the caption "For SUDEP information and support call (416) 964-9095."

The logo of the show appears.

Maureen says READY FOR THIS WEEK'S
QUIZ QUESTION.
PEOPLE WHO CONSUME EXCESSIVE
AMOUNTS OF TOMATOES OR
TOMATO JUICE MAY FIND THEIR
SKIN COLOUR TURNING RED,
YELLOW OR ORANGE.
STAY TUNED.
THE ANSWER IS COMING UP
LATER ON "YOUR HEALTH."

The quiz appears on screen.

Maureen now sits in the studio with two guests.

Maureen says WE CANADIANS
LIKE TO THINK OF OURSELVES
AS GENEROUS.
BUT WHEN IT COMES TO ORGAN
DONATIONS WE HAVE ONE OF THE
WORST DONATION RATES IN THE
DEVELOPED WORLD.
SEVERAL PROVINCES ARE TRYING
TO CHANGE THAT.
IN BRITISH COLUMBIA
HOSPITALS MUST ASK GRIEVING
FAMILIES ABOUT ORGAN
DONATION.
AND ONTARIO AND NOVA SCOTIA
ARE DEVELOPING SIMILAR LAWS.
BUT AGGRESSIVE CAMPAIGNS TO
INCREASE ORGAN DONATIONS
RAISE ETHICAL QUESTIONS.
WHEN DO YOU APPROACH A
SHATTERED FAMILY.
WHO DETERMINES WHEN A DONOR
IS ACTUALLY DEAD.
MARIA KJERULF IS A REGISTERED
NURSE AND ORGAN DONATION
COORDINATOR, MARGARET
SOMERVILLE IS A MEDICAL
ETHICIST IN MONTREAL AND
AUTHOR OF "THE ETHICAL
CANARY."

A picture of the book appears on screen. A feather on a palm of a hand illustrates the cover.

Maria is in her thirties, with straight blond hair in a bob cur. She wears a black blazer over a black and white printed top.

Margaret is in her late forties, with short straight light brown hair with bangs. She wears a white T-shirt under a black blazer with fine white stripes.

Maureen says WELCOME TO THE PROGRAMME.
MARGARET SOMERVILLE, DO YOU
AGREE THAT CANADA NEEDS TO
RAISE ITS ORGAN DONATIONS?

The caption changes to "Margaret Somerville. Medical Ethicist-Author."

She says YES, I THINK EVERYBODY
AGREES ON THAT.
AND WE'RE ALL CONCERNED
ABOUT IT.
AND IT IS A MATTER OF DOING
SO ETHICALLY.

Maureen says FIRST OF ALL,
MARIA, WHY DO WE HAVE A
LOWER RATE THAN SAY THE
U.S.?
WHAT IS GOING ON.

The caption changes to "Maria Kjerulf, RN. Organ Donation Coordinator."

She says WELL, I... TWO POINTS I
HAVE TO MAKE ABOUT THAT.
THE FIRST IS THAT WE HAVE A
VERY DIFFERENT DONOR
DEMOGRAPHIC POPULATION THAN
IN THE UNITED STATES.
10 TO 15 percent OF THE COPPER
POPULATION FROM THE U.S.
COME FROM GUNSHOT WOUNDS AND
WE DO NOT SEE THAT
POPULATION OF PATIENTS HERE
IN CANADA.
THANK GOODNESS WE DON'T HAVE
THOSE TYPES OF ISSUES HERE.
THE SECOND POINT I WANTED TO
MAKE WAS WE DON'T REALLY
KNOW WHAT OUR DONOR
POTENTIAL IS BECAUSE IT
HASN'T BEEN MEASURED WELL.
SO WE DON'T KNOW IF OUR
POTENTIAL IS 75 percent OF WHAT THE
AMERICANS CAN ACHIEVE OR
WHETHER IT IS ONLY 50 percent OF
WHAT THE AMERICANS CAN
ACHIEVE BECAUSE WE'VE
ACTUALLY NEVER MEASURED IT.

