SAN MARCOS -- After San Marcos High School football star Joshua Roberts was killed in a car accident July 3 near Brady, his heart, corneas and some of his bones were removed to be used for transplants.
But when his father, who was out of the country when his son's body parts were harvested, returned to Texas, he demanded that his son's tissues be donated without profit. Rick Roberts' sister had had a liver transplant that he said cost $300,000, and he felt strongly that no one should make money from transplanting body parts.
Roberts' request was not as simple as he thought. Officials with the American Red Cross and the Western Texas Lions Eye Bank Alliance said they could not guarantee that any profit would not be made from Josh Roberts' tissues. Both entities sent them back to Thomason Funeral Home in San Marcos last week, where the 17-year-old's body was awaiting burial.
In a FedEx package came his son's corneas, packed in a preserving solution. In a cooler filled with dry ice Roberts found his son's femurs, kneecaps, hip bones and shoulder blades. His son's heart was in a jar.
"He'd been deboned like a piece of sausage," Roberts said. "Then to send everything back to you and hold up the funeral while you wait, it's unbeliev- able.
"I did not want them back. I emphatically said plenty of times that you can have those body parts if you will just give them to people."
But the Red Cross, which provides nearly one-fifth of the tissue used for transplant nationwide, said it took the unusual, and perhaps unprecedented, step of returning the body parts, because that's what Roberts wanted.
"The Red Cross is a not-for-profit organization that operates on a cost recovery basis," officials said in a statement. "However, we work with hospitals and physicians who charge for their services. Therefore, the Red Cross could not ensure that any future procedures associated with this donation would be performed without charge.
"Because we could not meet the father's request, and in the interest of sensitivity to the family, the Red Cross hand-delivered the donated tissue to the funeral home director for proper disposition."
Spokeswoman Christine Pearson said Roberts' demand was unusual.
"Most families' main concern is whether their loved ones' tissue will help save or improve the life of another person," she said in an e-mail.
Jeff Cobb, the San Angelo eye bank official who returned the corneas after what Roberts said was an argument over fees, could not be reached for comment. Bob Noyes, president of the board that oversees the eye bank, said it was unreasonable to demand that all fees be waived by transplant organizations.
"Is it unusual to take your car to a garage and have no fee?" he asked.
The disagreement that led to the ghastly packages highlighted what some industry critics call a murky, unregulated world of tissue donation, in which donated body parts are sometimes used by profit-making companies for everything from bone grafts to penis enlargements. Others say it shows a basic misunderstanding of how the tissue donation industry works and the fees that are needed to make it viable.
Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said many people never suspect that the bones, ligaments, skin or fat of loved ones can end up in the hands of for-profit tissue banks.
Caplan, who has testified before the California Legislature against for-profit tissue use, said that Roberts had every right to demand that his son's body parts not be used for profit and that the reaction to such a demand should not have been to summarily ship the parts back.
"I don't think people understand that there's a for-profit side to this," he said. "The oversight of tissues is inadequate. There's not enough checks on what people charge."
The transplant of organs, such as livers and kidneys, are closely monitored and rarely handled by for-profit companies, experts say. But tissues, which include bones, ligaments, heart valves and skin, are a different story, Caplan said.
Caplan also called the tissue return barbaric.
"Repugnant doesn't capture it," he said. "The decision to do that is as serious a breach with the public as you can find. If you want to stop people from donating organs, return them to a funeral home."
The American Red Cross says that it does not provide tissue to cosmetic surgery centers, but rather to hospitals and burn centers. Once the tissue is delivered, however, the Red Cross leaves it to the facilities' discretion as to how it is used.
The Red Cross is one of several organizations in the country that contract with hospitals on tissue transplants. Every hospital that receives Medicaid funding is required to have a relationship with a tissue-harvesting firm and to call that firm when a patient dies. Representatives with the tissue organization then attempt to obtain consent for transplant from family members. In the case of Joshua Roberts, consent was provided by brother Jason since his father was out of town.
Federal law prohibits the selling of organs and tissue for profit, but allows firms to level "reasonable" fees associated with transplants that go above and beyond the actual cost of the procedures. Roberts wanted those extra fees waived in association with his son's body parts.
But Marshall Cothran, chief executive of the nonprofit Blood and Tissue Center of Central Texas, said tissue banks could not operate if they waived all such fees.
"It's a fundamental misunderstanding of what donation means and what it takes to turn donations into useful gifts," he said.
