Coma

However, most, if not all, states have now passed the Uniform Anatomical Gift Act. This law has helped to provide cadavers for medical schools (whose supply was already adequate), but it has not helped in rectifying the sad need for useful “live” organs for transplant purposes.

An alternate approach, by which all cadaver organs would be immediately available for salvage unless the deceased or the next of kin had made prior refusal, has been proposed. But alas, the wheels of change turn agonizingly slowly, and potential recipients are allowed to die while organs are wasted in the ground. Hard questions remain to be answered: such as an acceptable definition of death, and the legal rights of an individual after death. But such difficulties should not preclude a solution to the egregiously wasteful practice of discarding valuable human resources.

The problem of organ scarcity for transplantation represents only one flagrant example of the failure of society In general and medicine in particular to anticipate the social, legal, and ethical ramifications of a technological innovation. For some inexplicable reason, society waits to the very end before creating appropriate policy to pick up the pieces and make sense out of chaos. And in the instance of transplantation, failure to recognize mounting problems and enact appropriate solutions will certainly open Pandora’s box, with its countless unconscionable possibilities: the Stark et al. of my fiction suggest only possible, execrable aberrations.

For those readers who are interested in delving into the complex problems of organs for transplantation, I recommend two excellent articles which are delightfully illuminating, despite that fact that they appeared in law journals. This is not to cast aspersions on law journals, but rather to emphasize that the lay individual will find these articles very readable: J. Dukeminier, “Supplying Organs for Transplantation,”

Michigan Law Review, vol. 68 (April 1970), pp. 811-866; D. Sanders and J.

Dukeminier, “Medical Advance and Legal Lag: Hemodialysis and Kidney Transplantation,” UCLA Law Review, vol. 15 (1968), pp. 357-413.

For those who are interested in medical policy and its phlegmatic character, combined with some positive suggestions for future change, I recommend: J. Katz and M. Capron, Catastrophic Diseases: Who Decides What? Russell Sage Foundation, 1975. This is an excellent, thought-provoking book, probably years ahead of its time. Its only drawback is that not enough people in positions of power in medicine will read it.

A final word about women in medicine: I must admit that the research I did on the subject (there is not much available) caused me to alter my opinions. I now have a heightened regard for female physicians and female medical students. I recognize that their training experiences are much more difficult and stressful than those of their male counterparts.

Things are getting better in this respect, but at a snail’s pace. The article I found the most illuminating is: M. Notman and C. Nadelson,

“Medicine: Career Conflict for Woman,” American Journal of Psychiatry, vol. 130 (October 1973), pp. 1123-1126.