Maureen says DO WE SIGN OUR
DONOR CARDS, SO TO SPEAK,
OUR DRIVER'S LICENSES, WE
MUST KNOW THAT.

Maria says WELL, I THINK THE PUBLIC
THINKS THAT AFTER SIGNING
THE DONOR CARD THAT THAT'S
IT.
THEY DON'T HAVE TO DO
ANYTHING ELSE.
AND WE KNOW, THAT WORK IN
THE FIELD OF ORGAN DONATION,
AT THE TIME OF DONATION
WHERE SOMEBODY HAS HAD A
DEVASTATING INJURY AND
HAVEN'T TOLD THEIR FAMILY
WHAT THEIR WISHES ARE, THAN
IT BECOMES AN ISSUE.
SO THE DONOR CARD IN FACT IS
VOID, REALLY.
IT'S MORE USED AS AN
EDUCATION TOOL, PUBLIC
EDUCATION TOOL TO GARNER
SUPPORT FOR ORGAN DONATION
AND TO GET PEOPLE TO DISCUSS
IT.

Maureen says AND THIS IS
WHERE THE ETHICAL ISSUES
COME IN, MARGARET.

Margaret says MAJORLY IT IS NOT VOID
AND THERE IS A DISCUSSION
ABOUT THAT, BECAUSE SOME
PEOPLE FEEL THAT IF THAT IS
WHAT THE DONOR DID, THAT IS
WHAT THE DONOR WANTED TO DO.
AND THEREFORE YOU SHOULD
GIVE PRIORITY TO THE DONORS
WISHES.
BUT IN PRACTICE UP UNTIL NOW
AS MARIA SAYS, WHAT WE DO
EVEN IF THERE IS A SIGNED
DONOR CARD YOU ASK THE
FAMILY.
AND IF THE FAMILY OBJECTS,
AS FAR AS I KNOW, NOBODY
GOES AGAINST THE OBJECTIONS
OF THE FAMILY.
AND MAINLY THEY HAVE DONE
THAT BECAUSE THEY HAD BEEN
WORRIED ABOUT MAKING PEOPLE
ANGRY AND
ANTI-TRANSPLANTATION.
AND THEREFORE OVERALL
DECREASING THE NUMBER OF
ORGANS.
BUT IT IS A MATTER OF... I
MEAN THE OTHER REASON THAT I
READ THE OTHER DAY THAT WE
DON'T HAVE AS MANY ORGANS,
FOR INSTANCE, WE WERE
COMPARED TO SPAIN WHICH HAS
A MUCH HIGHER RATE THAN WE
DO.
IS THAT WE HAVE COMPULSORY
SEAT BELTS AND HELMETS.

Maureen says IN A CAR
ACCIDENT, MOTORCYCLE
ACCIDENT.

Margaret says SO THAT THE PEOPLE WHO
ARE KILLED...

Maureen says WHEN YOU APPROACH
FAMILIES ABOUT ORGAN
DONATION, HOW... HOW DO YOU
APPROACH THEM?
WHAT DO YOU SAY.
AT WHAT POINT DO YOU GO IN.

Maria says WE HAVE A PROCESS THAT I
BELIEVE IS AN ETHICAL
PROCESS FOR APPROACHING
FAMILIES FOR CONSENT FOR
DONATION.
WE REALLY FEEL IT'S
IMPORTANT THAT FAMILIES AT
END OF LIFE BE GIVEN ALL OF
THE OPTIONS AVAILABLE TO
THEM INCLUDING ORGAN
DONATION.
I MEAN ORGAN DONATION IS
ONLY ONE OF THE OPTIONS THAT
THOSE FAMILIES HAVE TO MAKE
A DECISION ABOUT AT END OF
LIFE.
IT COULD BE VENTILATION.
IT COULD BE WITHDRAWAL OF
CARE, IT COULD BE A NO CPR
TYPE OF AN ORDER AND ORGAN
DONATION IS ONLY ONE OF
THOSE ISSUES.
SO WHAT WE DO IS WE MAKE
SURE THAT THE NEEDS OF THE
FAMILY ARE MET AHEAD OF
TIME.
MYSELF AS THE ORGAN DONOR
COORDINATOR DOES NOT MEET
THAT FAMILY UNTIL AFTER
BRAIN DEATH HAS BEEN
DECLARED.
SO THERE IS A LEGAL
DETERMINATION OF BRAIN DEATH
THAT IS MADE BY TWO STAFF
PHYSICIANS.
AND THEN ONE OF THOSE
PHYSICIANS HAS A DISCUSSION
WITH THE FAMILY ABOUT THAT
DIAGNOSIS.
IT IS A MEDICAL
RESPONSIBILITY.
AND AT SAINT MICHAEL’S WE
HAVE PHYSICIANS THAT DO THAT
VERY WELL.

