Without losing the solemnity, the Official Gazettes appear from time to time with curious provisions. The latest has been carried out by the Official Gazette of the Basque Country (BOPV) which a few weeks ago issued a request for an anonymous person to pick up his amputated leg from the Irun hospital. The news has spread like wildfire and makes us ask ourselves an important question: What happens to the remains that we leave behind us when we leave the hospital?
A claim by the Official Gazette.
According to the request, a patient at the Bidasoa Regional Hospital underwent surgical amputation of his leg. After that he left the hospital, after which he ignored the first request to take care of the management of the removed limb.
In accordance with the laws that regulate administrative procedures, from the Integrated Health Organization that manages the hospital, the curious appeal was made through the BOPV, which also stipulated a deadline for collection and management. A situation worthy of a story by Franz Kafka.
The situation has surprised more than one and it is that we rarely consider what happens to the challenges that we leave behind when we go through the operating room. Perhaps because we assume that the probability of it happening to us is small and that we will find out if it happens, or perhaps under the assumption that others will be in charge of this management, after all, this is what happens in many occasions, such as blood samples that we send to a laboratory for analysis, for example.
But not all the remains that we leave after medical interventions are the same, and the protocols for their treatment are complex and depend on their nature. Some of these remains fall under the category of what is called mortuary sanitation. Despite its name, it is not only applied to the remains of people who have already died, but also to remains from amputations, as in this case.
In Spain, with few exceptions, the Autonomous Communities are in charge of regulating and managing mortuary health, although there is a Consensus Guide on Mortuary Health created by the Interterritorial Health Council. This states that the “final destination of all corpses, human remains, cadaveric remains or bone remains will be burial or cremation in an authorized place.”
Destination: the cemetery.
In many respects remains that fall into this category are treated like those of a corpse. And as such, it is a funeral home that is in charge of managing the process. People who suffer amputations must agree on this management with the funeral home of their choice, which will in turn be in charge of the collection, transfer and cremation or burial of the remains.
Basque law has required since 2004 that the new cemeteries have specific places for the burial of these remains and the ashes of their cremations.
More affordable fines than incineration costs.
The problem is that this management can be expensive. More expensive even than ignoring it. As explained from the local funeral homes to the SER chain, the laws carry sanctions for cases of non-compliance with health regulations, but these can be considerably lower than the cost of hiring a funeral home to take care of the management. At a rate of three times more, and while the fines range from 500 euros, the transfer of the amputated limb can reach 1,500 euros.
What is the mortuary health police?
There is a curious concept that is applied in this area, and it is that of the mortuary health police. No, it is not the police that comes to put the aforementioned fine. This is the group of officials in charge of these health aspects.
It is defined according to the Decree (of national scope) that regulates it, its activity encompasses “all kinds of sanitary practices in relation to corpses and cadaveric remains, and the technical-sanitary conditions of coffins, vehicles and funeral companies and cemeteries and other burial places.
The reason for such strict regulation has to do with the general treatment of healthcare waste. Many of them can be considered polluting, dangerous for the environment or public health.
The healthcare waste category encompasses a wide range of waste, from office paper to radioactive waste. They are classified for treatment based on their risk to health or the environment.
Something similar is done in the field of mortuary health. The same classification is sometimes applied to the remains of amputations as to corpses, they are classified into three groups: The first, when they constitute a “professional health risk for funeral personnel as well as for the population as a whole”; the second group includes remains with the presence of radioactive isotopes; and the third to non-hazardous remains.
The truth is that we do not know the vicissitudes of the Irún case, if it is a case of forgetfulness or forgetfulness or perhaps a rational decision to save costs. Each person who passes through the hospital has a story behind it. It is impossible to establish protocols that take each case into account, balancing the vicissitudes of each patient with mechanisms designed to save lives. We may never know who that leg belonged to, but perhaps the story helps us to be somewhat more aware of the parts of ourselves that we are leaving behind.
Image | National Cancer Institute