Wednesday, September 29, 2010

The Gift of Life

As far back as I can remember I have been a fan of organ donation. I have always checked the little box on my driver's license to be a donor myself. Like you, I have read the success stories and wept about the emotions experienced by both families and the donee. I never realized I was so ignorant of the process until recently when I heard an ARORA (Arkansas Regional Organ Recovery Agency) person speak.

I have wondered several times since Randy's death why no donation of any of his organs was ever mentioned (he too checked the box on his driver's license and was an organ donation supporter). I assumed his cancer and treatments prevented it, although I never did any research to fully understand why. I think it made me nervous to think about it - had an opportunity to share something from his life been missed?

Well, now I have learned that generally cancer (at least an active cancer diagnosis) disqualifies someone from organ donation. You're probably thinking "well, duh, of course," but I wondered about his organs that were not affected, since his cancer was confined to his neurological systems. Anyway, here's what I learned about requirements for potential donors for organ donation:

1. The donor must have a neurological injury - brain trauma, such as brain swelling, stroke, aneurysm, near drowning, hanging (strangely enough, I knew this last one from reading Change of Heart by Jodi Piccoult), etc.

2. The donor must be ventilated.

3. The donor must have a GCS (Glasgow Coma Scale) of 5 or less.

A series of tests are performed by a neurospecialist to determine brain death. Brain death is death—it is not reversible. Organs can only be recovered from individuals who are brain dead, or in some cases who die a cardiac death—meaning that their heart has stopped beating. Organ donors can also donate tissue. The only disease that completely eliminates you from being an organ or tissue donor is HIV or AIDS, however a current cancer diagnosis generally disqualifies you as well, or treatment for cancer (chemo or radiation) within the last five years. I say none of this to discourage anyone from agreeing to donate. Circumstances can always change and it's better to be safe than sorry.

I also did not realize that legally (under section 10 of the revised Uniform Anatomical Gift Act, which has been adopted by all states and the District of Columbia) family members, or a health care power of attorney, cannot revoke an individual's decision to donate his or her organs. So, if you have agreed to be an organ donor, then at your death, your family cannot revoke this decision. However, the ARORA organization works closely with families to get their buy-in and make sure they are comfortable with the entire process. In a very few cases, a family may be adamant about not donating the organs, and these decisions are respected. What this means is that if you want to be an organ donor, it is important that you share this decision with your family and let them know you want them to follow through with this decision when you die. Particularly with untimely and unexpected deaths, families may be grieving so deeply that making this decision is extremely difficult when it has never been acknowledged or discussed during the donor's life.

A few other things I didn't know and hadn't really thought about:

1. There is no cost to the donor family for donation. ARORA covers all costs once the decision is made.

2. Donating organs does not prevent a "viewing" of the body. (Randy and I had decided to be cremated, so had never considered this). All bodies are reconstructed well enough for clothing to cover any incisions, even with tissue and long bone (arm or leg) donation. I apologize if this sounds morbid to you, but since I had never thought about it, I was fascinated with the extent to which ARORA goes to respect a family's need for closure.

I hope you were already an organ donor before you read this post, but if not, I certainly hope you are planning to become one now. If you want more info, please visit (for some reason, blogspot won't let me put the link in here). Knowing that someone else may receive life from my physical death makes me happy now. Not that I'm in a hurry to die or anything, but when it happens, it happens.... so, having something good come from it gives me the potential to Pay it Forward even when I am no longer on this earth!

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