Maureen says IS TIME A FACTOR
THERE?

Maria says IT IS, IT IS, HOWEVER,
THE FAMILIES NEEDS NEED TO
BE RESPECTED AND THEY NEED
TO BE SUPPORTED THROUGH THIS
TIME.
THIS IS A DEVASTATING TIME
FOR THEM.
THEIR LOVED ONE HAS JUST HAD
A HUGE, TRAGIC INJURY,
USUALLY VERY SUDDEN.
YOU KNOW, THEY HAVEN'T EVEN
COME TO GRIPS WITH THE FACT
THAT THE PERSON IS SICK AND
IN THE HOSPITAL LET ALONE A
PHYSICIAN TELLING THEM THAT
THEY ARE DEAD.
SO I THINK THAT'S REALLY
IMPORTANT.
THE SECOND POINT IS THAT WE
ARE OPEN AND HONEST WITH
FAMILIES, I THINK FROM THE
TIME THEY COME INTO THE
EMERGENCY ROOM UNTIL THE
TIME THAT THEY LEAVE THAT,
YOU KNOW, THEY KNOW, IF THE
PERSON IS NOT GOING TO
RECOVER OR THERE IS LITTLE
CHANCE OF THEM RECOVERING
THAT THEY KNOW THAT RIGHT
FROM THE BEGINNING.

Maureen says OKAY.
NOW THIS GETS INTO THIS
DEFINITION OF BRAIN DEAD.
MARGARET, WHY IS THERE A
DEBATE ABOUT THIS.

Margaret says I DON'T THINK THERE IS
ANY MORE.
BUT THERE WAS ORIGINALLY
BECAUSE ORIGINALLY OUR
DEFINITION OF DEATH WAS
SENSATION OF RESPIRATION.
WE DIDN'T BREATHE AND OUR
HEARTS STOPPED BEATING.
IN ACTUAL FACT OUR HEART IS
DEPENDENT ON OUR BREATHING.
IF YOU STOP BREATHING FOR A
CERTAIN AMOUNT OF SHORT TIME
YOUR HEART WILL STOP.
BUT THAT WAS NO GOOD BECAUSE
YOU COULDN'T USE THAT
DEFINITION IF YOU WANTED TO
TAKE A HEART FOR A
TRANSPLANT.
AND SO WE LOOKED AT OTHER
WAYS TO HAVE DEATH DETERMINE
BOTH ETHICALLY
AND LEGALLY AND PEOPLE
CONCLUDED THAT YOU REALLY
DID... DEAD WHEN WE'VE GOT
WHAT WE CALL TOTAL BRAIN
DEATH, THAT MEANS YOU ARE AT
THE BRAIN, THE CEREBRAL
CORTEX, YOUR LOWER BRAIN
THAT HANDLES THE AUTOMATIC
FUNCTIONS LIKE BREATHING AND
THAT SENSATION OF BRAIN
FUNCTION IS IRREVERSIBLE.
AND THERE ARE TESTS THAT THE
PHYSICIANS DO TO SAY YES,
THAT HAS HAPPENED.
AND THAN YOU CAN DECLARE THE
PERSON DEAD EVEN THOUGH YOU
MIGHT BE SUPPORTING SOME
VITAL LIFE FUNCTIONS ON
CERTAIN LIFE-SUPPORT
SYSTEMS.

