Religion and culture were cited as reasons why the noble idea of saving lives through organ donation has not had much headway 30 years since the Organ Donation Act was enacted in 1991.
Dr. Romina Danguilan, chair of the department of adult nephrology at the National Kidney and Transplant Institute, said it was very hard to convince relatives to consider donating organs of a deceased loved one. “As Christians, we always hope for a miracle and that the patient will wake up,” Danguilan said in a report in this paper.
Lack of education about organ donation is also an obstacle to implementing the law, even among some healthcare workers who are still not aware that organs from deceased donors can be transplanted to patients, she said.
“We’ve done national surveys in the past and found out that there are really a lot of people still unaware of organ donation and its potential to help so many others. It has to be continuous education, exposure and awareness about organ donation,” said Danguilan.
Then there is also the dark side of organ donation in the Philippines and other countries, with syndicates exploiting poverty in order to obtain organs from living donors in exchange for money.
Take the story of Danilo (not his real name) featured on an online website who “donated” one of his kidneys to a Canadian national in 2002. They were not related by blood and did not even know each other.
With his family’s well-being in mind and with the urging of an organ broker, Danilo agreed to have one of his kidneys removed in exchange for P115,000, though he ended up taking home only P85,000 after the agent deducted his share. Danilo bought a house in the same urban poor area where his family lived, but just nine months later, a fire broke out in his neighborhood, razing the newly-bought house.
Now Danilo, a father of five, lives in the same abject state as before the operation. He has also paid a heavy price. With only one kidney left, the report says, Danilo gets tired easily and cannot work for more than two days in a week. He also needs to eat his meals on time, as missing a meal causes him unbearable pain. He can no longer lift heavy objects, which for someone engaged in manual labor is a real challenge.
Under Philippine law, Danilo and the recipient, along with the broker and those who facilitated the operation, would be considered criminals. While the number of commercial or coerced kidney transplants has been drastically reduced due to new rules and regulations, the number of such transactions remains scandalously high. Currently, the Philippines counts among the “top 10” countries in the world for organ trafficking. In the face of stringent rules imposed by both the government and the medical community, organ traffickers have resorted to coaching potential donors unrelated to the recipients to give the “right” answers to ethical committees judging the legality and rightness of an exchange.
This is borne out of a complex web of reasons: desperation and poverty in the case of living donors; and the surging number of patients with renal diseases, as well as the stratospheric costs attached to hemodialysis for those in need of a kidney transplant.
The law allows the transplantation of a kidney or other organs if both the donor and recipient are related by blood, or are related by other factors such as a long-standing friendship. Transplantation from a deceased donor is also allowed, so long as the deceased has previously indicated his or her willingness to donate, or if the surviving family members agree.
But this, as proponents of organ donation observe, is easier said than done.
So strong is the resistance of surviving families to the idea of organ donation, says Danguilan, that “sometimes, even when the patient is already brain dead, it’s very hard for the relatives to consider donating the organs, especially if they are not aware that the potential donor was willing to donate their organs.”
The organ donor card is easy to download and fill out for those willing to be organ donors. It’s important, say doctors, to carry the organ donor card to inform their family that they are organ donors, in case one meets an accident that leaves one brain dead. It is therefore important not just to carry the card on one’s person but also to inform family that they are organ donors.
Policymakers then should review the law to find areas that could be improved to make organ donation more acceptable to many. A serious information campaign must also be undertaken to remove the aversion to the idea, and encourage people to have an open mind about it.
This would be an act of kindness, not just toward the person in need but also for one’s loved ones who would know that they are not just following one’s wishes, but also honoring one’s legacy of life—even after death.