Body donation ethics: cause for concern?

A shocking newspaper series about the use of donated organs and tissues has alarmed some and created fears of a backlash

Roundtable

April 23, 2000|By Tricia Bishop | Tricia Bishop,SUN STAFF

Yesterday marked the conclusion of National Organ and Tissue Donor Awareness week, a time when donor advocates ordinarily welcome any and all media coverage.

But a huge, five-part newspaper report this past week shined an unflattering spotlight on some aspects of the donation business and has the donor community up in arms.

The "Body Brokers," an Orange County Register report circulated nationally by news services, took an in-depth look into what happens to donated body parts and makes some disturbing conclusions: "Nonprofit tissue banks and research institutions do not explain to families how the [donated] bodies will be used," the report said, meaning they don't tell them their gifts could go to plastic surgeons, safety product-testing outfits and for-profit companies.

Skin needed for burn patients is often auctioned to the highest bidder -- for the most part, plastic surgery companies that use it to "puff up the lips of fashion models" among other cosmetic procedures -- and that "donated human bodies are replacing crash test dummies ... in bizarre research projects."

Though the 1984 National Organ Transplant Act made it a crime to sell body parts, the report stated that "American businesses make hundreds of millions of dollars selling products crafted from donated human bodies," and that corporation top executives can make six-figure salaries.

The Sun asked some of those involved in organ and tissue donation in Maryland and elsewhere about the controversial claims, the potential effects of the stories and the general protocol that should govern what is supposed to be a gift of life, not a means to riches.

While many admitted the system needs tweaking, they more often expressed intense worry that the report's claims could spark a national cry to tear up donor cards.

The ethicist

"It's absolutely shocking," Arthur Caplan, Director of the Center for Bioethics at the University of Pennsylvania, says of the reported money-making. "People don't associate profit with gift giving."

Caplan, author of the 1999 book "Ethics and Organ Transplants" says the story the Register told is one he's been trying to get into print for a decade. Reporters' usual response, he says: They "yawn and say,`Tissues? Not that dramatic, not that glamorous.' "

The difference between organ donation and tissue donation is an important distinction to make, he says, something he doesn't think is clear enough in the Register report.

"People are going to become confused," he says. Organs, essentially represent a whole: a heart, a kidney, a lung. Tissues, on the other hand can be broken into parts of a whole: bones and ligaments, tendons and heart valves, veins, eyes and skin, and are often thought of as life-enhancing rather than life-saving. The problem, according to Caplan, is in the lack of regulation of tissue banks, not the organ procurement organizations.

Caplan says companies -- both for-profit and nonprofit -- skirt the law by hiding behind handling and processing fees.

"There's not much oversight, he says. "These companies get huge mark-ups. It's clearly fraudulent."

The for-profit company

"We've never hidden behind the way our company is set up," says Art Kurz, Director of Donor Services at CryoLife, a Georgia-based tissue-processing company with shares traded on the New York Stock Exchange. "We've always been a for-profit company. Anyone that does anything creates a fee for that. The law says we can't buy or sell tissues, but we can charge for our services."

Those services include high-cost tissue-preservation fees. CryoLife, which specializes in deep-freezing human tissue, supplies up to 70 percent of the heart valves distributed in the United States.

Kurz, whose company chairman earned $587,361 in 1998 according to the Register, says the revenue they've taken in is not a bad thing, but in fact, just the opposite.

"If you look at most nonprofit organizations, they do not have near the resource capabilities we do," he says. "[The money] has allowed us to advance the technology."

Kurz, who says the work of a company should be the criterion for judgment, not its profit margin, adds that the complaint shouldn't be with them anyway: "The groups still clinging to being nonprofit are the ones not being up front."

The non-profit company

"One of the things we know is that there's a very tight job market," says Martha Anderson, Vice President of Donor Service at the nonprofit Musculoskeletal Transplant Foundation in Eaton, N.J. "We have to pay a reasonable salary to compete against device companies and pharmaceutical companies and others like that."

The Register reported the 1998 salary of the tissue bank's president as $350,000. "We really feel like we've been burned [by the Register]," Anderson says.

"We were afraid they would use such a broad brush that everyone would get a black eye, and that's not good for us and not good for the patients we serve. Potential organ recipients could really suffer."

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