More Hawaii families are saying 'no' to organ donation

A story by Honolulu TV station KHNL reports a very disturbing trend: organ donation rates are dropping in Hawaii because families are refusing to allow transplantation of organs from registered organ donors.

According to the story, last year "only 55% of the potential donors actually became donors because family members agreed to allow their loved ones organs to be donated." But it gets even worse: "So far this year only 40% of potential organ donations actually went through because 25 families decided not to give consent even though the donor intended to."

The decisions these families made prevented about 75 transplants, since the average deceased organ donor contributes about 3 organs. So about 75 people will die or suffer needlessly.

It's outrageous to stop a relative's organs from being donated when you know that your relative wanted to be a donor. It's also outrageous that transplant and law enforcement professionals allow this to happen. Under Hawaii's anatomical gift law, "an anatomical gift that is not revoked by the donor before death is irrevocable and does not require the consent or concurrence of any person after the donor's death." (See Hawaii Revised Statutes chapter 327-2(h).) Just about every other state has a similar provision in its anatomical gift statute.

By the way, if you prevent a relative's organs from being transplanted you will remain eligible for a transplant if you ever need one. That's perhaps the most outrageous thing of all.

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L.A. Times criticizes transplant system oversight

An investigative report published by the Los Angeles Times on October 22nd criticizes the United Network for Organ Sharing. UNOS operates the national organ allocation system in the United States. According to the report, UNOS "often fails to detect or decisively fix problems at derelict hospitals — even when patients are dying at excessive rates." The report describes what it calls a "national pattern of uneven and often weak oversight" and says that at times UNOS "appears more intent on protecting hospitals than patients."

We can expect calls for improved oversight of compliance with UNOS policies. But those policies themselves also need improvement. Specifically, UNOS should allocate organs first to registered organ donors. This simple policy change would cause a large increase in the number of organs available for transplantation in the United States, and thousands of lives would be saved every year.

Problems at transplant hospitals would also be easier to spot if there were more organs to transplant.

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Washington Post editorial endorses idea behind LifeSharers

In an editorial today, the Washington Post says it's time to consider extra incentives to encourage more people to donate their organs when they die. One of the incentives it suggests sounds a lot like LifeSharers.

Among other incentives, the editorial suggests this: "The decision to pledge organs could be linked to the chance of receiving one: People who check the box on the driver's-license application when they are healthy would, if they later fell sick, get extra points in the system used to assign their position on the transplant waiting list."

This is the idea behind LifeSharers, although the details are different. The Washington Post says their suggested incentives "don't raise significant ethical issues" and "would save money and relieve suffering."

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