(Some people have queries about posthumous body-donation. A few questions and their answers, pertaining to that context have been discussed here.)

Q: What do you understand by posthumous body-donation?
A: Posthumous body-donation is the process wherein a body, instead of being cremated/buried etc according to said last rites and rituals, is donated to the cause of medical science.

Q: What is the role of a corpse in the field of medical science?
A: The importance of a body in the development of medical science cannot be overstated. Firstly, medical students get a first-hand experience of their field of study through studying a corpse. No education is complete without the practical aspect of experience. Ancient Indian surgeon Susruta has said, the greatest knowledge comes through practical experience. In case of medical students, practical knowledge may be gained to a great extent through dissection of a corpse. A working knowledge of the human body is very necessary for becoming an experienced practitioner later on in life. And for dissection, a corpse is necessary.

Q: Unclaimed dead bodies are there for such purposes.
A: No, they are not. At one point of time, unclaimed dead bodies were the only source for providing bodies for anatomical studies. But after the law against using such bodies for the purposes of study has been passed, unclaimed dead bodies are kept at least 48 hours in case a claimant for the body comes forward, thus decomposition starts in the natural process. And a decomposed body is not ideal for dissection. Donated bodies undergo chemical treatments in order to make them suitable for dissection.

Q: Is a body required for any purpose other than an educational role?
A: Dissection is required for knowing the exact cause of death. In medical science, this process is termed as “Pathological Post-mortem”.

Q: What is the use for knowing the exact cause of death? The person in question is already dead.
A: A reason for knowing the exact cause of death is for the prevention and protection of future generations from hereditary diseases. If the exact cause of death is not known, not only medical science, but on the whole, society itself is affected adversely. Pathological post-mortem can also provide the cause of unknown diseases too, the prevention of which is extremely necessary for the current generation. This is possible only through posthumously donated bodies.

Q: Where there is doubt as to cause of death, in such cases, what is the importance of posthumously donated bodies?
A: Man is alive due to the synchronous working of various organs and organ-systems of his body. Even after death, the organs and organ-systems remain in working condition till a certain period of time. Thalassaemia and leukaemia-affected children can be cured through bone-marrow transplantation. Cornea-transplantation can help return eyesight of people affected with corneal blindness. Even people afflicted with 70% burns may be brought to health by skin-grafting, the skin being used coming from bodies. Mainly, 5 organs and 14 kinds of tissues may be harvested and transplanted. The death of patients counting their days till their end may be delayed too, through such processes.

Q: How long can a dead person’s body-parts be said to remain in working condition when you say they may stay till “a certain period of time”?
A: The kind of death that follows after the heart stops beating, is known in medical terms as Cardio-respiratory fail in which case, if the donated body is preserved at a temperature of 4 degree Celsius within 6 hours of death then cornea, skin, heart valves, bones, bone-marrow, cartilages, tendons, muscle tissues and ear-cartilages from the body is fit for transplantation till 24 hours. In some cases, preservation is possible even for an indefinite period of time.
If the death is a brainstem death (when the brain ceases to work), then the heart may be kept alive and working through machines and the usable organs and organ-systems may be transplanted in such a case.

Q: Is brain-death a legally-recognised death?
A: The Transplantation of Human Organs Act passed by the Government of India in the year 1994, recognizes brain-death.
Q: Has this kind of organ-transplantation ever been carried out?
A: Yes, it has been carried out in various countries throughout the world, including India. The first successful heart-transplantation in India was carried out on August 3rd, 1994 at AIIMS (All India Institute of Medical Sciences), Delhi. Later on as well, quite a few heart-transplant operations were carried out there. Apart from Delhi, transplantations of kidney, liver etc were carried out in Mumbai, Chennai, Hyderabad, and Karnataka as well.
Before the Act was passed in 1994, heart-valve transplant was carried out in West Bengal in Nilratan Sarkar Medical College (NRSMC), in the body of a 19 year old youth. In 1988, a girl’s body received the kidney transplant from her father’s body. After that, no other instances have taken place concerning organ-transplantation, in this state.

