Why do Latinos rank lowest among all ethnic groups when it comes to participating in organ donation programs?
Ask members of the medical profession and you'll likely here a laundry list of factors that includes cultural predispositions brought from rural home regions, confused religious viewpoints, and a general lack of information.
That list misses one other element: A deep mistrust of the medical establishment among some Latinos.
"We're afraid of the system — that they'll take something from our body to give it to another patient," says Alfred Arroyo, an immigrant from Pachuca in the Mexican state of Hidalgo who now lives in Los Angeles. "We're afraid that the doctors won't cure us well, or they won't try to save us, so they can keep our parts."
Anyone inclined to dismiss Arroyo and other Latinos who express such skepticism as conspiracy theorists should consider this: The U.S. Attorney's office is currently pursuing a conspiracy theory of its own in a case that has led to the indictment of a doctor who formerly served as director of the liver-transplant program at St. Vincent Medical Center in the Westlake district on the edge of Downtown Los Angeles. Prosecutors in the U.S. Attorney's office allege that Dr. Richard Lopez, Jr., lied to the national organ transplant network after a liver accepted on behalf of one patient was instead given to another who was lower on the list. The eight-count indictment accuses Lopez of conspiracy, concealment of a material fact, and falsification of records in a matter under the jurisdiction of the U.S. Department of Health and Human Services.
The case offers a revealing look at the machinations that revolve around donated organs. The indictment contends that medical personnel at St. Vincent were offered a liver for a patient who ranked second on the match list but who was out of the country at the time. The backup patient for the liver was at another local hospital. Instead of advising the organ procurement organization of the intended switch and allowing the liver to be offered to the second patient, Lopez allegedly approved acceptance of the liver and its transplantation into a third patient at St. Vincent. That patient was ranked 52nd on the match list — behind nine other St. Vincent patients, according to the U.S. Attorney's office.
The indictment goes on to raise a number of other questions about procedures for organ donations. It's notable that nothing in the case suggests that any patients were neglected because doctors wanted to use their organs for transplant — but the string of alleged irregularities offers an indication of how mistrust can take root.
Indeed, Arroyo attributes his fears and skepticism about organ transplants to far more basic experiences with the healthcare system. He says that he's been disillusioned by the process of medical treatment for an injury to his back sustained while working at his job as a tree pruner. His condition isn't the sort of critical injury that might led to death and the eventual donation of organs, but he takes it as an indicator of a healthcare system that has little consideration for patients.
"The only thing the doctors do is give me pain relievers, and they don't really cure me, so they can keep getting money from the medical insurance," he says.
Wendy Verduzco, who works as an auto insurance broker, says that she also refuses to participate in organ donation programs for similar reasons.
"I don't agree with that because I've [heard] that the majority of doctors try to take organs instead of trying to save people's lives," she says.
Verduzco adds that she believes that some doctors do not really care about the well-being of the patients who arrive at hospital emergency rooms, which have become a care center of last resort for many working-class and undocumented Latinos in the U.S. She adds that she thinks some doctors see it as a numbers game.
"With one donor, they can save at least 50 people," Verduzco says. "So the doctors take advantage."
Dr. Alberto Martinez, M.D. of the Casillas Medical Group in Los Angeles works hard to overcome the reluctance among many Latinos when it comes to registering as organ donors. He focuses on basic factors he sees in the community, hoping that educational efforts will ease everyday skepticism that patients such as Arroyo and Verduzco currently express.
"There is a need for more information so that our community will be more trusting and motivated to register as organ donors," says Martinez. "Because what they know about this issue is very limited."
Martinez notes that many Latinos in the U.S. come from rural areas in Mexico and Central American nations, where rumors about medical practices have made them fearful of volunteering to donate their organs to be used for patients in need of a transplant. Martinez says he knows that Arroyo and Verduzco aren't alone in suspicions that doctors will allow the death of accident victims or some other patients in other critical condition in order to use their organs to help wealthier patients. Martinez does what he can to counter such skepticism by putting a human face on the medical profession, promising that he and his colleagues remain ethical.
"It's not true that doctors let their patients die in order to take out their organs and give them to others who need them," Martinez says. "When a person arrives at a hospital in very delicate condition, everything possible is done to help them. The doctors have the duty to do their job in order to protect the health of their patients."
Martinez emphasizes that patients or their family must give their permission for doctors to use their organs in any case. That's a key aspect when it comes to religious viewpoints on organ donations. Martinez says that a misunderstanding of religious considerations play a role the low number of Latino donors, according to Martinez.
"The majority of we Latinos are Catholic, and we're not used to this — but the same is true with other religions," he says. "It appears that some priests or pastors are against this."
The teachings of the Catholic Church maintain that organ donations and transplants are morally acceptable, provided patients or legitimate representatives, such as family members, are fully informed of the procedure and have given consent. Church teachings explicitly cite as immoral any attempts at such procedures unless those conditions are met. Pope Benedict endorsed the concept of organ donations and transplants prior to his elevation to Supreme Pontiff of the Catholic Church. Pope Benedict's writings on the subject hold that organ donations are fully acceptable if a patient or representative has agreed to the procedure and makes the gift as an act of love. Pope Benedict has said he is registered as an organ donor.
The official position of the Catholic Church on organ donations appears to be unclear to many of its faithful, though — another challenge for Martinez as he seeks greater acceptance for the practice.
"This can help a lot of people," Martinez says. "It could mean the difference between life and death."
Martinez continues his campaign through it all, urging Latinos to participate in organ-donation programs, and encouraging them to register through the California Department of Motor Vehicles (DMV). He's making some progress, too.
Elizabeth Adame, also an auto insurance broker, says she supports organ donation programs.
"I think it's a good idea because it helps people and their families to enjoy life a little more, so they can live better," she says. "I'm registered in that program, because I would like to help my loved ones when needed."
Miriam Reyes is a writer for Impulso. Labeez.org Group Editor Jerry Sullivan contributed to this story.
Photos from Impulso.
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