A story in yesterday’s New York Times Magazine raised some very thorny questions about organ transplants. I spent the afternoon reading more about transplants; by evening I had stumbled onto what seems to me at least a partial solution.
The NYT piece tells the story of Sally Satel, a 49-year-old psychiatrist in need of a kidney transplant. In 2004, her kidneys suddenly, quite inexplicably, began to fail. (The cause may have been a medication she had taken in her twenties.) She had no living relatives except a couple of cousins whom she rarely saw. A close friend came forward, was tested, found that her blood was a match, volunteered to donate a kidney–and then reneged. (It turns out that when she went to chorus practice one evening, “a fellow alto” talked her out of it. The fellow-alto was, of all things, an organ transplant specialist. Satel was enraged: “a transplant surgeon should know how hard it is to get a donor.”)
A second friend volunteered, and again proved a match. But then she, too, got cold feet– though she didn’t tell Satel right away.
Finally, a 62-year-old stranger in Canada saw Satel’s message on an organ match website, called and offered to help her. He was the right blood type, he seemed “steady” and “honest,” and after a few weeks of phone calls and e-mails, they set a date to do the operations in early January. Then, just before Thanksgiving, he went dark. “Everything turned to radio silence as my e-mail and phone messages went unanswered,” Satel recalls. When her transplant coordinator contacted him, he waffled. He wasn’t sure he would be able to make it in January; he was too heavily involved in a political campaign…
“I was astonished at the Canadian’s . . . what? Negligence, cowardice, rudeness?” Satel writes. “It was a sickening roller-coaster ride: hope yielding to helpless frustration, gratitude giving way to fury. How dare he reduce me to groveling and dependence? Yet I assume he intended no such thing. I think the Canadian was actually quite devoted to the idea of giving a kidney — just not necessarily now or to me.”
By now Satel is desperate. She realizes that her only alternative is dialysis “three days a week, for four debilitating hours at a time, I would be tethered to a blood-cleansing machine… I had an especially morbid dread of dialysis,” Satel admits. She was haunted by what she had read about “the playwright Neil Simon [who] received a kidney from his longtime publicist in 2004 . . .but before that he endured 18 wretched months on dialysis, suffering cramps and vomiting spells that kept him largely confined to his house. His memory deteriorated, and he hated the time away from his writing. Shortly before his donor came forward (unsolicited, it should be noted), Simon’s doctors said he might have to start spending more time on dialysis. If that were necessary, he said, he had decided, ‘I didn’t want to live my life anymore.’ Neither, I thought, would I.”
On dialysis, she realized that “even simple things like traveling to
see friends or to give talks would be limited. This would very likely
continue for at least five years until my name crawled to the top of
the national list of people waiting for kidneys from the newly
deceased.”
Satel also knew exactly how long the list was: “At the beginning of
2005, when I put my name on the list, there were about 60,000 people
ahead of me; by the end of that year, only 1 in 9 had received one from
a relative, spouse or friend. Today, just under 74,000 people are
waiting for kidneys
“I flirted with the idea of becoming a ‘transplant tourist’ in
Turkey or the Philippines, where I could buy a kidney,” she recalls.
“Or going to China, where I would have to face the frightful knowledge
that my kidney would probably come from an executed prisoner. Grim
choices, but I was afraid I could die on dialysis if I didn’t do
something to save myself.”
Satel would happily have paid for a kidney, but in the U.S it is
illegal to buy or sell organs. (The federal ban on organ sales dates
back to 1983, when Virginia physician Dr. H. Barry Jacobs proposed
buying kidneys — mostly from the indigent — and selling them to
whomever could afford to buy. His plan was met with widespread
outrage. In Congress, then-Rep. Al Gore introduced legislation banning
the sale of organs. The bill became law in 1984.)
Finally, an acquaintance heard of Satel’s dilemma, and sent a simple
e-mail. “If I’m compatible, I’ll be a donor. Best, Virginia.”
Two weeks later, 45-year-old Virginia Postrel sent a second message.