Maureen says WASN'T THERE A WOMAN WHO
TOLD A PARLIAMENTARY
COMMITTEE, I THINK A DOCTOR
FROM OUTWEST THAT SHE WAS
DECLARED BRAIN DEAD
SOMETHING LIKE THREE TIMES
AND SHE CAME BACK.

Maria says THAT WAS A LONG TIME AGO.
AND I DON'T THINK THE ACTUAL
LEGAL DETERMINATION OF BRAIN
DEATH... THEY HAD EVEN...
THERE WAS NO LAW ABOUT IT.
NONE OF... THE MEDICAL
COMMUNITY HADN'T COME OUT
AND SAID THIS IS THE POLICY
AROUND BRAIN DEATH.

Maureen says THAT WOULDN'T
HAPPEN TODAY.

Maria says ABSOLUTELY...

Margaret says WELL, IT THERE IS ALWAYS
A CHANCE OF MISTAKEN AND
UNUSUAL CASE.
THERE IS ACTUALLY TWO
CONDITIONS WHERE... FOR
INSTANCE, IF SOMEBODY HAD
HYPOXIA OR HYPOTHERMIA,

Maria says THERE ARE SOME CONDITIONS
THAT MIMIC BRAIN DEATH.
IF THE PATIENT HAS BEEN
GIVEN SOME DRUGS.
IF THE PATIENT HAS SOME OF
THE METABOLIC DISORDERS AND
THEIR METABOLISM IS OUT OF
WHACK, WHETHER THEY ARE
HYPOTHERMIC, AFTER A
DROWNING.

Margaret says BUT THE DOCTORS TAKE THAT
INTO ACCOUNT AND THEY SAY IN
THOSE CASES WE CAN'T DECLARE
BRAIN DEATH.

Maria says AND SO THOSE THINGS ARE
TAKEN CARE OF, THE DRUGS ARE
CLEARED OUT OF THE SYSTEM.
THE PATIENT IS A NORMAL
TEMPERATURE YOU CAN'T
DECLARE SOMEBODY.

Margaret says YOU SAY YOU DON'T EVEN
APPROACH THE FAMILY UNTIL
AFTER YOU HAVE... IS THAT
GENERAL PRACTICE ACROSS
CANADA.

Maria says I DON'T THINK THAT IS
GENERAL PRACTICE.

Margaret says NO, I DON'T THINK SO
EITHER.

Maria says I THINK A LOT OF TIMES
WHAT HAPPENS IS THAT THE
ORGAN DONATION DISCUSSION
SOMETIMES HAPPENS AHEAD OF
TIME.
WE HAD A CASE WHICH I FOUND
OUT ABOUT SIX MONTHS LATER
WHEN I WAS TALKING TO THIS
INDIVIDUAL, SHE, HER
BROTHER-IN-LAW WAS IN THE
HOSPITAL.
AND HE HAD AN ANEURYSM THAT
RUPTURED AND WAS VERY ILL.
WAS NOT BRAIN DEAD.
AND A WELL-MEANING RESIDENT,
I THINK, BUT NOT VERY
KNOWLEDGEABLE, APPROACHED
THEM AND SAID I DON'T THINK
THERE IS GOING TO BE A LOT
OF OPTIONS.
HAVE YOU THOUGHT ABOUT ORGAN
DONATION.
WELL, HE RECOVERED.
HE NEVER BECAME BRAIN DEAD
AND HE RECOVERED.
WHEN I HEARD THAT I JUST
THOUGHT OH, THAT IS
HORRIBLE.

Maureen says WELL, WHAT DID
THE FAMILY, HOW DID THEY
REACT.
WERE THEY ANGRY.

Maria says I THINK THEY WERE SO
SHOCKED AT THE TIME THAT HE
WAS SO ILL.
AND WHEN I SPOKE WITH HER
ABOUT SIX MONTHS AFTER THIS
HAD HAPPENED IT JUST HIT
HER.
SHE SAID I CAN'T BELIEVE HOW
INAPPROPRIATE HE WAS.
AND I HAD TO APOLOGISE.
I SAID I APOLOGISE.
I CAN'T BELIEVE THAT THAT
HAPPENED IT IS SO
INAPPROPRIATE.

