BRAZIL: Public Opposes Compulsory Organ Donation

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Jan 12 1998 (IPS) - The law which made all Brazilians organ donors with the turn of the year met growing resistence as awarness of the measure spread.

And the Federal Council of Medicine, representing the 200,000 doctors of the country, will be testing the constitutionality of the new legislation in the courts. It has already comissioned a legal feasiblility study.

The new law states all inhabitants of Brazil are now organ or body part donors except for those who specifically decide not to do so, getting themselves a special identity card.

In the countries which have adopted presumption of donation, like France and Spain, authorisation from the relatives of the deceased is still needed, but this is not so under Brazilian law, said president of the Council of Medicine, Waldir Mesquita.

This disposition violates “independence and freedom of belief,” especially in a country like Brazil, where there a millions of illiterates and people who cannot miss a day’s work to get themselves a “non-organ donor” identity card, he added.

Mesquita also pointed out there was no lack of voluntary donors in the country, but that there was a lack of a structure capable of receiving organs and distributing them rapidly to the hospitals needing them for transplants.

A glut of people opposed to organ donation appeared at the identity card offices in recent weeks. In the southern city of Porto Alegre, the proportion reached 83 percent of the population and in Rio de Janeiro, officials quoted levels of 70 percent.

Another controversy was spurred by a case in Florianopolis, a provincial capital in the south, last week, when the mother of a six year-old girl killed by a car offered the girl’s organs for donation on the condition the corneas be reserved for a niece.

The new law prohibits the donor’s family from intervening in the choice of receiver, in order to prevent the sale of organs. The transplant operations must be carried out through a waiting list prepared by provincial training centres.

When the mother was told her nieve would not be able to receive the corneas, she refused to allow any of the child’s organs to be used. The kidneys, heart, liver, lungs and pancreas, all of which were in perfect condition – and could have helped eight people – all went to waste, said the doctors.

This episode strengthened the argument of the Brazilian Organ Transplant Association, which is proposing changes in the legislation, including giving the family greater say over the bodies of their relatives.

Senator Lucio Alcantara, author of the final text of the law approved by Congress last year, said he was surprised by the controversy and resistence the measure had generated after it was already approved.

For the initiative was widely discussed last year, when it survived two votes in the Senate and another in the Chamber of Deputies. The details of the law were based on three bills, one of them presented by Senator Darcy Ribeiro, a well known anthropologist and teacher, who died a year ago.

Furthermore, said Alcantara, there were another 12 bills under discussion referring to stimulating organ donation and improving regulations in the Chamber of Deputies as a result of campaigns by voters.

Professional doctors and lawyers associations had a long time in which to present their criticisms, which were discussed and responded to in many debates and public audiences in the universities and the press, he added.

Lastly, he said, the government had carried out a survey before passing the law and 70 percent of those consulted supported the move.

Research by Brazilian daily “Folha de Sao Paulo” said there had been a reduction in people prepared to donate organs from 75 to 63 percent between 1995 and this year in the city.

Similarly, once the controversy over the law burst out, only 54 percent of those surveyed said they were disposed to authorise the use of the organs of dead realtives, compared with 69 percent two and-a-half years ago.

Health minister, Carlos Albuquerque, said the resistence would disappear in time when the public were better informed. The law introduces cultural and “behavioural changes, and these can only be achieved in the medium term,” he said.

Albuquerque predicted Brazil would register 20 donors per million inhabitants in five years’ time, compared with five at present, and that transplants would increase from 2,000 to 3,200 per year, on average.