The human body is a wonderful and marvelous gift. As wonderful as it is for us as individuals, it can also be a wonderful gift for the good of mankind. I posted a recent link about a special group of individuals. Every medical student, along with many other training medical professionals has the opportunity, in order to learn the art of medicine, to open up the empty shell left behind by these people in mortality and study it firsthand, orienting themselves to the structures that they will later learn the marvelous functions of. They donate their bodies to science, where we can learn from them prior to their returning to the dust and apply that knowledge to the healing of others.
This is an unforgettable, strange, moving experience that allows us to orient ourselves to the incredible structure that is the human body. Families are often unsure what to think about these donations. They are deprived of burial, viewing and a regular funeral. They miss out on the opportunity to say goodbye and return their body to the ground. Therefore most, if not all medical schools have a ceremony celebrating their lives, and the gift to the art and science of medicine which benefits all remaining mankind even as they move beyond. I feel it important that the families understand what they have given to all of us.
We gain more information on the wonder that is the human body in 3 months of anatomy than a lifetime of abstract study could teach us. Allopathic medicine would be nowhere without human dissection, as gruesome as we instinctively find the idea to be. It takes getting used to.
While in death, these individuals give life to we the remaining, there is a more direct way to do this, organ donation. As abundant as health care is in this country we have do have a desperate ongoing shortage forcing rationing of lifesaving care everyday, human organs for transplantation. Those that are best in position to donate organs are the brain dead patients, having lost function in the organ central to thought, personality, and consciousness often in a sudden and violent way. Families quite naturally struggle with the idea of giving away organs while overwhelmed with their own sudden, unexpected grief. As with cadaver donation to medical school, it feels strange, like a person is being violated in the most profound way simply to procure spare parts.
It is undeniably a strange technology, transplanting the heart, liver, kidneys, skin, or eyes of a dead body to one who requires these things to function, or even to live. It is strange that is, until you are the patient waiting for a new lung, continually short of breath and exhausted, until you are the one who had your heart ravaged by a virus in the prime of life, or until you are the one whose liver failed from unknown disease or toxin. At this point you become suddenly more cognizant of what this gift really means.
The depth of this need is underscored by the fact that people are dying every day waiting for an organ. The supply is short, in part because only a few die under circumstances that makes organ “harvest” possible, but moreso because of donor patient or family uneasiness with the whole idea. Often this concern has a Quasi-religious component. I have heard from many of my own faith that organ donation will make the resurrection more complicated for example. While this is certainly not Mormon doctrine, it is a real feeling they have, an expression of their uneasiness with the strangeness of the whole procedure. Perhaps many others even have valid spiritual reasons for not giving or accepting organs. I can respect that. No one should feel compelled to give a gift they would not accept themselves.
What we are then left with is health care rationing. This is an ugly, unpleasant practice foisted upon us by supply and demand. Ideally, we would never deny anyone medical treatment. In reality, we are forced to all the time. How to go about this is a complex ethical issue. Basically, we currently use a waiting list system that takes the patients nearest to death to receive the treatment, even though the benefits in said patients would be less. Need has been determined the most objective way to decide, but it is not without controversy. Do people living near large medical centers with thriving organ donation programs have a leg up on everyone else? Do people who have destroyed organs through habits deserve another organ, especially if they will destroy it again? Should age matter? Should be do a social calculus to maximize societal benefit or is this poisoned by social class, politics, prejudice to race, gender, and disability? These are very tough questions upon which volumes can be written.
More worrisome to me is the shortcuts that can be taken by desperate patients in need of organs. Folklore is rampant about the woman drugged in the bar who wakes up in the bathtub full of ice with a kidney missing. While these stories are typically fictional, there is the disturbing case of China. It has been confirmed that the organs of many Chinese prisoners were taken for transplant immediately after their executions, supposedly with their consent. Needless to say, prisoners are a vulnerable population to coerced consent. These organs were sold on a for-profit basis, often to foreign nationals. The Chinese justice system is alleged to work very quickly for those sentenced to death, without allowing for appeals or our idea of a fair trial. Therefore, many people like Harry Wu or the Laogai Research Foundation claim the entire justice system has been totally corrupted this institutionalized system of organ theft.
Can anything be done to stop these types of scenarios? Obviously, step number one is to make sure you declare yourself an organ donor. Step two, is to let your family know your wishes in no uncertain terms, perhaps even including it in a living will or other legal document. I wonder if more can be done than this individual contribution, however.
I have pondered long and hard what the most ethical way to increase supply and meet demand is in this tough issue. Supply is so short. Due to the extraordinary nature of these gifts, I wonder if it would make more sense ethically to limit the receivers to givers. What I mean is, what if the only people eligible to receive a transplanted organ were those who had prior to any illness or need, signed up as organ donors. If you are not an organ donor, you are not eligible to receive one.
Personally, I don’t see why someone who has trouble with the idea of giving shouldn’t have equal trouble with the idea of receiving. It is funny how concerns can evaporate in the face of need. Certainly denying treatment and health care rationing are always a problem, but those who are not organ donors are themselves closing off a treatment option to others. It only makes sense to me that those others should be individuals who have made the same decision. What do you think? Is this idea too radical? Harsh? Why or why not?