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But when his father, who was out of the country when his son's body parts were harvested, returned to Texas, he demanded that his son's tissues be donated without profit. Rick Roberts' sister had had a liver transplant that he said cost $300,000, and he felt strongly that no one should make money from transplanting body parts.
Roberts' request was not as simple as he thought. Officials with the American Red Cross and the Western Texas Lions Eye Bank Alliance said they could not guarantee that any profit would not be made from Josh Roberts' tissues. Both entities sent them back to Thomason Funeral Home in San Marcos last week, where the 17-year-old's body was awaiting burial.
In a FedEx package came his son's corneas, packed in a preserving solution. In a cooler filled with dry ice Roberts found his son's femurs, kneecaps, hip bones and shoulder blades. His son's heart was in a jar.
"He'd been deboned like a piece of sausage," Roberts said. "Then to send everything back to you and hold up the funeral while you wait, it's unbeliev- able.
"I did not want them back. I emphatically said plenty of times that you can have those body parts if you will just give them to people."
But the Red Cross, which provides nearly one-fifth of the tissue used for transplant nationwide, said it took the unusual, and perhaps unprecedented, step of returning the body parts, because that's what Roberts wanted.
"The Red Cross is a not-for-profit organization that operates on a cost recovery basis," officials said in a statement. "However, we work with hospitals and physicians who charge for their services. Therefore, the Red Cross could not ensure that any future procedures associated with this donation would be performed without charge.
"Because we could not meet the father's request, and in the interest of sensitivity to the family, the Red Cross hand-delivered the donated tissue to the funeral home director for proper disposition."
Spokeswoman Christine Pearson said Roberts' demand was unusual.
"Most families' main concern is whether their loved ones' tissue will help save or improve the life of another person," she said in an e-mail.
Jeff Cobb, the San Angelo eye bank official who returned the corneas after what Roberts said was an argument over fees, could not be reached for comment. Bob Noyes, president of the board that oversees the eye bank, said it was unreasonable to demand that all fees be waived by transplant organizations.
"Is it unusual to take your car to a garage and have no fee?" he asked.
The disagreement that led to the ghastly packages highlighted what some industry critics call a murky, unregulated world of tissue donation, in which donated body parts are sometimes used by profit-making companies for everything from bone grafts to penis enlargements. Others say it shows a basic misunderstanding of how the tissue donation industry works and the fees that are needed to make it viable.
Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said many people never suspect that the bones, ligaments, skin or fat of loved ones can end up in the hands of for-profit tissue banks.
Caplan, who has testified before the California Legislature against for-profit tissue use, said that Roberts had every right to demand that his son's body parts not be used for profit and that the reaction to such a demand should not have been to summarily ship the parts back.
"I don't think people understand that there's a for-profit side to this," he said. "The oversight of tissues is inadequate. There's not enough checks on what people charge."
The transplant of organs, such as livers and kidneys, are closely monitored and rarely handled by for-profit companies, experts say. But tissues, which include bones, ligaments, heart valves and skin, are a different story, Caplan said.
Caplan also called the tissue return barbaric.
"Repugnant doesn't capture it," he said. "The decision to do that is as serious a breach with the public as you can find. If you want to stop people from donating organs, return them to a funeral home."
The American Red Cross says that it does not provide tissue to cosmetic surgery centers, but rather to hospitals and burn centers. Once the tissue is delivered, however, the Red Cross leaves it to the facilities' discretion as to how it is used.
The Red Cross is one of several organizations in the country that contract with hospitals on tissue transplants. Every hospital that receives Medicaid funding is required to have a relationship with a tissue-harvesting firm and to call that firm when a patient dies. Representatives with the tissue organization then attempt to obtain consent for transplant from family members. In the case of Joshua Roberts, consent was provided by brother Jason since his father was out of town.
Federal law prohibits the selling of organs and tissue for profit, but allows firms to level "reasonable" fees associated with transplants that go above and beyond the actual cost of the procedures. Roberts wanted those extra fees waived in association with his son's body parts.
But Marshall Cothran, chief executive of the nonprofit Blood and Tissue Center of Central Texas, said tissue banks could not operate if they waived all such fees.
"It's a fundamental misunderstanding of what donation means and what it takes to turn donations into useful gifts," he said.
Want to learn more?
http://www.statesman.com/asection/c...tions/thursday/news_f361a48276f1d112003b.html