Maureen says WHAT GUIDELINES
THEN WOULD YOU LIKE PEOPLE
IN POSITIONS LIKE MARIA'S TO
DO.

Margaret says I THINK WE ARE WORKING ON
THE GUIDELINES.
I THINK MARIA IS EXPLAINING
IN THE WAY THAT THEY SHOULD
BE ETHICALLY.
BUT WE ALSO IN EVERY
INDIVIDUAL CASE IN APPLYING
THE ETHICS YOU HAVE TO HAVE
INDIVIDUAL SENSITIVITY.
I MEAN IT DEPENDS ALSO ON
THE FAMILY.
IT CAN DEPEND ON THEIR
CULTURAL BACKGROUND.
THEIR RELIGION, THEIR VIEW
ABOUT ITS BODY AND WHAT
SHOULD HAPPEN TO IT AFTER
DEATH.
IT CAN MAKE A DIFFERENCE IF
YOU'VE GOT SOMEBODY WHO IS A
VERY YOUNG CHILD.
YOU KNOW, BECAUSE IT IS SO
TERRIBLY TRAUMATIC FOR
THE PARENTS.
IN SOME CASES IT IS A
NEWBORN BABY THAT IS NOT
GOING TO LIVE AND YOU MIGHT
WANT TO TRY AND ASK THEM IF
THEY WOULD ALLOW THE ORGANS
TO BE USED.
IT IS AN EXTRAORDINARILY
DIFFICULT THING TO DO.
AND WE REALLY NEED PEOPLE
LIKE MARIA TO BE ABLE TO DO
IT.
I THINK ON THE OTHER HAND,
WHEN IT IS WELL DONE,
SOMETIMES, ALTHOUGH IT HAS
BEEN... THE WHOLE THING IS
AN AWFUL EXPERIENCE FOR
PEOPLE, THEY CAN ACTUALLY
COME OUT ON THE OTHER SIDE
OF IT THINKING ALTHOUGH IT
WAS AWFUL THAT THEY LOST THE
PERSON THEY LOVED, SOME GOOD
CAME OUT OF IT.
SOMEONE ELSE IS BENEFITTING.
AND THERE IS QUITE A LOT IN
THE LITERATURE THAT SHOWS
THAT WHEN HANDLED WELL,
PEOPLE CAN FEEL THAT THAT
WAS A GOOD THING THAT
HAPPENED TO THEM, THAT THEY
HAD AN OPPORTUNITY TO DO
THAT.
BUT I THINK ETHICALLY THE
BIG MESSAGE IS THERE IS NO
RIGHT TO TAKE ANY ORGAN FROM
ANYBODY.
THE PERSON WHO DOES IT
THEMSELVES OR THE FAMILY IS
GIVING A GIFT, BOTH TO THE
OTHER PERSON AND TO THE REST
OF US BY HELPING TO MAKE
PEOPLE BETTER.

Maureen says ARE YOU SAYING
THAN, WOULD EITHER OF YOU
SUPPORT THE KIND OF
PROGRAMME OR LAW THAT THEY
HAVE IN SOME EUROPEAN
COUNTRIES WHERE YOU ARE
PRESUMED TO HAVE DONATED
YOUR ORGANS WHEN YOU DIE
UNLESS YOU SPECIFICALLY...
IT IS LIKE THE NEGATIVE
OPTION THING.

Maria says I JUST DON'T THINK THAT
THAT TYPE OF A SYSTEM IS
GOING TO WORK IN CANADA.
I MEAN WE'VE GOT AS MARGARET
WAS MENTIONING, WE'VE GOT SO
MANY DIFFERENT CULTURES THAT
WE DEAL WITH HERE IN THIS
COUNTRY THAT I DON'T THINK
THAT IS TYPE OF A SYSTEM IS
GOING TO MEET THE NEEDS.
I MEAN THERE IS NO COOKIE
CUTTER APPROACH TO MEET THE
NEEDS OF ALL OF THOSE PEOPLE
IN A...

