Tuesday, August 07, 2007

Who shall be saved?

Dr. Sally Satel has a very thoughtful piece in the August-September 2007 issue of the Hoover Institution's Policy Review.

Dr. Satel attended a forum on proposed revisions to UNOS kidney allocation rules. The proposed new rules are an attempt to maximize "Life Years from Transplant", which would mean older patients would get fewer kidneys. This prompted one attendee to say "That’s playing God and people aren’t going to like it.”

Dr. Satel writes: "That is not playing God; that is playing man — the all-too-human affair of people deliberating strenuously and in good faith to determine what is right." She goes on to describe the dilemma caused by the shortage of transplantable organs: "It is the eternal tradeoff that comes with medical rationing: individual versus societal benefit. Who will be saved?"

If there was no shortage of organs, everyone would be saved. There would be no need to decide who to save. Until then, we should decide to save registered organ donors first. Why? Because that will cause more people to register as organ donors, which will increase the supply of organs and save more lives. It will also mean we will face fewer decisions about who to save.

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