Wednesday, April 28, 2010

Thoughts on Organ Sales

This article on a proposal by a lawmaker from New York caught my eye:

ALBANY, N.Y. - A New York assemblyman whose daughter is alive because of two kidney transplants wants his state to become the first in the nation to pass laws that would presume people want to donate their organs unless they specifically say otherwise.

Assemblyman Richard Brodsky believes the "presumed consent" measures would help combat a rising demand for healthy organs by patients forced to wait a year or more for transplants. Twenty-four European countries already have such laws in place, he said.

It goes on:
Brodsky's interest in organ donation is personal; his 18-year-old daughter, Julianne "Willie" Brodsky, received a kidney four years ago from a donor who was struck by lightning and an earlier transplant from her mother.

"People's survival should not rest on acts of God alone," said the elder Brodsky, a Westchester County Democrat.

Advocates say the availability of healthy donor organs is low just about everywhere nationwide, where 106,000 people are on a waiting list that averages three to four years for each type of organ. (emphasis added)
I'd add that in 2008, in the U.S. alone, 5000 people died waiting for a kidney transplant. This isn't a theoretical problem by any means, and it's personal to me because a friend of mine died 2 months ago as an indirect result of the faulty system for organ allocation that we have today.

I'm much more inclined to support allowing compensation for organ donors or their families, which has been against the law since the National Organ Transplant Act of 1984. Though presumed consent could reduce the shortage of organs, it's got moral problems of its own - people are going to be offended that their relative's organs are taken without their consent.

I've discussed this issue with many people who tend to recoil at the idea, because it's viscerally repugnant to think about people buying and selling body parts. I've had one friend say it "incentivizes murder", and I can't recall a single instance where the reply was "yeah that's a great idea!".

Usually, though, people have found it persuasive that it's not wrong for families of the deceased to be able to better pay funeral expenses or medical bills, or for a living organ donor to receive compensation given the pain and risk of undergoing surgery. And the estimated costs of a donor organ are far less than the cost of continued dialysis, as Alex Tabarrok's op-ed linked above points out.

And as mentioned above, this issue is not abstract to me. My friend was on the waiting list for a kidney transplant. She also worked in a doctor's office, and was well aware of how donor organs are allocated, and that a cancer diagnosis would move her to the bottom of the waiting list. So she hid the lump on her shoulder as best she could, figuring that she'd get her transplant and then treat the cancer.

She was in one of the top 5 slots on the waiting list when she collapsed, had to be taken to the ER and couldn't hide the cancer any longer. 2 months later she was dead at 35. I can't help but wonder how many others have had their lives cut tragically short by the same misguided law.
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