Shortage of organ donors

January 15, 1992

Early stories of organ transplants told of brave pioneers who submitted to risky operations in the hope of earning a few more weeks or months of life while helping to expand the frontiers of medicine. Now, successful transplants are routine, and news reports are focusing on another kind of story -- the quiet tragedies of people in need of transplants.

These people live each day hoping to hear that a heart or a lung or a liver is available to replace their own failing organ. They are waiting for the kind of miracle that happens when a death creates the possibility of new life. But these miracles -- often the result of sudden tragedy -- simply aren't frequent enough to save all the lives that can be mended through transplant surgery.

Trauma victims, especially young adults between 18 and 35 years old, have been the prime donors for organs. The good news is that better trauma care and stricter safety practices have resulted in fewer accident fatalities and, thus, fewer lives ended prematurely. The bad news is that there is no effective system in place to build up a larger pool of potential donors, even though organs from older donors can be just as effective.

Despite a federal Required Request Law, adopted in Maryland in 1988, hospitals have generally failed to develop adequate procedures and training programs to ensure that staff members approach families appropriately when raising the subject of donating a relative's organs -- or that they are approached at all. Regardless of the law, the requirement is often ignored. The result is that many of the 23,000 people around the country who are waiting for an organ will never get one.

Before that can change, there are plenty of myths to dispel: Organ donation does not mutilate a body, create any delays in funeral planning or cost the donor's family any money. Moreover, most religious opposition to organ donation has disappeared, although some disagreement remains. For instance, in the Jewish community there is still not unanimous support for transplants among Orthodox Jews, but Conservative rabbis have gone on record as supporting organ donation as an ethical obligation.

The most effective way of increasing the pool for organ donations is for families to discuss the matter among themselves. Regardless of a person's wishes or what a driver's license indicates, hospitals will not take organs over a family's objections. Until more Americans make their wishes known -- or until the United States follows the lead of some European countries and begins to consider every deceased person a potential donor unless families specify otherwise -- the waiting list for organs will continue to grow.

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