Margaret says IT IS AN INTERESTING WORK
ON THAT.
WHEN THEY ASK PEOPLE IN
FRENCH AND ENGLISH STUDY
DONE TO SEE HOW PEOPLE FELT
ABOUT THAT.
AND FRANCE HAS THE SYSTEM
WHERE YOU CAN TAKE IT UNLESS
YOU SAY NO AND ENGLAND HAS
THE SYSTEM THAT YOU CAN'T
TAKE IT LIKE US UNLESS YOU
SAY YES.
WHAT THEY FOUND THAT THE
FRENCH SAID WAS AS LONG AS
WE DON'T HAVE TO KNOW ABOUT
IT AND WE DON'T HAVE TO MAKE
ANY DECISIONS WE DON'T CARE
WHAT YOU DO.
WHEREAS THE ENGLISH WERE
APPALLED THAT YOU WOULD TAKE
ORGANS.
SO WHAT THAT SHOWS US IS
THAT THERE ARE DEEP CULTURAL
DIFFERENCES IN HOW WE FEEL
ABOUT THESE THINGS.
SO MAYBE IT WOULD BE
INTERESTING TO DO A STUDY IN
CANADA TO SEE HOW WE FEEL.

Maureen says WE WILL TALK
ABOUT THAT WHEN IT COMES
OUT.
THANK YOU BOTH FOR THIS.

Maria says OH, YOU ARE WELCOME.

A clip shows a person unearthing carrots.

Maureen says COMING UP, THE
LINK BETWEEN BETA CAROTENE
AND CANCER.

The logo of the show appears.

Now Maureen stands next to a screen with the caption "Health Digest. Parkinson."

Maureen says AND NOW OUR
HEALTH DIGEST.
THE DYING TO SIS FOR
PARKINSON DISEASE MAY CHANGE
IN LIGHT OF NEW RESEARCH
THAT SHOWS THE ILLNESS
AFFECTS NERVES IN THE HEART
AS WELL AS THE BRAIN.
PARKINSON RESULTS FROM A
LOSS OF NERVE ENDINGS IN
PART OF THE BRAIN BUT A NEW
STUDY IN THE U.S. NOTED A
DECREASED NUMBER OF NERVE
ENDINGS IN THE HEART AS
WELL.
THIS SUGGESTS THE ILLNESS
MAY AFFECT THE ENTIRE
NERVOUS SYSTEM.
NEUROLOGISTS ARE CAUTIOUS
ABOUT HOW THE RESEARCH MIGHT
BE USED TO HELP DIAGNOSE
PARKINSON.
THEY SAY THE SPECIALIZED
EQUIPMENT NEEDED TO SEE
NERVES AROUND THE HEART
WOULD BE TOO EXPENSIVE TO
HAVE IN EVERY HOSPITAL.

The caption on the screen changes to "Tooth decay."

Maureen says CHOCOLATE TO FIGHT TOOTH
DECAY.
RESEARCHES IN JAPAN SAY
PARTS OF THE COCOA BEAN
FIGHT MOUTH BACTERIA.
TOOTH CAVITIES ARE CAUSED
WHEN BACTERIA CONVERT SUGAR
INTO ACID THAT EAT AWAY FROM
THE SURFACE BUT WHEN THEY
ADDED COCOA BEAN HUSKS TO
WATER AND FED IT TO RATS
THEY NOTICED THE RODENTS HAD
BETTER DENTAL CHECKUPS.
THE HUSKS USUALLY AREN'T
CLUED WHEN TURNING COCOA
INTO CHOCOLATE BUT THE
AUTHORS SAY IT MIGHT BE TIME
TO PUT IT BACK IN THERE.

The caption on the screen changes to "Sexercise."

