Today's Richmond Times-Dispatch contains a nice article about LifeSharers. The article repeats some misconceptions about LifeSharers:
(1) Bioethicist Laura Siminoff of Case Western Reserve University says LifeSharers members are "double-dippers" who opt out of the national organ donation system. That's just not true. LifeSharers members direct that each of their organs be offered first to the fellow member on the national waiting list who is the best match for each organ. Non-members can have our organs if no member is a suitable match. The real "double-dippers" are the people who haven't agreed to donate their own organs when they die. They get 70% of the organs transplanted in the United States. (Ms. Siminoff's statement that LifeSharers members "expect the government to pick up the tab for procuring, testing, matching and transplanting organs when they need them" is puzzling. These costs are typically picked up by transplant recipients and their insurance companies, not by the federal government.)
(2) Mark Fox of UNOS says LifeSharers undermines the existing allocation system by creating an open system in which its members accept organs from anyone while preferentially restricting donation to its members. But the real "underminers" are people who will accept an organ transplant but refuse to donate their own organs. In Dr. Fox's language, they create an open system in which they accept organs from anyone while refusing to donate at all. UNOS would be better served criticizing these people. LifeSharers doesn't undermine the system. LifeSharers improves the system by increasing the number of donors and by making the system more fair.
(3) "Federal officials" say an organ procurement organization would violate federal regulations if it honored a LifeSharers member's request to offer their organs first to fellow members. This is not true. Federal law recognizes and respects a person's right to direct their organ donation to individuals of their choosing. So does state law in all 50 states.
(4) Ms. Siminoff says LifeSharers would have to sign up just about everybody in the country to make a difference. We've already made a difference by recruiting over 2,100 organ donors. At our current membership level, there is a 10% chance that one of more of our members will actually donate their organs in the next 12 months. She also says that once LifeSharers did sign up just about everybody in the country "you wouldn't need it." Finally she's correct about something. If just about everybody in the country signed an organ donor card then we wouldn't need LifeSharers.
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Thursday, March 25, 2004
Thursday, March 04, 2004
Rewarding organ donors
A story in the March 2nd edition of The Patriot Ledger describes how the Living Donor Exchange Program works: "Chris Mazzeo will donate his left kidney on [Bill] McDonnell's behalf next week. Because Mazzeo's kidney is incompatible with McDonnell, the organ will go to a stranger, but his donation will move McDonnell to the top of the list of people waiting for a kidney from a cadaver."
The Living Donor Exchange Program is a great idea. It moves people up the transplant waiting list in exchange for the donation of an organ.
LifeSharers does the same basic thing. We reward people for their promise to donate in the future, while the Living Donor Exchange Program rewards relatives and friends of living donors.
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The Living Donor Exchange Program is a great idea. It moves people up the transplant waiting list in exchange for the donation of an organ.
LifeSharers does the same basic thing. We reward people for their promise to donate in the future, while the Living Donor Exchange Program rewards relatives and friends of living donors.
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Monday, February 23, 2004
Organ donor fairness in New Zealand
Stephen Franks, a Member of the New Zealand Parliament, has proposed that organ donation be encouraged in New Zealand by a simple law change. In a press release, Mr. Franks said, "Non-donors should not be denied a transplant, but should go to the bottom of the list. Those who are prepared to contribute should get priority."
Mr. Franks' proposal is based on the same ideas that are behind LifeSharers.
"People are free to not donate, but they should then lose their moral claim to receive organs - it's fairness: people shouldn't expect others to do for them what they will not do for others," Mr Franks said.
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Mr. Franks' proposal is based on the same ideas that are behind LifeSharers.
"People are free to not donate, but they should then lose their moral claim to receive organs - it's fairness: people shouldn't expect others to do for them what they will not do for others," Mr Franks said.
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Thursday, February 12, 2004
Charity and fairness
Organ donation is perhaps the greatest gift a person can give. It is literally the gift of life.
LifeSharers members give their organs first to others who have promised to do the same. Critics say that’s unfair. What a weird thing to say.