“By the way, I absolutely promise you that I will not back out.” They
weren’t close friends; Satel describes Postrel as “a fond
acquaintance.” But she had the temperament suited to the task at hand.
She said she would do it and she did.
Still, Satel knows how close she came to what she saw as a death
sentence on dialysis, and she feels that the government must do
something to make organs more available. Too many people don’t have a
loving relative who is a close match. And to count on friends,
acquaintances or strangers to make a gift this large may be expecting
too much, Satel suggests:
“Altruism is a beautiful virtue, but it has fallen painfully short of
its goal. We must be bold and experiment with offering prospective
donors other incentives for giving, not necessarily payment but
material reward of some kind — perhaps something as simple as offering
donors lifelong Medicare coverage. Or maybe Congress should grant
waivers so that states can implement their own creative ways of giving
something to donors: tax credits, tuition vouchers or a contribution to
a giver’s retirement account.
“In short,” she continues, “we should reward individuals who relinquish
an organ to save a life because doing so would encourage others to do
the same. Yes, splendid people like Virginia will always be moved to
rescue in the face of suffering, and I did get my kidney. But unless we
stop thinking of transplantable kidneys solely as gifts, we will never
have enough of them.”
At first, I am half-persuaded that Satel is right. This sounds like a
sensible solution. Yet . . . there is something about the idea of
giving a tuition voucher, tax credits or a contribution to a 401-k in
exchange for a living body part that I find very troubling. It means
that even the body is a commodity. It seems such a ghoulish reminder of
how important money has become in our society. People who would not
donate an organ to save a friend’s life might well sell a body part if
the price is right.
Today, the federal government has a program to reimburse living donors
for expenses they incur while donating including travel, lodging and
meals. And more than a dozen states offer a tax deduction of up to
$10,000 to help defray expenses. This all seems to me very fair. Donors
shouldn’t have to pay for the privilege of donating; their costs should
be covered. It’s the idea of donors profiting from the sale that
bothers me.
It’s not that I would begrudge them the money. I don’t believe in
looking into someone else’s pocket. But I begin to imagine the
slippery slope ahead. It seems inevitable that if we begin paying for
organs, the poorest and most desperate among us will be the ones who
are most likely to sell pieces of their bodies. Imagine the 64-year-old
couple who face mandatory retirement and realize that they don’t have
nearly enough in their 401-k to cover the mortgage, their rising
heating bill, and the medications they will need . . . But if one of
them gives up a kidney, the government will make a contribution to
their retirement fund. Think of the parents of a very bright
17-year-old who cannot afford college tuition. What parent wouldn’t
sell an organ in exchange for a tuition voucher?
One can imagine a novel set sometime in the not-so-distant future in a
society where it has become commonplace for wealthy people with good
insurance to have multiple organ transplants as their bodies begin to
wear out: a kidney, a piece of a liver, a lobe of a lung, a portion of
a pancreas, a piece of an intestine, or a heart-lung “bloc.” (Today,
it is possible to transplant any one of these pieces from a living
donor, though intestine transplants are very rare.)
Meanwhile, in this brave new world, the government rewards poorer
people for giving up pieces of their body in exchange for access to the
necessities of life: education; enough retirement money to pay off the
mortgage and buy food; perhaps full coverage (with no co-pays) of the
medications they need . . . No doubt plenty of organs would be
readily available, and with some reasonable advances in transplant
technology, one might imagine that many at the top of our income ladder
could expect to live much, much longer—perhaps to 110, maybe even 120.
Of course less affluent people also could have a transplant—if they
could afford it. Organ transplants are very expensive operations.
Although American law stresses that the organ itself is a gift, the truth is that
“unless the recipient has very comprehensive health insurance he will
find that a transplant in the U.S. costs between $ 250,000 and $800,000
dollars, depending on the type of organ.”
