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Thursday 30 December 2010
Virginia Ironside: There is nothing sacred about dead bodies. So put them to use
It's long overdue that we introduced 'presumed consent' in this country. But a pagan pre-occupation with body parts holds us back
I wonder, if the so-called "Alder Hey scandal" happened today, whether there would be as much of an outcry as there was at the time. Ten years ago, it turned out that doctors had removed 104,000 organs and body parts from dead children and stored them – some to be sold for research, others for heaven knows what purposes. Naturally enough, the parents of the dead children were furious that their permission had not been asked for... but I never really understood why the fuss was quite so great. After all, these were only dead bits of flesh and tissue.
Did the parents really feel their children lived on in these random livers, hearts or kidneys? If so, wasn't that rather pagan and superstitious?
Following the revelations of the Alder Hey scandal, the UK scientific community started to worry about the effects of it on organ donation rates. And there's no doubt that it did have an effect, resulting in the resistance to the introduction of "presumed consent" for organ donors, despite the fact that surveys show that 90 per cent of Britons support organ donation.
But over the past few years it seems as if views are finally starting to change. Yesterday, the decision to start harvesting (what a word!) body parts from those who die in A&E as well as in intensive care passed with barely a murmur, and rightly so. The only reason that it hasn't been done before is, apparently, because the teams in A&E haven't existed – teams to perform the withdrawal of the living organs and counsel the bereaved.
These days nearly everyone must know someone who's either received, or is on the waiting list for, a new liver, kidney, cornea, heart or lung. Body parts are swapped around with comparative impunity. And surely an opt-out scheme, where it is assumed that every dying patient gives automatic permission for their body parts to be raided in order that others may be given life unless they specifically say otherwise, must soon be on the way.
A total of 24 European countries have some form of presumed consent system, with the most prominent being Spain, Austria and Belgium. Australia lags behind, with just 12 deceased donors per million population; in the States, one of the leading countries for organ donations, there are still some cultural obstacles and religious concerns, and Japan, because of pressure from Shinto and Buddhist groups, didn't even legalise organ transplants from brain-dead donors until 1997.
With the exception of the above, nearly all religious groups now approve of organ donation, and the attitude to spare parts has come a long way since the ethics of cremation were argued in the century before last.
The reason body parts were given such sacred status in the past was, of course, religious, and to do with the resurrection. If we were all going to be pottering around heaven after death, dressed in white robes, what would we do if someone had removed our vital organs? How would we exist? Indeed, that was one argument raised against approving of cremation, until someone pointed out that surely God wouldn't allow those Christian martyrs burnt at the stake to be excluded from an afterlife simply because they were a pile of ash. Now even those groups who do believe in Heaven-pottering believe that we will live in different sorts of bodies to those we inhabit on earth.
Add to this, there is still a faintly pagan preoccupation with the idea that body parts retain some of the characteristics of their original owners, which then transmit to the new recipients. We've all read stories with headlines on the lines of "I got the heart of a singer and now, having never sung a note before, I'm giving a concert at the Wigmore Hall." It's all a bit like the 1924 film The Hands of Orlac, about a pianist who lost his hands in a railway accident, and was then donated the hands of a murderer. He spent most of the rest of the film having to resist killing people.
And even when I had my colon removed acouple of years ago, I was surprised when a couple of perfectly rational and civilised friends asked if I had "mourned" my colon – as if my colon had been some kind of close buddy of mine. Good heavens, I'd never even met it! Women are said to "mourn their breasts" when they have them removed, and I suppose they know their breasts better than they know their colons, but I don't know any woman who says: "Hello, beautiful breast!" every morning, or has a kind of personal relationship with one. Most men have a more personal relationship with their cars than their kidneys.
But despite the fact that most people seem to be more rational about body parts, there is a new and growing element of squeamishness in some areas. In her excellent book Contesting Human Remains in Museum Collections (Routledge), Tiffany Jenkins writes that museums are increasingly keeping mummies' coffins semi-closed or even covering them with a white sheet because "it is more respectful".
It really is time for "presumed consent" to be introduced here in the UK. The idea is supported by the British Medical Association and the British Heart Foundation, and though 28 per cent of the population have signed up to the organ donor register, signalling their willingness to donate their organs after death, only 1 per cent die in circumstances where their organs can be used.
In the last thirty years, transplant surgery has been used far more widely than it used to be, and demand for new body parts is rising. Every year, three people die each day before they can get a transplant and though the number of donors is rising, the number of people needing transplants is rising as well.
And keeping people alive on dialysis machines is incredibly expensive. Over a few years, the cost of a transplant can be easily covered by the money saved on dialysis.
A friend of mine recently said he was amazed that there should be any kind of resistance to organ transplants. "As far as my body goes," he said, "I only feel I live in rented accommodation."
It's the right attitude to have. And in an age when we're all banging on about equality and brotherhood, surely giving our organs, after our deaths, to someone suffering and who may be given the chance to live with one of our spare parts beavering away inside them is the very least we can do for our fellow human beings.
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