When you give food to a hungry person, nobody criticizes you for not giving it to a different person who is even hungrier. When you give money to your church, nobody criticizes you for not giving it to the United Way.
So how does it make sense to criticize someone for deciding who gets his organs?
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LifeSharers members give their organs first to others who have promised to do the same. Critics say that’s unfair. What a weird thing to say.
When you give food to a hungry person, nobody criticizes you for not giving it to a different person who is even hungrier. When you give money to your church, nobody criticizes you for not giving it to the United Way.
So how does it make sense to criticize someone for deciding who gets his organs?
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Friday, January 30, 2004
UNOS supports donors rights
At its June 2003 board meeting, the UNOS board meeting adopted the following resolution:
"WHEREAS the consensus among transplant professionals, donor families, and transplant candidates and recipients attending the UNOS Research to Practice Consensus Conference regarding organ donation was that, to the extent medically feasible, the wishes of those who give the gift of life through organ donation by executing a valid anatomical gift instrument
indicating their wish to become an organ donor upon death should be honored,
IT IS THEREFORE RESOLVED that the OPTN/UNOS Board of Directors endorses the principle that the wishes of organ donors should be honored upon death to the extent medically feasible and that state and federal laws should reflect such principle. To that end, the OPTN/UNOS Board of Directors strongly encourages the adoption and full implementation in all states of the provisions of the Uniform Anatomical Gift Act as amended pertaining to honoring the donor's wishes and the adoption of legislation expressly prohibiting valid organ donations from being reversed after the donor's death or declined for any reason other than medical suitability."
Since UNOS supports a person's right to become a donor, it should also state that it supports a donor's right to donate his/her organs first to another donor. UNOS hasn't done that yet, but their support isn't needed. Your organs are yours, and the law says you can decide who gets them. UNOS has stated it won't block a LifeSharers member's wish to give his/her organs to another member.
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"WHEREAS the consensus among transplant professionals, donor families, and transplant candidates and recipients attending the UNOS Research to Practice Consensus Conference regarding organ donation was that, to the extent medically feasible, the wishes of those who give the gift of life through organ donation by executing a valid anatomical gift instrument
indicating their wish to become an organ donor upon death should be honored,
IT IS THEREFORE RESOLVED that the OPTN/UNOS Board of Directors endorses the principle that the wishes of organ donors should be honored upon death to the extent medically feasible and that state and federal laws should reflect such principle. To that end, the OPTN/UNOS Board of Directors strongly encourages the adoption and full implementation in all states of the provisions of the Uniform Anatomical Gift Act as amended pertaining to honoring the donor's wishes and the adoption of legislation expressly prohibiting valid organ donations from being reversed after the donor's death or declined for any reason other than medical suitability."
Since UNOS supports a person's right to become a donor, it should also state that it supports a donor's right to donate his/her organs first to another donor. UNOS hasn't done that yet, but their support isn't needed. Your organs are yours, and the law says you can decide who gets them. UNOS has stated it won't block a LifeSharers member's wish to give his/her organs to another member.
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LifeSharers logistics
The Denver Post published a story about LifeSharers a few days ago.
The story quotes a spokesman for the organ procurement organization in Colorado as saying "it could be a nightmare trying to honor a LifeSharers donor's wish to give organs to another member who is not sick enough to rank high on the national recipient list." This is not true. The LifeSharers donor card contains simple instructions to transplant personnel. It tells them to call either of two telephone numbers to get names of LifeSharers members who are on the national transplant waiting list.
The story also quotes a UNOS spokesperson as saying that UNOS "would not block a member's wish to provide organs to other network members." UNOS maintains the national transplant waiting list.
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The story quotes a spokesman for the organ procurement organization in Colorado as saying "it could be a nightmare trying to honor a LifeSharers donor's wish to give organs to another member who is not sick enough to rank high on the national recipient list." This is not true. The LifeSharers donor card contains simple instructions to transplant personnel. It tells them to call either of two telephone numbers to get names of LifeSharers members who are on the national transplant waiting list.
The story also quotes a UNOS spokesperson as saying that UNOS "would not block a member's wish to provide organs to other network members." UNOS maintains the national transplant waiting list.
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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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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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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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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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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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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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