Even if a government program that reimbursed donors made tens of
thousands of organs available at a relatively reasonable price, neither
the government nor private insurers could afford to cover the full cost
of operations and post-op care for the hundreds of thousands of people
who might want to rebuild their bodies, a piece at a time, as they
aged. True, kidney transplants could save Medicare the millions that it
now spends on dialysis. But once you have a new kidney, why not think
about giving your liver a new lease on life? (Once we establish a
market for organs, it’s hard to imagine that we would stop with one
product.)
Private insurers might well offer deluxe policies that reimburse for
the full cost of surgery, but if transplants became commonplace,
premiums would have to be steep. Only the very wealthy could afford
these policies. And it’s not at all clear how Medicare could afford to
foot the bill for the tens of thousands of baby-boomers who might hope
to refurbish their bodies as parts began to wear out.
So middle-class and working-class Americans would be more likely to be
donors, less likely to be recipients. And as they sold off a kidney
here, a piece of liver or a lobe of a lung there, one could expect some
complications. (Kidney transplants are quite safe for the donor; liver
transplants, however, are more risky, with living donors dying in 1 of 100 surgeries.)
And unlike blood or sperm, an organ does not restore itself. The donor
is left with a defect. A significant percentage of donors might not
live as long or be as healthy as they would have been if they hadn’t
sold an organ. We just don’t know much about how live donors fair.
Transplant centers track them for only one year after the surgery –and
36 percent of the time, they lose contact within the year.
The scenario I’m spinning in an imaginary country where the poor sell
body parts to survive might well sound like a fantastic story—something
that could never happen in a civilized nation.
But then yesterday afternoon, I read this 2003 article from the Knesset Library,
a member of the Israeli university library network: “In Israel there is
a serious shortage of organs available for transplant. Over a thousand
people a year are on the waiting lists . . . .
"There are few alternatives available for those on the waiting list.
For a price of tens of thousands of dollars one may purchase a kidney
on the black market, from an organ merchant, for transplant in Israel
or overseas. . . A new aspect to this phenomenon is developing in
Israel. The difficult economic situation is pushing more and more
Israelis – especially single mothers – into selling one of their own
kidneys in order to maintain themselves and their children.
“Newspapers have reported that recently a group of 50 people, mostly
women, was established for the purpose of selling their organs in order
to make a living. They meet periodically for discussions as a kind of
support group,” the article reported.
Where else are organs sold? It is telling that Iran is the only country
in the world with a government-sanctioned market for organs. According
to the Wall Street Journal,
“Outside medical observers say that sellers . . . are often exploited.
Much of the fees go to unscrupulous brokers, for instance, and there is
little screening to ensure that patients are well enough to withstand
the operation. . . . Kidney sales [also] are common in some developing
countries, including Pakistan and the Philippines, though they are
technically against the law.”
Still, if people who need the money want to take the risk, why shouldn’t they? Last month, the Wall Street Journal quoted
the University of Minnesota’s Dr. Arthur Matas, a leading proponent of
creating a market for organs, acknowledging that “the poor might be
the most likely to sell a kidney. But if it is safe enough for friends
or family to donate out of a sense of compassion or obligation, why
should giving up a kidney be banned for someone motivated by money?”
Free market enthusiasts agree. The American Enterprise Institute, an
influential center-right think tank, has published a book by two
economists who argue for the creation of a free market in organs. And on SeekWellness,
wellness guru Donald Ardell writes: “I favor the capitalist business
model, with minimum restrictions, because free people should be able to
do what they like with their lives, including decisions that affect
their health, life and death…"
Ardell cites James Blumstein, an advocate for organ sales, who
reasons that “organ selling should be allowed because it would be no
different from the selling of other goods and services in the health
care market. For example, those with more money can buy life-saving
drugs like AZT for AIDS — why should they not have more access to
organs?”
But there is a reason why the U.S. has made it illegal to buy and sell
organs. We are reluctant to view a pound of flesh (or even one-tenth of
a pound) as a commodity.
Moreover, as opponents like Dr. Francis Delmonico, a Harvard University
professor who has played a central role in shaping national transplant
policy, observe: “Payments eventually result in the exploitation of the
individual. It’s the poor person who sells.” At a recent New York
transplant conference. Delmonico argued that problems found abroad would be inevitable here, too:
“young people forced by their poverty-stricken families to sell a
kidney, out-of-control bidding for the best organs.” Meanwhile, “the
person is not left better off, but they’re left with one less kidney.”