Maureen says IT TURNS OUT MEN WHO WANT
TO BE MORE POTENT IN BED
SHOULD GET OUT OF IT AND
EXERCISE BEFORE THEY TURN TO
VIAGRA.
BOSTON SCIENTISTS HAVE
DETERMINED THAT MIDDLE-AGED
MEN WHO BURN AT LEAST 200
CALORIES A DAY GREATLY
REDUCE THEIR CHANCE OF
IMPOTENCE.
IT TURNS OUT THE SAME THING
THAT IS GOOD FOR THE HEART
ARE GOOD FOR ERECTIONS AND
VICE VERSA.
ROUGHLY HALF OF MEN AGED 40
TO 70 REPORT AT LEAST MODEST
TROUBLE ACHIEVING AN
ERECTION AND EVIDENCE
SUGGESTS IT IS MORE COMMON
IN MEN WITH POOR
CIRCULATION.

Maureen says HERE'S THE
ANSWER TO THIS WEEK'S QUIZ.
PEOPLE WHO CONSUME EXCESSIVE
AMOUNTS OF TOMATOES MAY GET
LYCOPENEMIA, A HIGH
CONCENTRATION OF LYCOPENE IN
THE BLOOD CAUSING THE SKIN
TO TURN YELLOW BUT OVERALL
THEY ARE GOOD FOR US SO KEEP
EATING THOSE TOMATOES.

Maureen says SPEAK OF FOODS
THAT ARE GOOD FOR YOU, YOUR
MOTHER PROBABLY TOLD YOU TO
EAT YOUR CARROTS.
SHE KNEW THEY WOULD IMPROVE
YOUR VISION.
BUT AS CHEMISTRY PROFESSOR
JOE SCHWARCZ TELLS US, WE
SHOULDN'T BE NEAR SIGHTED
WHEN IT COMES TO THE
BENEFITS OF BETA CAROTENE.

Joe appears in a lab.

A caption reads "Doctor Joe Schwarcz, Ph.D. Professor of Chemistry."

Joe is in his mid-forties, clean-shaven and with short wavy gray hair. He wears a black suit, a black shirt and a printed black tie.

He holds a bottle of beta catotene capsules.

