Dubious Harvest

Is the Los Angeles County coroner’s office taking undue advantage of a state law that allows it to remove eye tissue from autopsy subjects without seeking permission from their families? Ask Yolanda Aguirre of El Monte or Frank Casias of Canoga Park. Each lost a grown child but did not know that the coroner had removed the corneas until they were contacted by The Times. They say that given the choice they would have refused.

Medical experts maintain that families should be informed and allowed to make the decision, despite the law. Coroners in Orange County, San Francisco and other parts of the state do not allow cornea removals without family approval. Los Angeles County announced Monday it will begin to follow the same practice. But the action came only after a Times investigation raised disturbing ethical questions about the coroner’s unusually abundant harvest of corneas for the Doheny Eye & Tissue Transplant Bank.

Initially the coroner and Doheny sought cover under the letter of the law. A little-known 1983 state law allows coroners to remove the eye tissue from bodies that are to be autopsied if there are no known objections from the next of kin. The aim 14 years ago was to relieve a shortage of the valuable but fragile eye tissue, which disintegrates within 24 hours of death. Thus coroners were not specifically required to seek family permission under the law.

But questionable procedures involving the Los Angeles coroner’s office and the Doheny eye bank stemmed not from need but from greed. The coroner provided a cheap supply--more than 1,000 corneas annually that were removed without family authorization, at least half of all of Doheny’s requirements. The eye bank paid the county $215 to $335 for a pair of corneas, then charged a processing fee of $3,400 to transplant institutions.

Employees at both the coroner’s office and Doheny said their supervisors discouraged them from seeking family approval, even when it was no problem, since the corneas could be removed under the so-called “Coroners Law” anyway.

Moreover, some corneas were removed from bodies of recently incarcerated individuals or drug users, contrary to federal health safety guidelines. On occasion eye tissue was removed from bodies even when no autopsy was performed.

It took an expose to force the coroner to stop ignoring families’ wishes, an unconscionable disregard of human values. The state law should be debated and, we think, dumped.