10.15.07
A Little More on Transplants
From reading Black Markets, the Supply and Demand of Body Parts, by Michele Goodwin, the topic of corneal transplants came up. Apparently, there was a scandal regarding inappropriate harvesting of corneas from homicide victims. What I was not aware of, and evidently many other people are not aware of, is “presumed consent.” Presumed consent involves those persons who have *not* specified whether they want to donate organs or not. So once a person dies, and for whatever reason his organs (particularly corneas in Goodwin’s chapter, which discusses presumed consent) have not be specifically barred from donation, then it is taken for granted that his organs can be used for donation. The idea being that, “If he were alive, then he would agree to donate because he didn’t specifically say that he didn’t want to donate.” Ack! I had never heard of that, and apparently, many others including many politicians were not aware of presumed consent in regards to organ harvesting when asked about it.
The particular scandal regarding presumed consent and organ harvesting occurred when it was found that the corneas of many homicide victims were harvested without consent of the donor, or the families and without the families knowing that it was done. Evidently, corneas are easy to take without it being obvious, especially since the deceased eyes are usually closed during viewings. These corneas were later sold and resold for profit. Apparently, cornea transplants are a common thing. I didn’t know that. So I looked up cornea transplants and found that it is estimated that in the U.S. (depending upon which source one reads), there are around 20,000 to 40,000 corneal transplants done a year. Wow, where do all those corneas come from? Well, apparently, lots of them came from homicide victims under the presumed consent reasoning. While not all deaths end in autopsy, all homicide victims routinely are sent for autopsy. And it is during that autopsy where these homicide victims end up “donating” their corneas or anything else deemed harvestable.
Goodwin discusses the arguments for and against presumed consent, which does appear to be a bit controversial.
Another thing that came to my attention was “do corneal transplant recipients need to take any immuosuppressant?” It seems not, and reminds me of other “implants” wherein foreign material is placed inside the body seemingly without the body rejecting them–i.e. metal screws, various plastics, etc. Hmmm. While it is obvious that those items are not naturally supposed to be in the body, it does seem that the body will accept some foreign materials to a certain point. BUT, I do know that places like the Gerson Institute does not accept people with any types of implants because the idea is that once the immune system is fully functioning and in pristine condition, then it will recognize foreign materials and cause the body to reject those foreign items–including metal hip screws, pacemakers, breast implants, etc. I have heard from a man who had corneal implants who claimed that he was not feeling well, so he went on a more healthful diet, which did improve his overall feelings, BUT he also started to reject his corneal implants. The idea is that once on a better diet and his immune system was improving, it also started to recognize that his corneas were foreign and proceeded to attack them. And then again, some of those foreign materials are considered in themselves immunosuppressants, like various plastics are believed to cause cancers and other health problems. Consider the debates on silicone breast implants and pthalates that can leech into foods from various food containers and wraps. But the bottom line is if corneal implants don’t require immunosuppressants, it seems to me that they are not in the same league as full organ transplants. Therefore they don’t seem as “wrong” to me. Although some of the “harvesting” practices do seem questionable because it not only involves “non-consent” issues, but also involves lack of screening of the tissue–i.e. it is common to “not” obtain medical history of homicide victim, so the quality of his organs, or in this case, corneas, can be of questionable quality since transmissible diseases can be passed on through contaminated corneas.
Okay, I’m out of time again. Must dash, but hope to get back with a little more on transplants, particularly since this topic brought back my old interest on the history of transplants. I blew off the dust on my old notes and thought it would be interesting to share some transplant history.
But for now, toodles!
Marlakins
