Here's an irony: Stricter safety laws and improved care...

Coping/ Mortal Matters

January 27, 1992|By Sara Engram | Sara Engram,Universal Press Syndicate

Here's an irony: Stricter safety laws and improved care for accident victims are saving more lives, but meanwhile more people in need of a transplant are dying while waiting for a suitable organ.

Trauma victims have long provided a steady pool of organ donors, especially the kind of donors transplant specialists have preferred - healthy adults between 18 and 35 whose lives were abruptly ended and whose bodies weren't ravaged by disease or too many years of wear and tear.

The good news that fewer young lives are ending tragically has been bad news for the 23,000 people in this country who are waiting for an organ transplant and wondering whether it will come in time. They're lucky if it does; currently, fewer than 10,000 potential donors turn up in any given year.

That good news-bad news scenario seems unnecessarily cruel - and it is. This country has not worked as hard as it should to develop a bigger potential pool of organ donors. Government and the health care industry share the blame for the fact that public education on the need for organ donations has lagged so far behind the need.

Last year, Johns Hopkins Hospital in Baltimore took a step that more medical institutions should consider. The hospital hired its first "donor advocate," whose job is to educate both hospital personnel and the general public in the need for donations and to dispel the myths that often prevent donations.

The advocate, Greta Cuccia, is a nurse experienced in transplantation work and fully aware of both the need for a bigger donor pool as well as the many reasons - from outdated attitudes to lack of awareness to procedural lapses - that allow so many potential candidates to go untapped.

For instance, she notes that even among physicians and nurses, there can be a lack of awareness of the effectiveness of new transplant techniques. Many of them have not kept up with the dramatic progress since the days when transplant successes were more the exception than the rule. When transplants were riskier, the reasons to urge families to consider donating a relative's organs were less compelling, and fewer physicians felt obligated to raise the question.

Now, however, federal law requires that a request be made. Even so, that requirement often falls through the cracks - in part, Cuccia says, because there have been no consistent attempts to see that hospitals train their personnel in the need for donations or in ways of raising the subject with families in a sensitive, appropriate manner.

After all, it is families who have the last say in these matters. Regardless of your preferences - or even what your driver's license says about organ donation - if your family objects, hospitals will defer to their wishes.

As Ms. Cuccia points out, your family may harbor their own myths on the subject. Many people shy away from donations because they mistakenly believe it will mutilate the body or make an open-casket funeral impossible. It doesn't - and neither does it cause any delay in funeral planning or cost the donor's family any money.

Moreover, most religious groups have become strong advocates of organ donation, since it is clearly a way to save a life. And with the decline in available young adult donors, physicians are learning that older people can be potential donors as well.

The early reports of brave transplant pioneers with slim chances of survival have been replaced with a different kind of story - the quiet tragedies of people who know they have a strong chance of living a normal life if only a suitable organ were available. With better public education, perhaps more of them will get their chance to live.

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