When people make plans for their final disposition after death, many choose to donate all or part of the body to medicine. It's a generous gesture. But because there are different types of anatomical gifts, it is important for people to understand more about them before they make a decision.
There are actually two kinds of anatomical gifts: body donation for medical research and organ donations for transplants. Usually a body is donated for one of these purposes, but not both
Body Donation For Research
Thousands of bodies are needed each year for medical research, yet most institutions have little trouble obtaining them. In fact, in some urban areas, medical schools are over-supplied and will only accept bodies if prior arrangements were made for the gift. Fortunately, bodies can be stored for a limited time and transported to rural areas where they are needed.
Even if arrangements have been made, an institution will not always accept a body for donation. Some schools refuse bodies that have been autopsied or mutilated by a violent death. They may not want a body that is missing a limb or major organs. In some cases, schools also consider the weight or age of the donor at the time of death when deciding whether to accept a body.
If you plan to donate your body to medical research after death, you should first check with the institution for which your gift is intended. Ask them what their conditions are for accepting a body. And ask about transport costs. While institutions are forbidden to pay for bodies, they may reimburse the family for the cost of transporting the body. Some, however, expect the donor to provide the cost of transport. When you arrange for your gift, you should also specify whether or not the institution may send your body to another school that is under-supplied.
In the past two decades, the science of organ transplantation has advanced so quickly that we almost take some operations for granted. Because of donated kidneys, thousands of kidney patients are now free of dialysis machines. People who would otherwise be blind can see because of donated corneas. And of course, hundreds of people are happy to be alive thanks to a transplanted heart, liver, lung or pancreas. Certain bones and even skin can be transplanted—victims of severe burns may receive transplanted skin as a temporary covering until their own skin grows back.
Unlike whole bodies for research, organs for transplant are in short supply. Susan Navarro, a transplant patient services liaison at Rush Presbyterian-St. Luke's Medical Center in Chicago, says that for some organs there may be three people who need a transplant for every suitable donor. This puts doctors in the awkward position of trying to decide which patients most need the organ.
"Usually what's needed most are kidneys, livers and hearts," Navarro says. "Kidneys because so many people have kidney disease and are on dialysis for many years; livers because there's been an increase in liver disease."
Organs are in short supply partly because they can be donated only under certain conditions. "We have age limits for taking organs," Navarro explains. "We won't take a heart older than 30 in a man, or for a woman 35 to 40." Navarro explains that a younger heart is a stronger heart and more likely to remain healthy once transplanted. Younger hearts are less likely to have developed plaque in the arteries. Doctors also prefer younger donors for most other organs, although they'll take corneas, which are durable tissues, from people up to age 70.
There are restrictions other than age. As Navarro explains, once a person's heart stops beating he can only donate tissues—skin, bones and corneas-not organs.
"The potential donor is someone who comes into the emergency room still breathing but who eventually needs a ventilator," she says. If tests show that the person is "brain dead" but his or her organs are alive because of the ventilator, he or she is a good donor.
While most organs can be "banked" for a day or so, doctors prefer to transplant an organ as quickly as possible to avoid damage to the tissues. So when "brain death" occurs, medical personnel need to quickly get permission to remove the person's organs.
According to the Uniform Anatomical Gift Act, a model law created in 1968 to provide guidance to states passing their own laws, any person older than age 18 may agree to donate all or any part of his or her body after death. Many states allow people to become organ donors simply by filling in a space on their drivers license. If a person has never indicated that he or she wants to be an organ donor, doctors can get permission from members of his or her family in this order of priority: spouse, adult son or daughter, parent, adult sibling or guardian.
This can be a difficult decision for families of the donor. Because of the restrictions previously mentioned, most potential donors are young victims of traumatic accidents—people struck down in their prime. Their loved ones, already in shock over an unexpected death, must then decide whether or not to give away their organs.
Navarro explains that Rush Presbyterian, like other hospitals, trains nurses to talk with families and explain the importance of organ donations. "When families understand that nothing can save their loved one, but his or her organs can perhaps save someone else, most agree to donate," Navarro says.
They do occasionally refuse, however. Navarro says that people who want to be organ donors should talk about it with their families, because even if a person has signed an organ donor's card, doctors usually won't remove the organs if the family objects.
Anatomical Gifts and Funerals
Navarro says families sometimes refuse to donate a loved one's organs because they are afraid the body will be mutilated and won't be available for an open-casket viewing or funeral. This simply isn't true.
Medical personnel recognize the importance of funerals. A viewing helps confirm the reality of a death to the person's loved ones—an important step in the healing process we call grieving. A funeral brings together a community of mourners so they can share their emotions and support each other during a difficult time.
Whether the entire body or just the organs are donated, medical personnel can usually make arrangements for the body to be present for the funeral. In some instances, if the funeral director knows a body has been donated to a medical school, he or she will call the school and prepare the body according to their directions. The body will then be taken to the school after the funeral.
When organs are removed, the funeral director can use his or her embalming and restorative art skills to help return the body to a natural-looking state for the viewing and funeral. The body can still be buried according to the family's wishes.
In short, anyone who is inclined to donate any or all of his or her body after death should not hesitate to do so. Life is a precious gift. We can all take comfort knowing that we may offer life to someone else even when our own lives have ended.