Saturday, December 06, 2003

Financial incentives for organ donors -- a good dog that can't hunt

The idea of using financial incentives to increase organ donation rates has been getting a lot of attention in the press lately. I personally think that a free market in human organs would end the organ shortage and save thousands of lives a year. But there are two big problems with the idea.

First, buying and selling organs is illegal in the United States. Second, that's not likely to change in the foreseeable future because there is a lot of opposition to the idea. Politically, an organ market is a non-starter.

Over 83,600 people are on the transplant waiting list in the United States. The waiting list keeps getting longer, even though somebody gets removed from the list every 90 minutes because they've died. The people who need organ transplants literally can't wait for the political sea change that is needed to let financial incentives fix the organ shortage.

That's one of the reasons LifeSharers is so important. LifeSharers harnesses the power of incentives, but does so in a way that is already legal. It also does so in a way that avoids the controversy surrounding financial incentives. The idea that organs should go first to organ donors strikes most people as fair, while the idea of buying and selling body parts leaves many people uneasy.

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Sunday, November 30, 2003

Alonzo Mourning

Within days of the announcement that New Jersey Nets star Alonzo Mourning needed a kidney transplant, dozens of people volunteered to donate a kidney to him.

Live kidney donation is a remarkably generous act. The operation is not without risk, and living with one kidney instead of two also involves some risk. The national organ allocation system rewards live donors by moving them up the waiting list if they ever need an organ later in life. This makes a lot of sense, and it seems like the fair thing to do. It makes sense to do the same thing for people who agree to donate after they die, and it is also the fair thing to do. That's what LifeSharers members do for each other.

The reaction to Mr. Mourning's need for a kidney transplant also demonstrates that people are more willing to donate an organ when they can decide who gets it. LifeSharers is proving that the same thing is true when donation after death is involved. By increasing the number of organ donors, LifeSharers will reduce the number of people who die waiting for organ transplants.

Nobody objects when people offer to donate an organ to a celebrity. Nobody should object when people offer to donate their organs first to fellow organ donors. That's what LifeSharers members do for each other.

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Tuesday, November 11, 2003

National Donor Sabbath

November 14-16 is the eighth annual National Donor Sabbath. It's an effort by the U.S. Department of Health and Human Services' Division of Transplantation to get churches and faith-based organizations involved in increasing awareness of the critical need for donation of organs and tissue.

This is a wonderful effort. Unfortunately, 20 years of efforts to increase awareness have left us with an organ shortage that continues to get larger every year. Why? Because just about everybody is already aware of the critical need for organs. We don't need more awareness. We need more donors.

Until LifeSharers came along, every effort to increase the number of donors used the same message: "do it because it's the right thing to do." That message hasn't worked well enough to reduce the organ shortage.

Just about everybody knows that organ donation is the right thing to do. Just about everybody says they support organ donation and would want to be a donor. But only about 30% of Americans have actually signed up to donate. So too many organs that could save lives get buried instead.

Signing up to be an organ donor means thinking about your own death. It's not surprising that lots of people put it off, particularly when the only reward is the warm feeling that you might be doing something good for somebody else some time in the distant future. LifeSharers appeals to a different motivation -- self preservation. By joining LifeSharers, you do something good for yourself. You improve your chances of getting an organ if you ever need one. You also do something good for others. It's the right thing to do.

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Tuesday, November 04, 2003

Why is there a shortage of organs?

The Lowell Sun published a story about LifeSharers today titled "Can give-and-take end organ-donor dearth?"

In the story, Sean Fitzpatrick of the New England Organ Bank says LifeSharers "is based on an incorrect assumption that the primary reason for the shortage is that people say no to donations. But the primary reason for the shortage of organs is that very few people die in a manner suitable for donations."

It's true that usable organs can be recovered from less than 1% of the people who die. But if every one of those people actually donated their organs, then the organ shortage would be a whole lot smaller than it is. Some experts say it would even disappear.

Unfortunately, in the United States we recover organs from only about half of the people who could have actually donated. Some of these people didn't sign up to be donors. Some of them did sign up but had their wishes vetoed by family members.

LifeSharers helps solve both of these problems. We recruit new organ donors. Since many of our members have convinced their family members to also join LifeSharers, we also make it less likely that donors' wishes will be overridden.

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Monday, November 03, 2003

Ohio's new kidney registry -- It's a lot like LifeSharers

The Ohio Health Department has launched a registry for people who want to donate a kidney to a relative but can't because of blood type incompatibilities.

To see how the registry is meant to work, consider the Smiths and the Millers. Mrs. Smith and Mrs. Miller both need kidneys. Mr. Smith is willing to donate a kidney to his wife, but their blood types are different so a transplant is impossible. Likewise, Mr. Miller is willing, but unable, to donate his kidney to his wife.

But if Mr. Smith and Mrs. Miller have the same blood type, and if Mr. Miller and Mrs. Smith both have the same blood type, then the couples can swap kidneys. The Ohio registry will help get pairs of couples like the Smiths and the Millers together.

This is obviously a good idea. Mrs. Smith and Mrs. Miller both get the kidney transplant they need.

This is also a lot like LifeSharers. Both programs move people up the transplant waiting list in exchange for the act of organ donation.

Mrs. Smith moved to the top of the waiting list when Mr. Miller's kidney became available in exchange for the donation of Mr. Smith's kidney. There may have been someone on the UNOS kidney waiting list who needed Mr. Smith's kidney more than Mrs. Miller did, was a better match for it than she was, or had been waiting longer than she had. But no reasonable person would insist that Mr. Smith's kidney go to anyone other than Mrs. Miller.

In LifeSharers, members move to the top of the waiting list for the organs of other members in exchange for the promise to donate when they die. The big difference between the Ohio registry and LifeSharers is that one deals with live organ donors and the other deals with donation after death.

If it makes sense to move people up the waiting list in exchange for a live donation, it also makes sense to do it for a promise to donate after death.

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