We think with our hearts, Saudi doctor asserts

Cardiologist contends the heart is a special organ that raises ethical issues about organ donation and end-of-life care.

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RIYADH // Anyone who has suffered the pangs of unrequited love would surely vouch for Abdullah A Al Abdulgader's observation that "the heart is not just a pumping machine".

But getting his peers in the medical community to agree with this, says the Saudi Arabian cardiologist, is difficult. "During the 20th century, there was a major wave created by modern science that gave rise to the idea that the heart is just a pump," Dr Abdulgader said in a phone interview from Al Hasa, where he heads the Prince Sultan Cardiac Centre.

"But that's not true. The heart is emotion, the heart is decision-making … We think that the heart is a very critical organ controlling other organs," he added. Major implications flow from this perspective - both medical and ethical - including a need to reconsider the morality of end-of-life decisions, according to Dr Abdulgader. Dr Abdulgader, who enjoys international recognition for his cardiac disease research, contends that a growing body of science about the heart requires a fresh look at the moral advice given to the Saudi medical community.

Specifically, he said, the fatwa or religious ruling that has long guided decisions governing the end of life for patients considered "brain dead" needs to be revised. When the fatwa on this matter was issued 22 years ago, "doctors told religious people that when the brain is gone, the human being is gone", Dr Abdulgader said. "But this is wrong because if the heart is beating we know now, it gives energy, there is an electromagnetic field around the person… We know from research that when someone is brain dead and a family member enters the room, his heart reacts."

Therefore, he argues, to take a brain-dead person off a ventilator "is something like killing". A person whose brain shows no response but whose heart is still beating "is fully alive and nobody should have the decision to stop his life", Dr Abdulgader added. To plumb these ethical issues and highlight heart research being done around the world, Dr Abdulgader organised "King of Organs", an international conference of cardiac researchers.

The third "King of Organs" has been meeting this week in Al Hasa in the eastern part of the kingdom. Its 55 participants have been listening to peers talk about "cardiac energy", heart-brain pathways, neurons, heart rate variability, the heart's "emotional nature", and the effect of stress on the heart's well-being. "It's a pretty cool conference," said Rollin McCraty, director of research at a California-based company called Heartmath, which seeks to help relieve stress by "harness[ing] the power of heart/brain communication," according to its website.

Mr McCraty, reached by phone in Al Hasa, said Dr Abdulgader was suggesting a return to the view that was dominant "for hundreds of years" up until recent decades when brain-wave activity rather than heart beats became the determining factor in declaring a person dead. "If we're just talking about the cold, hard facts, it was changed somewhere in the 1980s so that people who [medical personnel] didn't think were going to recover, they could go ahead and harvest their organs even though their heart was still beating … that was the simple reason for it."

This is a matter of great debate in the United States, where courts have been asked to intervene in cases where family members sought to take a brain-dead person off a ventilator. Both Mr McCraty and Dr Abdulgader noted that the heart produces the largest electromagnetic field in the body, much bigger than that produced by the brain, reaching up to roughly a metre from the body. Mr McCraty also said there is significant research that indicates that "the heart is connected to a field of information that is not bound by the limits of time and space".

"If we're talking quantum physics, this is no big deal," he added. "This type of non-locality…has been experimentally proven multiple times now in the quantum physics world." Dr Abdulgader echoed Mr McCraty's observation about the heart's access to unseen information. "Yes," he said, "I think the soul is within the heart. The source [of the soul] is coming from the heart." This year's conference, he wrote, "is not only a call for change but it is an actual call for revolution".

He said he would like to see change not only in how the heart is viewed by the medical profession, but also "in the principles of our thinking". Open any textbook in the cardiac sciences, he said, "and there is not one line about cardiac energy.

"This is not fair," he said. "It's not fair."