Official Gazettes occasionally come out with interesting provisions without losing their seriousness. The most recent was by the Official Gazette of the Basque Country (BOPV), which a few weeks ago made a request to have an unidentified person’s amputated leg removed from Irun hospital. The news spread like wildfire, causing us to ask ourselves an important question: What happens to the remains we leave behind when we leave the hospital?

A claim from the Official Gazette.
Upon request, a patient’s leg at Bidasoa District Hospital was surgically amputated. After that, he left the hospital, after which he ignored the initial request to deal with the management of the removed limb.

In line with the laws governing administrative procedures, an interesting call was made from the Integrated Health Organization, which manages the hospital, through BOPV, which also stipulates a deadline for collection and management. A case worthy of the story of Franz Kafka.

morgue health.
The situation has taken more than one person by surprise, and we rarely think about what happened to the challenges we left behind as we walked through the operating room. Perhaps because we assume that the probability of it happening to us is small and we’ll find out if it happens, or perhaps assuming that others will be responsible for this management, after all, this is what happens in many cases, such as blood samples that we send to a lab for analysis.

But not all residues we leave after medical interventions are the same, and treatment protocols are complex and dependent on their nature. Some of these remains fall into the category of so-called mortuary sanitation. Despite its name, it applies not only to the remains of people who have died, but also to those from amputations, as in this case.

In Spain, with a few exceptions, the Autonomous Communities are responsible for regulating and managing morgue health, but there is a Reconciliation Guide on Morgue Health created by the Interregional Health Council. It states that “the final destination of all corpses, human remains, cadaveric remains or bone remains will be burial or cremation at an authorized location.”

Destination: cemetery.
Remains that fall into this category are in many ways treated like a corpse. And therefore, it is a funeral home that is responsible for managing the process. Amputation survivors must agree on this management with the funeral home of their choice; this will then be responsible for the collection, transport and cremation or burial of the remains.

Basque law has required since 2004 that new cemeteries have special places for the burial of these remains and cremation ashes.

More affordable penalties than incineration costs.
The problem is that this management can be expensive. It’s even more expensive than ignoring it. As explained to the SER chain from local funeral homes, the law imposes sanctions for non-compliance with health regulations, but these can be much less than the cost of hiring a funeral home to deal with management. It is three times higher and the fines range from 500 euros, while the amputated limb transfer can reach 1,500 euros.

What is a morgue health police?
There is an interesting concept applied in this field and that is the morgue health police. No, it is not the police who came to give the above sentence. This is the group of authorities responsible for health-related matters.

It is defined according to the Decree (in national scope) that regulates it, and its activity is “all kinds of sanitary practices related to corpses and cadaveric remains and technical-sanitary conditions of coffins, vehicles and funeral companies, as well as cemeteries and other burial places.

Avoid risks.
The reason for such strict regulation has to do with the general treatment of healthcare waste. Many of them can be considered pollutants, dangerous to the environment or public health.

The health waste category covers a wide variety of waste, from office paper to radioactive waste. They are classified for treatment according to their risk to health or the environment.

Something similar is being done in the field of mortuary health. The same classification is sometimes applied to amputation remains with respect to corpses, which fall into three groups: First, when they pose a “professional health risk to the mortuary personnel and the population as a whole”; the second group includes residues with radioactive isotopes; and third, non-hazardous residues.

Unknown situations.
The truth is, we don’t know the ups and downs of the Irún case, whether it’s forgetfulness or forgetfulness, or maybe a logical decision to save costs. Every person who passes through the hospital has a story. It is impossible to create protocols that take each case into account, balancing each patient’s ups and downs with mechanisms designed to save lives. We may never know who that leg belongs to, but perhaps the story will help us be a little more aware of the parts we left behind.

Image | National Cancer Institute