When we think of what will become of us after our death - and by this we mean not the metaphysical question of what will become of our soul or conscience, but the very down-to-earth question which refers to the carcass that serves as our bodily envelope — we tend to think first of all about the type of funeral we would like:buried or cremated? eaten by worms or scattered to the four winds? For some, the answer is categorical and certain ways of managing bodies generate reactions that are almost more frightened than the question of death itself. Others are completely indifferent to it:once you are dead, you are dead.
All of these are questions that will concern those around you in the days following your death. But in the few hours that follow, and depending on the circumstances of the event, a much more urgent and vital question arises - literally, since the survival of another human being is at stake:organ donation or not ? If we have all heard of the famous organ donor card, in the end we often know very little about the formalities surrounding the question. Like writing a will, it's something you don't worry too much about during your lifetime, believing you're safe from the hourglass, until you find yourself faced with a fait accompli - or rather until you put your loved ones in front of them. him. So, in order not to find yourself lying on your deathbed, embarrassed by all our equipment that the medical team could be interested in:organ donation, let's talk about it!
There are two methods of organ donation. If 92% of the organs are taken from deceased people, it is indeed possible to donate organs during one's lifetime - this essentially concerns the kidney, since it comes in pairs and it is possible to live with only one of them. between them — although the procedures are long and arduous, and include clinical, radiological and biological examinations, in order to ensure that the donor is in good health and fully understands and accepts the risks involved. However, this does not exclude the elderly! Indeed, there is no age to donate a kidney – nor a hepatic or pulmonary lobe, the other two parts of an organ can be removed from a living subject. Only doctors are in a position to decide, on a case-by-case basis, on the relevance of the donation. On the other hand, this donation is only possible between relatives. The exception is that of cross-donation, where the relatives of two transplant applicants, not being themselves compatible with their loved one, will reverse their roles.
The other organs are taken from people who are brain dead. And as such, there are no conditions relating to age or state of health either:any corpse can be useful. Contrary to what one might think, even an elderly and suffering person can be a healthy donor. Seniors have nothing to be ashamed of, since in 2020, 40% of brain-dead donors were over 65 years old.
And while you can be indifferent to what happens to you after you die, it can be heartwarming to know that another life will be able to continue through its organs. How to go about it ? Well actually, nothing could be simpler, just do… nothing at all. In France, since the Cavaillet law of December 22, 1976, everyone is indeed "presumed donor".
It is therefore necessary to actively oppose organ donation, during his lifetime, so as not to see them removed upon his death. Despite this, only half of potential donors actually have their organs removed, either because of a medical history or because the family of the deceased (who unfortunately have to speak out almost immediately after hearing the news) are against it. This refusal, on the part of relatives or the principal concerned, may be justified by religious beliefs, or even sentimental ones, when a relative would not bear to see the body of their spouse touched, for example (on this subject, the body of the deceased must be restored by an embalmer following the removal in order to be presentable to his relatives). It doesn't matter, it's not debatable. If the deceased has taken the necessary steps, his refusal can be entered in the national register of refusals. It may also have simply been served orally, in which case his relatives will have to certify this to the medical team.
You should know that in France, more than 20,000 people are on the waiting list, in the hope of the removal of a compatible organ. However, only 5 to 6,000 organs are transplanted each year – with a sharp decline since the pandemic – which only widens the gap between applicants and donors. A fatal difference:500 to 800 people die each year because they did not receive a transplant in time. We can never repeat it enough:organ donation saves lives .
For those who accept organ donation, there is therefore nothing to do... at least theoretically speaking. Because in reality, the removal and transplantation of an organ is a race against time, which starts as soon as the death is confirmed by two doctors:it is then necessary to carry out analyzes which will determine the possible compatibility with patients waiting transplant, then remove the organ(s) and send them to their destination hospitals. It is therefore necessary that the medical team know as soon as possible the dispositions of the deceased person in order to know or not if their organs are usable. However, checking the national register of refusals and asking relatives about a possible veto expressed orally costs time.
A donor card theoretically makes it possible to abstain from these steps. Theoretically, because in practice, the medical team will always talk to the relatives of the deceased. Moreover, the donor card is in reality only rarely found when considering the removal, and it has not been distributed by the Biomedicine Agency since 2018, so as not to add to the confusion. However, it is always possible to download it and fill it out yourself. However, it is best to communicate your wishes verbally or in writing to your loved ones. This saves precious time, the organs having to be quickly removed and transported in order to hope to complete a transplant.
Finally, a little aside:donating your organs and donating your body to science are two entirely different things. In the second case, it is simply a question of serving education, by serving as a "guinea pig" for medical students and their teachers. Because of the much less urgent nature of this question, no one is presumed to be a donor. This requires taking steps with the nearest faculty of medicine.
Organ donation is - it should be specified - free, by virtue of the principle of non-commercialization of the human body, which also justifies that one cannot be remunerated for even more benign donations, such as those of blood or sperm. Any remuneration or advantage is therefore expressly prohibited, for fear of mercantile abuses. The third major principle of the bioethics law, along with presumed donation and gratuity, is anonymity between donors and recipients, in order to ensure equal opportunities in access to transplants and the pursuit of a normal life. .
These principles nevertheless raise fascinating philosophical questions:from where do we draw the limit of a "benefit", particularly in the case of organ donations during one's lifetime, which only take place between relatives? Is this gift then so free? And so free on the part of the giver, subject to a certain moral pressure? As for "mercantile excesses", aren't they also invoked to justify repressive policies, particularly in the context of surrogacy (surrogacy) and the adoption of homosexual couples? In short, as is often the case when we find ourselves at the intersection of physical integrity and human life, a pandora's box of ethical philosophy opens up to us...