Q: Can eyes from any dead body be collected?
A: Yes. But eyes from persons who died due to AIDS/HIV infection, Hepatitis B virus infection, cancer or snake-bite may be used only for research purposes.
Q: That means, all eyes are not fit for transplantation?
A: It is not the eye, but the cornea (or the clear part of the eyeball) which is used in transplantation. This is process is known as corneal grafting or Keratoplasty. Here, however, what must be kept in mind is that, eyesight may not be able to be restored to all blind persons. Corneal grafting can restore eyesight only to persons who are blind because of corneal opacity.

Q: Can cornea of aged people or people who use spectacles be used for corneal transplantation?
A: If the cornea tissue remains healthy, then age, spectacles or cataract are not an inhibiting factor.
Q: Which organs may a living person donate?
A: A portions of the liver and one kidney may be donated by a living person. Parts of the skin may be donated as well. But in that case, the donor must follow restrictions as instructed by the doctor. However, transplantation of organ(s) from a dead body does not require such restrictions.

Q: Is it possible to transplant organs and tissues taken from any dead body?
A: No. The role of a dead body in research and medical studies has already been stated. Apart from that, the importance of posthumous body-donation relating to environmental aspects is also immense. Two important methods of posthumous rites are burial and cremation. People from different religions reserve areas in crematory or burial for carrying out rites and rituals after death. There is no way those areas may be used for other purposes. For cremation, large amounts of timber and/or electricity are used. The ashes and other substances generated after cremation may be immersed in rivers, which in turn pollute the water-bodies.

Q: What does a person, who is willing to donate his/her body posthumously, need to do?
A: A written agreement. After a donor has signed 2 agreement documents in the presence of 2 witnesses, for one of the documents (to be kept in the donor’s personal possession), a donor card will be given to him/her. He/she should carry it with self all the time. In case an accident befalls him at any point of time (say, while he is commuting), the donor card will come of use.

Q: Is there an age-limit for signing the agreement?
A: No. Any adult, who is 18 years and above, regardless of sex, may sign such an agreement,. For willing persons below the age of 18, consent of parents/guardians is required.

Q: What else is needed to be done once a donor has signed the agreement?
A: What the donor now needs to do is inform his/her friends and relatives that his wishes (for posthumous body-donation) are carried out accordingly. It is ultimately their duty to make sure that the donor’s wish to donate his/her body is respected.

Q: If Ganadarpan or any hospital is informed immediately after a person’s death, would they come to collect his/her body?
A: No. After a person’s death, do representatives from the crematorium or cemetery come to collect his body? The relatives of the dead person themselves bring the body to the crematorium/cemetery. Similarly, for donation of a dead body for the sake of medical science, the relatives have to do the same and bring the body to the Anatomy Department of a medical college. If the college is closed, the Ward Master of the Emergency Ward should be contacted and the body should be arranged to be preserved in the Cool Chamber. After the college opens, the donation of the body will be accepted.

Q: In such cases, how is a Death Registration Certificate supposed to be acquired?
A: After a dead body is accepted, the college authorities will issue a receipt for the same. If the receipt, along with the photocopy of the Death Declaration Certificate (the original copy of the document will be kept by the authorities, along with the body) is submitted to the municipal corporation or any other local governmental organisation, the death shall be registered and on the basis of that the Death Registration Certificate shall be issued.

Q: If a body is donated posthumously, can one get any special advantages?
A: A donation is always sans conditions. A donation that is subject to conditions can no sooner be called a “donation” than a contract. The donation of a body by a responsible person of the society, for the sake of medical science is the ulterior aim of such an agreement for donation.

Q: Is this agreement irreversible?
A: No agreement is irreversible. This agreement is not an exception either.
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