Archive for the ‘Causes’ Category

If You Only Gave Your Heart

In Causes on May 10, 2010 at 2:11 pm

Being the awesome substitute teacher that I am, I use my lovely, sparse free periods to browse the internet for interesting articles, especially those pertaining to health care, so I have something educationally related to pick the kiddies’ brains about. Today, I came across a very interesting article pertaining to a cause that is close to my heart  – organ donation.  CNN Health is my homepage, it makes it easier for me to keep up with the latest health developments.  One of today’s main articles is California, New York mull changes to organ donation laws.   The article details the proposed legislative changes to current organ donation laws. While using two different approaches (in a typical West Coast vs. East Coast style), each is progressive in it’s own right.

California is pushing to be the first state to create a living donor registry, a move lead by Steve Jobs (Apple co-founder who himself was a liver transplant recipient).  This move is backed politically and, personally, I always find it refreshing when wealthy people are aware of their beneficial treatment and make moves to erradicate this preferential treatment.  I find it interesting that there are unofficial registries online.  Seeing how ~75% of people waiting for an organ are waiting for a kidney (an organ we could each live just fine with only one of), this move by Cali has a possibility for making a substantial impact at decreasing the wait list, especially if proved successful and mirrored throughout the nation.  Cali’s approach aims at increasing the amount of organs available for transplant by increasing availability of those from the living.

Conversely, New York aims to increase the amount of organs available for transplant by increasing the availability of harvesting organs from the recently deceased.  In my opinion, New York’s proposal is a bit more radical, and something, while with good intention, probably will rub certain policital groups the wrong way…you know we can never legislate moves that would radically benefit society without stepping on some toes and offending some group who’ll cry “Foul!” at the slightest impingement of their liberty.  Sorry, I just get a bit worked up about how sensitive and cry-babyish Americans have historically been, when slightly cramping their freedom for the increased good of the people leads to protesting cries of injustice (probably has moreso to do with this book I am just finishing up…) Anywho, NY wants to implement the implied consent for donation already in place in many European countries, making it so that everyone is automatically an organ donor by default, unless you opt out. And I know, various cultures have strict views on their bodies and donation of any parts, but guess what?  They can always chose to say no, so I don’t see the big deal. And bet, it will up the amount of available organs for donation, thus decreasing the amount of people dying after sitting on the wait list (nationally about 101,000 people long). I’m all for autonomy, but what are you going to do with your organs when you are dead? It’s not like you’re going to be killed for your organs… Give someone the gift that keeps on giving – life!   A particular part of this bill I appreciate stops relatives from reversing decisions made by their loved ones regarding donating their organs…something I never understand how was previously justified.

Since I can remember being interested in medicine, I recall being told that one of the larger disparities pertains to organ donation. Blacks wait 2-3x longer than Whites to receive organ donations…which means that more often than not, we are dying at a higher rates than other groups due to thie prolonged waiting period.  Now, this is not due to any systematic prejudice within the donation system, but rather reflects a hesitation and an underlying distrust within the Black community regarding the medical community.  We are ~12% of the US population, but only ~3% of organ donors.

A certain proportion of this disparity is due to religious beliefs, such as those of Jehovah’s Witnesses, who consider it against God’s laws to accept blood transfusions. [actually, I cannot find a document that explicitly states organ transplants are prohibited, but it would logically follow that unless we drain a transplant of all blood, this too would be prohibited by their laws]. But, this only accounts for a relatively small part of this disparity…

As anything else that truly touches me, I try to start my efforts for change close to home, and then work my way outward.  I’ve heard of how distrustful members of the African American are of the health care profession, but I never explicitly heard this mistrust vocalized until a few years ago.  I was visiting a close family friend (a second mother to me) discussing with her how much this issue bothered me and how I was starting with friends and family members to slowly gauge the response of the community to a proposed increase in organ donator status. While she lauded my interest and drive, she flat out stated how she would not join in the effort and preceded to go on a 10 minute monologue about how she honestly felt that having “organ donator” checked on her driver’s license would put a big red bullseye on her back if she was ever in an emergency situation that threatened her life. She legitamately felt that every effort would not be extended to preserve her life in such an event. I could see the fear in her eyes as she spoke these words. I tried to reassure her that no doctor wants their patients dying at their hands, and that they wouldn’t just let people die on their tables so that they could harvest these peoples’ organs for unknown patients X, Y, and Z. As of yet, it’s been to no avail – she flatly refused to believe me.

I’m sure you’ve heard time and time again that much of this mistrust stems from degrading and despicable abuse of the African American community by the medical profession over the 20th century – most notably, the infamous Tuskegee Syphilis Experiments, which ran from 1932 -1972! (Us government apology came in 1997… [insert side eye])  [aside: one of the next books I will read is Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present] To be frank, just thinking of events like Tuskegee boils my blood still, no matter how many years have passed.  But, as angered as I get about this past and near-present mistreatment of my people, other things anger me even more.  It angers and frustrates me to see my community not helping itself out, to see us sitting by an being content with poorer health outcomes.  Frustration is key to igniting change – the past angers me, but there is nothing I can do to change it, thus no frustration…however, I can most certainly change our future. I still have no idea what I want to focus my future practice of medicine on, but this is an effort I plan on becoming intimately involved with throughout my career.  I like the proposed NY legislation – might substantially help decrease the time African Americans spend on transplant waitlists…

p.s. – August 1st is National Minority Donor Awareness Day. I believe this is also the day of my white coat ceremony. Sounds to me like it’s the perfect coincidence

Related Short Reads:

New Articles: Tuskegee’s ghosts: Fear hinders black marrow donation, Blacks’ mistrust of medical system limits organ donations

Academic Articles: Organ donation in the African-American population: a fresh perspective with a simple solution. African-American Reluctance to Donate: Beliefs and Attitudes about Organ Donation and Implications for Policy.