Q: My wife and I have left instructions for cremation upon our demise. We have recently signed and now carry "donor cards" for any organs that may be needed. If a body is taken to a hospital for organ donation, who is responsible for the costs? What happens to the rest of the body? Does the hospital then dispose of the body? How, and at whose expense? -- M.R. Caris, Boca Raton, Fla.
Q: In regard to the column about the donation of organs at death, I had heard awhile back that the estate of the donor had to pay for the expense of organ removal. Is this true? -- Charles Slagle, Seal Beach, Calif.
A: Organ transplants may be paid for in a variety of ways by the procurement organization, insurance, the recipient or whatever. But the cost never falls on the donor or the donor's estate.
By the same token, neither does the donor profit financially from the transaction. These life-saving donations are freely given. That's exactly how it should be.
Organs are removed quickly by the hospital, after which the procedures are the same as in any death. Families or next-of-kin, not hospitals, are responsible for disposal of bodies of organ donors.
Generally, bodies are removed to a funeral home or crematory, and families plan funerals or memorial services. The removal of organs does not disfigure the body, and many organ donors have open caskets during the visitation or funeral service.
Organ donation does not involve any financial sacrifice, nor does it deprive survivors of a traditional funeral and burial. Yet according to Cindy Wolkovich of the National Kidney Foundation, more than 20,000 people in this country are waiting for a kidney, heart, liver, lung, pancreas or heart-lung transplant.
Somehow, we haven't gotten across the urgent message that donating an organ can literally mean the difference between life and death.
Organ donor cards are an important step in closing this gap. But when death occurs, hospitals must make their decisions quickly, and donor cards are not always at hand. Moreover, even if a person has clearly indicated a desire to be an organ donor, the objection of family members will cause hospitals to shy away from pressing the issue.
The best way to make sure your wishes will be followed is to supplement your organ donor card with frank conversations with your family and even your doctor.
Unfortunately, the organs most suitable for transplant come from young, healthy men and women who die suddenly -- often before they have thought about becoming a donor. In these tragic cases, hospital personnel are sometimes reluctant to approach families still shocked by the tragedy, despite regulations requiring them to ask for permission to use organs for transplantation.
Another reason the decision can be traumatic is that in order to keep oxygen and blood flowing to the organs, candidates for donation are kept on respirators even after they are officially declared dead.
Families coping with the tragedy may have a hard time coming to terms with the fact that their loved one is dead when his chest is still rising and falling.
Yet in these situations families and hospitals alike need to remember that the chance to bring life to someone else can help to assuage the senselessness of such a death.
Since the demise in May of the American Council on Transplantation, the National Kidney Foundation has taken over the duties of providing information about organ donations. For a pamphlet answering the most common questions about organ donations, write to: Organ Donation, c/o National Kidney Foundation, Dept. M, 30 E. 33rd St., New York, N.Y. 10016. The foundation asks that you include a stamped, self-addressed, business-size envelope.