Should organ allocation follow the "Golden Rule?"

MSNBC.com is running a poll asking if people willing to donate their organs should get preferential treatment if they ever should need an organ.

The results so far:
Yes - 90%
No - 7%
I'm not sure - 3%

Click here to vote and see updated poll results. You can also post a comment and read other comments.

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Experts praise "organs for organ donors" law in Israel

Israel recently enacted a law that gives organs first to registered organ donors. Jacob Lavee, director of the heart transplant unit at Israel's Sheba Medical Center, says the law "will rectify the unfairness of the situation where people who are unwilling to donate wait in the same line as those who are willing."

The same Associated Press story reports other positive reactions to the law:

Writing in the December issue of The Lancet, the British medical journal, Dr. Paolo Bruzzone of Sapienza University in Rome said... "giving holders of donor cards priority in organ allocation sounds more acceptable than the introduction of organ conscription or financial incentives for organ donation."

Luc Noel, coordinator of clinical procedures at the World Health Organization in Geneva, praised the Israeli law for its educational value and for introducing a "community spirit" to the field of organ donations. "The bottom line here is doing to others as you would like others to do to you and that is where the community has a role," he told The Associated Press.

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said the Israeli measure was ethically sound — he called it "reciprocal altruism" that would benefit society as a whole.

In the United States, registered organ donors can get preferred access to donated organs by joining LifeSharers.

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Need an organ? Maybe you should move!

Geography plays a large role in allocating donated organs to patients in the United States. Under the allocation rules of the United Network for Organ Sharing, most organs are offered first to local patients. If no local patient needs an organ, it's then made available to patients elsewhere in the donor's geographic regions.

St. Louis University explains why this is important:

Recent studies have found that patients with similar diseases but living in different parts of the country had substantially different waiting times and waitlist mortality rates due to geographical differences in organ supply.

The resulting disparity can mean some patients will not have access to organ donations that could save their lives, says Krista Lentine, M.D., associate professor of internal medicine and lead researcher at Saint Louis University School of Medicine.

"The geographic regions were established prior to the availability of modern systems of organ preservation and without anticipation of the current unevenly distributed organ supply-demand ratios across the country," said Lentine.

Supporters of UNOS allocation rules say that only medical criteria should be used in allocating organs. But if geography was ever a "medical" criterion it isn't any more.

Most people think organs should be given first to the people who need them the most. It's a nice thought, but that's not how the system works. As long as UNOS is going to use non-medical factors in allocating organs, it should use "donor status" as one of them. UNOS already moves live organ donors up the transplant waiting list if they later need a transplant. UNOS should do the same for people who register to donate their organs upon their death.

UNOS should establish two transplant waiting lists: the "A" list for registered donors, and the "B" list for non-donors. All organs should be offered first to donors on the "A" list. Non-donors on the "B" list can have any leftovers. This would save thousands of lives every year by creating an incentive for non-donors to become donors.

Only about 50% of adult Americans are registered organ donors. Americans bury or cremate 20,000 transplantable organs every year. That wouldn't happen if UNOS put organ donors first.

Join LifeSharers if you'd like to donate your organs to other organ donors. Your membership will increase your chances of getting a transplant should you ever need one. It's free. It could save your life.

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