Given her ordeal, it is completely understandable that Satel would
want to see organs become more available. At the same time, it’s worth
noting (as she does in the article) that she is a resident scholar at a
conservative think tank, the American Enterprise Institute Given her
affiliation, and her writing at the institute, it is clear that she believes in market solutions.
I, on the other hand, believe that the health care market is different
from other markets. And I know that the drive for profits has corrupted
our health care system. You have only to pick up a paper to read about
a drug company that has lied about the risks of one of its products, a
hospital that is gouging the uninsured, or orthopedists who are taking
bribes from device-makers. Creating a market for our body parts takes
for-profit medicine to its ultimate, nightmarish extreme.
Isn’t there a way to make more organs available by inspiring more
altruism? As it happens, Congress recently endorsed an idea that I
think is vastly preferable to the market solution. On December 7, the Senate approved a bill
authored by Sen. Carl Levin, D-Mich., that will make it easier for
people to receive organs from compatible donors through a new program
called “paired organ donation.” Currently, an estimated 6,000
individuals nationwide have offered kidneys to family members and
friends, only to have the donation rejected because they are not a
match with the patient. Paired transplantation finds a blood match for
the would-be donor so that he can give his kidney to someone else who
also has an incompatible donor, setting off a chain reaction of
altruism.
Here’s how it works: One of the first patients involved in the
program was Barb Bunnell, a 53-year-old from Phoenix, Arizona, who
lived for years with polycystic kidney disease. Mrs. Bunnell’s husband,
Ron, wanted to donate a kidney to his wife, but their blood types
didn’t match. Eventually, however, Mrs. Bunnell was able to get
another kidney from a matching donor in Michigan — a 28-year-old man
who donated for no other reason than altruism. Mr. Bunnell then went
ahead with his plan to have his kidney removed, and instead of giving
it to his wife he donated it to a complete stranger.
The recipient of his kidney had been in a similar position as Mrs.
Bunnell: her best friend wanted to donate but, as with the Bunnells,
there was no match. Now that the woman has been given Mr. Bunnell’s
kidney, her best friend is following his example and give her kidney to
another stranger, and so on, the London Times reported,
“resulting in a chain reaction that could rapidly shorten the kidney
waiting list and bring the waiting time down from years to months. “It
is thought that eight transplant patients will ultimately benefit from
the chain that began with Mrs. Bunnell and her Michigan donor, although
it could be many more.”
The paired donation program was launched in 2000, but up until now many
hospitals refused to participate, fearing that they would be violating
the 1984 law that bans buying or selling human organs. Levin’s bill,
which has passed the House as well as the Senate, is designed to
clarify the situation, making it plain that a paired donation, such as
Mr. Bunnell’s “gift” of a kidney to a woman he had never met before,
does not represent a form of payment.
Indeed, Bunnell is not paying back a debt, he is “paying it forward” to
a third party, just as described in the 2000 Warner Brothers film based
on a novel by Catherine Ryan Hyde. The idea is simple: rather than
bartering with each other, individuals perform good works for others to
repay the good that has happened to them.
Between 15,000 and 20,000 kidney transplants are performed in the U.S. each year while more than 70,000 people are on the transplant waiting list at any given time. For those who have to rely on working their way up the waiting list for a kidney transplant, they appear destined to spend quite a long time on dialysis. Despite a strong free market bias in most economic matters, I would be appalled if we legalized the sale of body parts in the U.S. for exactly the reason you stated – it would lead to the exploitation of the economically disadvantaged. By the way, potentially paying people in the form of lifetime Medicare, tuition credits or 401-K contributions is no different from just writing a check. Reimbursing expenses, by contrast, is an entirely different matter. Indeed, it defies common sense to not reimburse expenses.