Joe says BETA CAROTENE IS SOMEWHAT OF AN
ENIGMATIC NUTRIENT IT WASN'T
THAT LONG AGO THAT PEOPLE
WERE JUMPING ON THE BETA
CAROTENE BANDWAGON.
IT WAS GOING FULL STEAM
AHEAD.
PEOPLE WERE TAKING
SUPPLEMENTS.
WHY?
WELL, FIRST OF ALL BETA
CAROTENE IS THE BODY'S
PRECURSOR FOR VITAMIN A. IT
IS VERY IMPORTANT IN THE WAY
THAT OUR IMMUNE SYSTEM
FUNCTIONS.
IT MAKES US SEE BETTER, IT
IS IMPORTANT FOR SKIN TONE.
BUT THAT WAS NOT THE ONLY
REASON.
SOME STUDIES HAD SHOWN THAT
PEOPLE WHO HAD HIGH LEVELS
OF BETA CAROTENE IN THEIR
BLOOD WERE LESS LIKELY TO BE
AFFECTED BY CERTAIN TYPES OF
CANCER, HEART DISEASE OR
STROKE.
AND THERE WAS EVEN A
SCIENTIFIC EXPLANATION FOR
WHAT WAS GOING ON HERE.
BETA CAROTENE IS AN
ANTI-OXIDANT.
WHAT DOES THAT MEAN?
IT MEANS THAT IT HAS THE
ABILITY OF NEUTRALIZING
THESE ROGUE MOLECULAR
SPECIES THAT CROP UP IN OUR
BODY CALLED FREE RADICALS.
FREE RADICALS ARE IMPLICATED
IN CANCER AND IN HEART
DISEASE.
EVERYTHING SEEMED FINE.
UNTIL A STUDY WAS DONE IN
FINLAND.
FINNISH SMOKERS WERE GIVEN
BETA CAROTENE SUPPLEMENTS.
WHY SMOKERS?
BECAUSE THEY ARE MORE PRONE
TO CANCER THAN ANYONE ELSE.
THE RESULTS OF THE STUDY
WERE SURPRISING.
IT TURNED OUT THAT THEY WERE
NOT PROTECTED FROM CANCER IN
FACT THERE WAS A HIGHER
INCIDENT OF CANCER AMONG THE
BETA CAROTENE SUPPLEMENT
TAKERS.
THIS STYMIED THE SCIENTIFIC
WORLD.
SCIENTISTS DECIDED TO FERRET
OUT THE PROBLEM.
LITERALLY SPEAKING.
THEY TOOK THESE WEASEL-LIKE
ANIMALS AND GAVE THEM BETA
CAROTENE SUPPLEMENTS AND
EXPOSED THEM TO CIGARETTE
SMOKE.
AND WHAT THEY DISCOVERED WAS
THAT AT HIGH LEVELS OF BETA
CAROTENE, THE SUBSTANCE
ACTUALLY ACTED AS A PRO
OCCIDENTAL INSTEAD OF AN
ANTI-OCCIDENTAL.
IT WAS IMPLICATED IN DOING
DAMAGE.
THE RECENT PROBABLY IS THAT
WHEN IT IS OUT OF TOUCH WITH
VITAMIN C AND E, BETA
CAROTENE DOES NOT PERFORM
THE WAY THAT WE WOULD LIKE
IT TO PERFORM.
WE NEED THOSE THREE
ANTI-OXIDANTS TOGETHER TO
GET THE MAXIMUM EFFECT.
AND IT TURNED OUT THAT IN
THE FINNISH SMOKERS, THEY
HAD LOW LEVELS IN ALL
LIKELIHOOD OF VITAMIN C.
SO WHAT CAN WE SAY TODAY
ABOUT TAKING BETA CAROTENE
SUPPLEMENTS?
WHAT WE WOULD REALLY LIKE TO
SEE IS A PROSPECTIVE STUDY,
OF PEOPLE TAKING SUPPLEMENTS
HAVING THEIR HEALTH
MONITORED.
THAT HASN'T REALLY BEEN DONE
FOR HEALTHY PEOPLE SO FAR.
WHAT WE DO KNOW, HOWEVER, IS
THAT THERE IS A LOT OF
EVIDENCE IN TERMS OF TAKING
FOOD THAT ARE HIGH IN BETA
CAROTENE.
PEOPLE WHO EAT THOSE KIND OF
FOODS BASICALLY ARE BETTER
OFF.
25 MILLIGRAMS A DAY IS WHAT
WE SHOULD BE SHOOTING FOR.
A SPEAR OF BROCCOLI, ABOUT 4
OR 5.
YOU CAN GET ABOUT 10
MILLIGRAMS FROM A CAN'T
HOPE.
CARROTS OF COURSE ARE GREAT,
ABOUT 12 MILLIGRAMS OF BETA
CAROTENE IN THERE.
BUT THE CHAMPION IS THE
SWEET POTATO, YOU CAN GET
ABOUT 15 MILLIGRAMS OF BETA
CAROTENE AND THAT JUST MAY
AFFORD A LOT OF PROTECTION.
HOW SWEET IT IS.

Maureen says THANKS, JOE.
TRANSCRIPTS FROM JOE'S HERBS
ARE AVAILABLE ON OUR WEB
SITE.
GO TO
WWW.TVO.ORG/YOURHEALTH.
IF YOU WOULD LIKE TO GET IN
TOUCH WITH US OUR MAILING
ADDRESS IS YOUR HEALTH BOX
200 STATION Q TORONTO, M 4 T
2 T-1.
OUR FAX NUMBER 416-484-4519.
AND OUR E-MAIL ADDRESS IS
YOURHEALTH @TVO.ORG.
THAT IS OUR PROGRAMME FOR
THIS WEEK.
WE WILL SEE YOU NEXT TIME.
I'M MAUREEN TAYLOR.

Music plays as the end credits roll.

Prince John photographs courtesy of The Monarchist League of Canada.

A production of TVOntario.

Copyright 2000. The Ontario Educational Communications Authority.

Watch: Show #7