Making a final donation

Donating your body to science helps medical research that could lead to enormous benefits for others in the future. But it's a personal decision - what makes people opt for it? Fiona McCannreports.

'I DON'T THINK it's the kind of thing that you wake up in the middle of the night and say 'Gosh! I'm going to leave my body to medical research!'," says Maurice Bryan of his decision to donate his body to Trinity College, Dublin for, as his registration form puts it, "the advancement of medical knowledge".

For Bryan, the decision process began with the death of his aunt, Iris Bardon, who had specified that she wished to donate her own body for the same purpose. "She'd made no secret of it," says Bryan. "She was quite a formidable woman, and very keen on helping people." On her death, Bryan was charged with carrying out her request. "We wouldn't have dared override her wishes. We'd have been hit by a thunderbolt or something."

What struck Bryan at the time was how well-orchestrated and dignified the process of removing his aunt's remains to the university was. "The arrangements worked very well. We rang up the anatomy school and everything was taken care of from there on, so that was impressive." Inspired by his aunt's gesture, and a memorial ceremony which he subsequently attended in Trinity for all those who had donated their bodies to the university for medical research, Bryan and his wife both registered and are now among the 1,000 or so potential donors on the database in Trinity's anatomy department.

It's a substantial number. When added to the hundreds more on the books in UCD and in the Royal College of Surgeons, as well as in Galway and Cork, it shows that Ireland is not experiencing the UK's difficulty in finding donors. Indeed, such has been the response from the public here that Trinity has temporarily halted registering new donors. However, you are still encouraged to send in your details, and you may be contacted with a view to registration after the situation is reviewed this time next year.

"Due to the generous response from the public over the past few years, we are currently in a good position in relation to donations," explains Siobhan Ward, chief technical officer in Trinity's anatomy department. "We are receiving enough donors each year to meet our needs. We just don't want to say to everybody, 'please sign up' and then have to turn around and say 'no, we don't need you'."

Those who want to register now can still do so at UCD, which continues to add to its database of donors. "The number of medical places here has expanded," explains Eilis O'Brien, director of communications at UCD. "We need to keep up the numbers we have."

According to O'Brien, although there may be hundreds of donors registered, this number bears little relation to the amount of bodies taken in on an annual basis.

"People can be quite young when they give you that commitment, and may be living 20 or 30 years beyond when they have committed their body to you," she explains, adding that people who have already registered to donate their bodies can change their minds.

Relatives of prospective donors can also decide against going through with the process once the donor has passed away, given that the registration form is not considered a legally binding document.

Those who do decide to register with any of the universities receive an information pack detailing how things will operate in the event of their death, and a donation form to be signed by the donor and his/her next of kin. The procedure varies little between the institutions involved, usually requiring the remains to be picked up within a short space of time after the donor's death and taken to the academic institution of choice. Bodies can then be kept there for up to three years.

During this time, they are used primarily to help medical students learn the systems and physicality of the human body, explains the head of Trinity's anatomy department, Paul Glacken.

"The prime purpose of the whole exercise is for the education of undergraduate healthcare students," he explains.

Many postgraduates also use the subjects donated for further study in a number of areas, including ear, nose and throat surgery and endoscopic surgery.

"From time to time, we also allow the department to be used by surgeons who want to try out a new incision or a new technique before embarking on [surgery on] a living human. They don't want to try out something new without seeing would it work, or what the problems might be." In the past, this has included new procedures concerning hip replacements, a happy coincidence for Bryan, who is currently on his third artificial hip.

"I've certainly benefited. If it hadn't been possible to have a hip replacement, I'd be in a wheelchair," he says.

ONCE AN INSTITUTION wants to release the person's remains, their family is contacted and arrangements made to transport the body of the deceased to the final resting place. This can be one of the private plots in Glasnevin cemetery maintained by the universities for burial, with the cost of this burial covered by the relevant institution.

Other options include transport to Glasnevin crematorium, cremation, and burial in the same plot, the costs of which are again covered by the university.

If the family wishes to bury their loved one at an alternative location, the university will cover the costs of transport, providing it is within a specified radius of the institution, while the opening of the grave and other expenses involved are borne by the deceased's estate.

YET DESPITE THE possible financial advantages to such an outcome, the universities involved are at pains to stress that the financial considerations are not usually what compel those on their books to donate their bodies.

"There is no link between the price and funerals and whether somebody donates," says Ward, who adds that not every person who registers for a donation can even be sure that he or she will be accepted in the end. There are a number of factors that can preclude the university from accepting certain bodies, including contagious diseases, extreme emaciation or obesity, or whether or not a post-mortem has been carried out on the body. Organ donors whose organs are used for transplant are also excluded.

Nor is there a typical donor profile, according to Ward, who points out that those who choose to donate their bodies come from all walks of life and tend to do so for altruistic motives. As she flips through the list of registered donors, she notes the presence of an artist, a bank official, a careworker, a carpenter, a civil servant, a musician, a pilot, a priest, a historian and an insurance broker.

Among them is Maurice Bryan, who is a conservation adviser and retired engineer. "I wouldn't think we're any kind of heroes," he says with winning pragmatism. "It's a little bit more complicated than a blood transfusion, but it's the same principle. You give something back for what humanity's done for you.

"When you die you're finished with your body anyway, and if it can do some good, why not?"

He is not in any rush to return to his alma mater, however. "We've been registered for eight years now," says Bryan. "I hope we'll go on being registered for a lot longer."