The Health, Human Services and Elderly Affairs Committee deals with a broad range of issues affecting us throughout our lives. This year, we dealt with an issue that will affect us after our death.
Anatomic gifts are the donation of all or part of a human body after death for the purpose of transplantation, therapy, research or education. HB 587 is a bill to clarify the question of revocation of a person’s anatomic gift after their death.
Organ donation for transplantation is the most familiar anatomic gift. Advances in medicine have allowed us to use many parts of a deceased person’s body to help others. Donation of a kidney can allow a person to resume a more normal life, not having to undergo dialysis three days a week. Donation of a heart, lungs or a liver is a gift of life as these organs are transplanted into those who will die without them. Donations of corneas give the gift of vision. Donated skin can be grafted onto burn patients. We even transplant portions of bones and joints to reconstruct limbs after cancer surgery, preventing an amputation.
It is rare to be able to give so much to so many people as one can achieve with organ donation. One deceased donor can save up to eight lives through organ donation.
Strides are being made toward organ regeneration and growing organs in the lab, but the technology that will ultimately allow us to avoid transplants is still far in the future.
In 2018, organ donors saved more than 28,000 lives, but there is still great need for organs for transplant. There are over 113,000 people on the national transplant waiting list. Twenty people die each day in the United States waiting for an organ transplant. Although 95 percent of U.S. adults support organ donation, only 58 percent are signed up as donors.
As an orthopedic resident at the Massachusetts General Hospital in the 1980s, I served on a team that procured donations. Because the harvesting of hearts, lungs, kidneys and corneas is more time-sensitive than bones and joints, we would be the last team to arrive to harvest anatomic parts.
Organ procurement is done using sterile technique as though we are in the operating room. The deceased is always treated with great respect.
Anatomic donations are also used in research and for teaching purposes. Cadavers are used to teach anatomy in medical school. Progress is being made with virtual-reality, but touching actual structures really helped us learn anatomy.
Anatomy is particularly important for surgeons. As orthopedic residents, we worked with fresh anatomic specimens to carry out surgical dissections and demonstrate them to our peers. Though we learned in the operating room, it was best to practice in the lab where we were able to take our time and examine the relationships of the different anatomical parts. As medical students and residents, we were profoundly grateful to those who donated their body to help us learn.
Both of my parents were too old and ill to donate their organs when they died, but they did donate their bodies to the medical school. Afterward, their remains were cremated and buried.
Though New Hampshire statutes defining the process of donation are rather dense and written in “legalese,” they clarify the rules about donation.
You may register as a donor on an online donor registry or through NH DMV at any time. A separate donor card is not necessary as all hospital deaths must be reported to the local organ procurement organization who will check donor registries and the DMV. You should also make your wishes known to your family.
If you are incompetent to donate, due to serious illness or injury or dementia, your guardian or agent (under a power of attorney) may authorize donation. A minor, if emancipated or old enough to apply for a driver’s license may donate his or her organs.
You can also authorize donation in a will, or during a terminal illness if witnessed by at least two adults, one of whom is a disinterested witness. A gift of your body for teaching is usually arranged through a medical school.
Before death, a donation may be revoked in a manner similar to making the original donation if the donor changes his or her mind.
After death, organs may be donated by an agent of the decedent under a power of attorney or next of kin such as spouse, parents, children or other relations.
After their death, the donor’s wishes must be honored. Revocation of a donation cannot be made by another person except the parents of an unemancipated minor, who may revoke their child’s donation. HB 587 clarified the issue of revocation of donation after death.
Your medical care will not be compromised in any way if you register as an organ donor. You will still receive all of the appropriate care that you have directed.
Organ donation is part of end-of-life wishes. It is wise while you are still healthy to consider your end-of-life wishes and make them clear to your family through discussion and by completing an advanced directive, power of attorney and organ donation forms. An attorney can help you with this process and the Visiting Nurse Home Care and Hospice of Carroll County can advise you.
Please consider giving the gift of life, sight or function to another person.
Jerry Knirk is the Democratic state representative from Freedom.