In March of 1999, I was given a gift from a person I never knew; a person Ill never get to know. This gift cost the person who gave it to me, no money, but it was the most valuable gift Ill ever receive. The gift was a piece of life from another person.
At the age of twenty-four, I broke my hip. After three unsuccessful surgical attempts to heal it, my doctors performed a total hip replacement. The top four inches of my femur were sawed off, and the inside of my bone was hollowed out. A steel rod, nine inches long, was pressed fit into my bone. I was on crutches for over a year, but I really believed I would be able to walk on my own again. Less than one year after the surgery, I was back on crutches and in terrible pain. I had developed stress fractures in several places along my femur. For nearly one year I walked only when it was necessary and ate painkillers as though they were candy. Finally, my doctors decided to try something new. On March 9, 1999, my doctors took a rib bone, donated from a cadaver, split it in half, and wired it around my broken femur. Less than two months later, I was off crutches and walking normally for the first time in almost five years. I could actually enjoy life.
I was lucky. I wasnt going to die if I had no donor, donated bone is easier to acquire that a heart, lung or kidney. Other people are not as lucky. Patients waiting for one of those life-sustaining organs must rely on the generosity of others, and the misfortune of that generous person. Someone must die, in order for that person to live.
No one likes to talk about death, but lets face it, we all die. Dying is a part of life. Many people dont talk about organ donation because it involves talking about death. But, what if, from our death, we could give another person a chance to live, or merely improve the quality of his or her life?
As of September 1999, over 65,000 people wait, with their name on a list, for a life saving organ. Only a fraction of those will live long enough to receive that organ.
Many people are not aware of what it actually means to be an organ donor. An organ donor is someone who has previously consented to donate his or her organs after death. Organ donations are usually taken from victims of motor vehicle accidents, gun shot wounds, strokes or major head injury. Organs that can be donated are heart, kidney, liver, lung, pancreas and intestines, also tissues such as skin, bone, and ligaments can be donated.
According to the Center for Organ Recovery and Education (CORE), between 10,000 and 12,000 people die annually who are considered medically suitable for organ donations, yet, only an estimated 5,200 donate(www.core.org 11 Nov 99).
One of the most common reasons for objecting to organ donation is a belief that doctors will not try to save ones life if they are aware he or she is an organ donor. The only way to completely convince someone that this would never happen is to explain the whole process of organ donation.
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First, and most important, if a person is dead, he or she can not be an organ donor. If someone dies outside the hospital setting or in the emergency room of a cardiac death, he would be able to donate tissues and corneas, not organs(www.core.org 11 Nov 99). Organ donations are taken from people who have been pronounced brain dead. Extensive tests are done on the donor to determine that the brain has stopped working. Lifesaving measures are taking place continuously throughout. When brain death occurs, blood is no longer flowing to the brain. The brain has ceased functioning. The victim can not breathe on his own. When a person suffers from a brain injury, the brain swells and creates pressure. Sometimes this pressure is so great it prevents blood flow to the brain, the result being brain death.
After brain death is determined the potential donor is sent to intensive care. Doctors notify the family of the potential donor and obtain consent for organ donation. At this point the patient is still, essentially alive, only being kept this way by machinery. However, his brain is no longer functioning. The doctors who are taking care of him are entirely separate from the doctors who will handle the donation procedure.
According to Dr. Punch, In reality, you must be more dead to be brain dead than is necessary to be declared dead. As weird as this sounds, you officially dead when a licensed physician declares you deadyou are brain dead when a complex set of conditions are satisfied that vary from state to state and hospital to hospital (www.transweb.org 07 Nov 99).
When consent is given the potential donors vital information is put into a computer and matches are printed out for recipients in that area. Time is critical. Organs can only be out of the body for a certain amount of time. Once the organs are harvested from the donor, they are packed in ice and transported to the transplant location, by the quickest means possible. Again, only 10,000 to 12,000 people die each year in a way that enables them to become organ donors, one can understand the urgency of pre-consenting to organ donation.
Another common objection to organ donation is ones religious beliefs. However, according to CORE, Major organized religions support donation, typically considering it a generous act(www.core.org 11 Nov 99).
Many people have expressed feelings that well connected people, or wealthy people receive organs for transplant quicker than others do, for example, Mickey Mantle receiving a liver. Many people stated it was because he was famous. However, Dr. Punch states, There is absolutely no evidence that he was not the most ill person in his region of the country on the day he got his liver transplant(www.transweb.org 07 Nov 99). Organs are matched within regions. When CORE receives information of a potential donor, that persons height, weight and blood type are put into a computer. A list is then printed out of most medically in need of the organ. Sometimes, there is more than one name on that list, then the time ones name has been on the list becomes the determining factor. In essence the organ goes to the sickest patient, if there is more than one, then the one who has been on the list the longest, receives the organ.
Concerns about having an open casket funeral if one chooses to donate his or her organs is also a factor in deciding to become an organ donor. Many people fear their bodies will be mutilated in the organ recovery process. CORE states, Donated organs, tissues and eyes are removed surgically, in an operation similar to gall bladder or appendix removal. Normal funeral arrangements are possible(www.core.org 11 Nov 99).
Procedures have been developed to make it hard to distinguish if that person was an organ donor.
In addition, one can specify which organs or tissues he or she wants to donate with prior consent to organ donation and discussion with family members. For example, if one does not want his whole eye donated, the cornea of the eye can be surgically removed and used for transplant, while the eye itself is left intact.
Another common objection to organ donation is the belief that one might be too old for donation. But, organs may be donated from someone as young as newborn, and there are no age limits for organ donation. Along with this, people often believe that they may not be healthy enough to donate. At the time of brain death, complete medical history is taken from the potential donors family. Tests are performed to determine that no damage has been done to vital organs. CORE states, With the exception of AIDS, very few diseases-including diabetes-prevent someone from donating(www.core.org 11 Nov 99).
Misconceptions aside, the lack of organ donors is a result of non-communication. If one wishes to be an organ donor, and has signed a donor card, often the consent of his or her family must still be given. Ones family must be aware of his or her wishes about organ donation. Jeffery Prottas states in his book, The Most Useful Gift, Willingness to donate ones own organs is relevant to actual donation, however, only if that decision is communicated to ones family(55). A study done by Prottas and Batten, in 1991, revealed 90% of respondents approve of organ donation, but, only 46% of those have discussed it with their families. And, only 53% would donate the organs of a relative who had not discussed the issue(Prottas 56) Communication is a huge factor in organ donation. Merely signing a donor card is not enough. One must discuss the issue with family members.
The lists of people waiting for donated organs are not getting shorter. New names are added each day. Me must make a decision about organ donation, and make our families aware of our wishes. One organ, tissue and eye donation may help between 200 and 400 people(www.core.org 11 Nov 99). Organ and tissue donation not only saves lives; it greatly improves the quality of some peoples lives.
Twelve people on that list will die today. Picture the name of a loved one on that list. Wouldnt you hope and pray, that someone, in his or her death had agreed to donate that heart or liver your loved one needed to continue to live? We may not be able to help today, or tomorrow, but someday, although it may be sad, our death could give another life.
Center for Organ Recovery and Education Home Page. General Statistics and Questions. http://www.core.org.html 11 Nov 99.
Punch, Jeffery MD. Can well-connected people like Mickey Mantle get
transplants faster? http://www.transweb.org/qa 07 Nov 99.
Prottas, Jeffery. The Most Useful Gift: Altruism and the Public Policy of
Organ Donation and Transplants. San Francisco: Jossey-Bass Pub.,