Tissue & Organ Donation and Religion
Organ and Tissue donation is a life-saving hope for many people. The conception of this medical miracle became a reality twenty-five years ago, Dr. Christian Barnard who from South Africa had mesmerized the world by performing the very first heart transplant. Ever since the transplantation of not only the heart but other vital organs and human tissue began its practice around the world. Currently, anybody can be a potential organ and tissue donor after death. The organs that can be donated include the heart, kidneys, liver, lungs, pancreas and intestines; this also depends on the cadaver’s age, circumstances of death and medical condition. Tissue donations on the other hand include the cadaver’s tissues, such as whole eyes including the cornea and sclera, heart valves, cardiovascular tissue such as the thoracic aorta, abdominal aorta; these tissues can restore compromised blood circulation. Basically tissue donation includes donation of the eyes (sclera and cornea), skin, bone, tendons and heart valves. Some tissues such as bone can be donated during life; which is called “living donations”, however, most of it is usually donated after death occurs. In the transplant of the sclera and cornea, the sclera of the eye is required for transplantation as it is used for replacing the damaged or diseased cornea. For the skin, it is used to treat severely burned patients, it acts as a biological dressing, reducing pain, increasing regeneration rate and healing . Bone donations are used for grafts in operations that are aimed to reduce pain, improve or restore mobility in patients. Tendons tissues are used to restore mobility in patients with badly damaged knee joints. Heart valves can be used to replace diseased or damaged valves. Before all donations occur it has to be checked that the donor does not have a virus that can be transmitted such as HEP B or C, HIV.
Donating organs is a life saving gift to any person in the society. But this can be at the expense of another family losing a loved one and although a family is in the midst of grieving they still are amazing in a humanity and compassionate way. Unfortunately, the need for organs still grows in comparison to the need; this is due to the unawareness about the knowledge of organ and tissue donation and the need for addressing the public’s attitudes and beliefs in this area of issue. According to Health Canada, the rates for donation of organs are still too low to meet the growing need for organs. The number of Canadians on waiting lists for an organ as of December 31, 2004, there were 4,004 people, 2003 was 3,914 (124 out of every million Canadians), a decrease from the two previous years there were 3,956 patients waiting in 2002 and 3,964 in 2001. The Trillium Gift of Life Network, which is a provincial organization, is dedicated to create awareness and knowledge in every Ontarian about organ and tissue donation, they plan, promote, coordinate and manage the organ and tissue donation system in Ontario. The total number of transplants performed in 2007, have been six hundred and ninety one in Ontario, and there is one thousand seven hundred and forty five people on a ten-year waiting list for the year of 2006.
The brain dead organ donor is the principle source of transplantable organs in Canada . As there are misconceptions often associated with the term brain death, it is better understood as brain arrest. It is analogous to the event of a cardiac arrest - once irreversible; the individual’s death is subsequently determined by cardio circulatory criteria based on the absence of heartbeat and circulation. Once brain arrest occurs and is irreversible, death is subsequently determined by neurological criteria based on the absence of brainstem function. This neurological determination of death is the process and procedure to determine death. According to the surveys conducted on family’s understanding of brain death, the families pointed out that if the hospital or health care provider told them that their loved one was brain dead, they could not interpret the meaning of brain dead. The families were unable to provide a correct definition of brain death, 67.4% provided a correct definition and 4.5% provided completely incorrect meaning of brain death . They families that stated the incorrect statements focused on their belief that brain death was not the same as death itself. The perception of brain death is a confusing term to the general public and especially families as most of the feed back received had incorrect descriptions and this can lead to the some of the myths and misconceptions in organ and tissue donations.
When people were surveyed in regards to their overall attitude and belief about donation for organs and tissue, it was found that “People’s opinions about organ donation are formed by their diverse conceptions of the intriguing phenomenon of the transplantation enterprise” . Since its inception, organ transplantation has advanced greatly meeting ancient and typical beliefs and reactions. One of the most typical beliefs lies in the people’s religious beliefs. Religious viewpoints are dispelled commonly as a misconception that they do not allow for organ and tissue donation, and most commonly the question of religious approval from the public is that “does my religion approve of this ?”. Majority of the people are unaware of their own religious sayings or rules, as most major religions not only at the very least approve, but also encourage donation of organs after death, with exception to this rule that include respect for the dead, treated with dignity, organ transplantation should be the last chance of survival for the recipient and the donor should have an informed consent given prior to death. Religious views are sometimes seen as a barrier to tissue to organ transplantation. No world religion actually prohibits organ donation but there are differences in the attitudes between some religions.
Major religions like Christians, Muslims, Jews, Hindus and Sikhs generally approve of donations as acts of giving, love and kindness, Jehovah’s witnesses see this issue as an individual/personal decision. Where as Buddhists do not have any objection but are cautious due to the doctrine of Karma. Hinduism is of the belief that it is an individual’s choice. The most significant religion for this project is Islam, in which there are two groups that argues to and against organ donation. One argues that humans do not have the right of property on themselves, which includes their organs as cannot be given to anyone else. Another point in the argument is that the Creator (God) has the only right to the human body and is held by the person as a trust for lifetime. According to the Hadith, “Breaking a bone of the dead is equal to breaking a bone of a living person”.
The other group strongly believes in the principal of saving human life and organ transplant is a life-saving operation. Islam permits organ transplant as a priority in saving human lives under the following conditions; as long as the human body is respected and treated with dignity, the sanctity and protection of human life are paramount; a person must give freely and without undue pressure, for the purposes of saving another life or to enable another person to perform a missing and essential function. The Quran says: “They give their brothers preference over themselves, even though they were in need of that which they gave”. Culture and religion play a significant role in end-of-life experiences, including how people respond to illness, what rituals are important at death and which members of the family are present and how grief is demonstrated. Most religious groups endorse organ donation and respect the individual’s choice in their right to donate their organs after death. Beliefs about tissue donation vary as some groups may consider tissue donation life enhancing, and distinguish it from organ donation which is more often life saving.
Most major religious texts were clearly written before the idea of transplanting organ was heard of, and there were many controversies on this idea, more then it is now. The important point is that when dealing with the individual donor or family it is clearly understood to avoid any preconceived ideas about their religious views. The beliefs and wishes must be respected and this can have a great effect on their opinion in organ and tissue donation, not only for the present generation but also for the future generation.
The main points of this paper have been to raise self-awareness of the overview knowledge about the attitudes and beliefs about organ and tissue donation and addressing religious beliefs and values in this issue can be the most beneficial way for increasing the awareness for organ and tissue donation. When addressing a particular religion or community and “if the community has religious leaders or its own social workers, they can be very useful”.