I wonder how many useable organs go to waste each year because the newly deceased have not filled out an organ donor card, signed up for an organ donor registry or otherwise previously given permission to harvest their organs if they should die. I’m sure we could devise programs to proactively increase the number of people who agree to sign up for organ donor registries allowing their organs to be harvested when they die if the organs are useable. Perhaps the law could even be changed to allow harvesting unless the person has previously expressed a preference to the contrary or signed up for a registry to NOT allow his or her organs to be harvested.
The cost of performing the transplants and its potential impact on already high healthcare costs is a different issue. Here, explicit rationing would probably be appropriate. Maybe Medicare and private insurance should just simply refuse to pay if the potential recipient is beyond a certain age or has a very limited life expectancy due to other health issues that a transplant would not address. Of course, if an organ is available and a patient beyond the insurable age limit wants it and can self-pay, fine. This assumes that there is nobody on the waiting list below the insurable age cutoff.
Thank you for a very insightful post. The paired organ donation program you mention seems like the most logical solution. After all, these people have already made the decision to donate. However, after reading Dr. Satel’s analysis of donor psychology, I wonder what percentage of these donors would reconsider their offers once the friend or family member was no longer the recipient. Still, those who move forward with the donation would make a huge impact on the numbers of people on the transplant waiting lists. Also, I agree that much needs to be done to raise awareness of and participation in donor card programs. Perhaps high school driver education instructors and primary care physicians could be enlisted to help with this initiative. A patient’s wish to donate could become part of the permanent health record. I have publicized my decision to donate loudly and often with my family, often to the dismay of my children who understandably do not want to discuss this. However, I’m fairly certain they’ll honor my wish when the time comes. And if not, it’s right there on my driver’s license.
The commoditization of human flesh has gone far enough. It is unethical and immoral to sell body parts. Or for that matter sell gift certificates for surgeries-yet another unethical trend. Dr Arthur Matas is misguided and dangerous.
I think the paired donation program makes sense for transplants.
Dr. Rick Lippin
http://medicalcrises.blogspot.com
Patricia, Barry and Rick–
I appreciate your comments.
And Patricia: welcome to the ongoing conversation on HealthBeat.
I agree with you that “after reading Dr. Satel’s analysis of donor psychology” one might “wonder what percentage of these donors would reconsider their offers once the friend or family member was no longer the recipient.”
But the fact is that “pay it forward” is infectious. It inspires people to become part of a network of charitable acts. I think that Satler is overly pessimsitc about altruism.
Barry–It’s good to hear someone with a “strong free market bias” speak out against a free market in organs.
But actually, I’m not surprised; being a free marketeer and being someone who has no concern about inequities in our society are very different.
Your comments in the past have suggested that you belong to the first group, not the second.
And given finite resources, I agree that we cannot afford unlimited transplants for all. I also agree that we should give first preference, not to the rich over the poor, but to young over the old. People who have not yet had a chance to lead a full life should be at the front of the line.
Dr. Rick–
Thanks for endorsing the “paired transplants.” It makes a lot of sense ot me too,and I really think it could inspire altrusim.
The whole idea of a transplant market realy is beyond the pale.
I have blogged about organ donation in the Philippines: http://health.tesstermulo.com/?p=376
I think the paired donation program might work. However, what if the supposed donor of the recipient of the donated kidney would refuse to donate to somebody else? Does that mean that his relative is already ineligible to receive the donated kidney?
The generosity of live organ donors like Virginia Postrel is wonderful. It’s a shame we need so many live organ donors. Americans bury or cremate 20,000 transplantable organs every year.
There is another good way to put a big dent in the organ shortage — if you don’t agree to donate your organs when you die, then you go to the back of the waiting list if you ever need an organ to live.
Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. About 50% of the organs transplanted in the United States go to people who haven’t agreed to donate their own organs when they die.
Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at http://www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.
Prudence and Dave–
Thanks for commenting.
Prudence: As I understand it the paired donation program, like other “pay it forward” programs is entirely voluntary. And I guess I think it should be. Altruism can’t be forced; it relies on good will.
But even if occasionally someone backs out, it still has a major multiplier effect.
