Organ Selling

Organ Selling is a website dedicated to ending the organ shortage and the attendant needless suffering and death each year of thousands of prospective organ transplant patients simply by allowing monetary compensation for cadaveric organs, which will greatly increase the supply.

How many wasted organs?
An Alarming Trend

An alarming trend toward living donors

When I read the following Washington Post editorial, I was quite surprised at their statement that last year nearly half of all transplants used organs from living donors. This came as a shock, as I'd thought cadaver organs were far and away the norm.  It turns out that the Post's figures were exaggerated, but not grossly so.   According to the figures on the website of the government-funded group that tracks such statistics around the country, 39.4% of all kidney transplants performed in the year 2000 utilized living donors. In 1996 the figure was 29%, so there is a trend afoot.
    Why do I say the trend is alarming? Given the abject failure of the current altruistic system, doesn't this trend mean that more people are being saved?   Yes, and that's great. But it won't be long before someone dies trying to donate a kidney or portion of their liver, and then we're going to have something to think about. And, given that surgeons put the accidental death rate from such surgeries at 1% or so, it's likely that some perfectly healthy people have already died while donating. Given that cadaver donation is the only way to prevent surgeon's from violating their Hippocratic Oath to do no harm (cutting into a healthy person is, to me, a clear violation of that moral imperative), we should be doing all we can to bolster cadaver donation.   And as you know, that means allowing monetary incentives, and changing the current federal law prohibiting it.
    My second reason for considering this trend alarming is the potential for black market activity, similar to what has been occurring in India, Brazil and other countries for many years. Don't surgeons and hospital personnel have enough to do already, without having to conduct lengthy interviews with prospective donor/recipient pairs, to determine whether or not money is being passed under the table or not?  We don't need to have our hospital personnel doing the jobs of policemen, and we don't want to have ill-conceived laws on the books that turn ordinary citizens into federal criminals. We don't want to become a society where we're all spying on one another, and where we view everyone as a potential enemy, to be feared. Hasn't our devastating "War on Drugs" created enough misery already?  Do we need to be encouraging more black market activity?

Washington Post editorial of July 9, 2001 - "The Wait for Transplants"
    The worsening shortage of organs for transplant is propelling the field in some troubling directions. The most striking trend is the rise in organ donations by living people--a phenomenon not confined, as in the past, to close relatives who donate a genetically matched kidney, but widening to encompass swaps between families, donations in return for a relative's favored treatment on waiting lists, donors sought through classified ads and even, apparently, a thriving international black market. In the United States, living donations jumped last year to nearly half the total, while donations from people with brain death--long considered the preferable route--have stagnated.
    Improved technology has made it safer than before to take organs from living donors; for instance, a person can now donate part of a liver. But living donations are no panacea. Even at best, living donations carry some health risk, and allowing them to become the dominant option could create troubling pressure on potential donors. A steady supply of organs from cadavers remains the route a responsible society should favor.
    Getting that supply up to the level needed, roughly triple the current rate, will require sustained government attention.
[Ugh!] About half of all families approached after brain death is declared agree to donate their relative's organs. But as many as two-thirds of such families are never approached. Tommy Thompson, the secretary of health and human services, has urged states to add organ donation to drivers' education curriculums and has proposed some other useful but modest steps. International research suggests that far more aggressive initiatives are needed. Spain, for instance, has a rate of cadaver donation about double the U.S. rate; there, every hospital has its own team of transplant managers, doctors and nurses. They identify and discreetly monitor likely donors [how'd you like to have these guys hovering around you or your loved one?!] and, once brain death is declared, take over management of the donation process.
    Some argue such aggressive measures could lead patients and relatives to fear that care will be compromised in an emergency. Any such system needs safeguards--as U.S. hospitals now have--separating the determination of brain death from the transplant decision. Inducements, too, need to be handled carefully--an intriguing proposal by Rep. James V. Hansen (R-Utah) would give a $10,000 tax credit against the estate of anyone whose family donates his or her organs.  The main lesson from Spain is that practical and systematic measures, not exhortation, are what alter donation rates.


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Last updated: September 26, 2006.