Dave–
Lifesharers sounds like a good idea.
But I wouldn’t want to see a law saying that anyone who hasn’t agreed to donate organs when they die automatically goes to the back of the line if they need one. That seems too punitive.
I can imagine people being afraid of donating their organs after they die for a variety of reasons. I don’t think this is rational, but death is terrifying enough–I don’t think we should add a level of fear by forcing people to agree to donate their organs.
If we just signed up everyone who is willing–and changed the laws so that hospitals would honor donor cards (which many do not unless the relatives of the dead person agree) — we would have enough organs.
Prudence and Dave–
Thanks for commenting.
Prudence: As I understand it the paired donation program, like other “pay it forward” programs is entirely voluntary. And I guess I think it should be. Altruism can’t be forced; it relies on good will.
But even if occasionally someone backs out, it still has a major multiplier effect.
Dave–
Lifesharers sounds like a good idea.
But I wouldn’t want to see a law saying that anyone who hasn’t agreed to donate organs when they die automatically goes to the back of the line if they need one. That seems too punitive.
I can imagine people being afraid of donating their organs after they die for a variety of reasons. I don’t think this is rational, but death is terrifying enough–I don’t think we should add a level of fear by forcing people to agree to donate their organs.
If we just signed up everyone who is willing–and changed the laws so that hospitals would honor donor cards (which many do not unless the relatives of the dead person agree) — we would have enough organs.
The paired donation program sounds good, but what if I say I’ll donate a kidney so my wife can get one but there’s no penalty if my wife gets her kidney before a suitable recipient is found for me but I get cold feet when that recipient is finally found?
A better idea might be “donor communities”. Groups of healthy people who promise organs to each other if the need arises. Each member pays an annual fee to a group insurance policy that pays if 1)you need an organ and one is not available in the community or 2)you reach an age where you are too old to donate or 3) die (life insurance). If you renege on your promise to donate you lose your insurance.
Marc–
There are enough people waiting for kidneys that I don’t think it takes much time to find a suitable recipient. In other words, there is not much time to get “cold feet.”
And I really like the idea of keeping money out of it. This is a new program (started in 2000 and just starting to spread), so I’d like to wait and see how many people actually renege . .
You bring up insurance, and rightly so. We do all need comprehensive insurance that will cover big-ticket items like transplants–at least for people under a certain age.)
I really don’t think that we as a society, can afford to pay for transplants for 85-year-olds who want to replace two or three body parts in hopes of living to 105. (Though if people want to pay for this sort of thing on their own, that’s fine.)
But insurance premiums for comprehensive insurance would be too high if we started using organ transplants to try to extend life. And Medicare couldn’t afford it either.
So as medical technology makes more transplants possible, we probably need to make some decisions about limits. (Other countries have done this.)
Marc–
There are enough people waiting for kidneys that I don’t think it takes much time to find a suitable recipient. In other words, there is not much time to get “cold feet.”
And I really like the idea of keeping money out of it. This is a new program (started in 2000 and just starting to spread), so I’d like to wait and see how many people actually renege . .
You bring up insurance, and rightly so. We do all need comprehensive insurance that will cover big-ticket items like transplants–at least for people under a certain age.)
I really don’t think that we as a society, can afford to pay for transplants for 85-year-olds who want to replace two or three body parts in hopes of living to 105. (Though if people want to pay for this sort of thing on their own, that’s fine.)
But insurance premiums for comprehensive insurance would be too high if we started using organ transplants to try to extend life. And Medicare couldn’t afford it either.
So as medical technology makes more transplants possible, we probably need to make some decisions about limits. (Other countries have done this.)
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It seems to me there is cognitive dissonance between the position that a woman’s body is hers to do with as she sees fit (“right to choose”) when it comes to abortion but not hers to do with as she sees fit (“no right to choose”) when it comes to organ transplants.
The same argument applies to so-called surrogate motherhood. How can a woman have a right to sell her baby and not her kidney?
I believe these and many other behaviors are simply demonstrations that we already regard the human body as a “commodity.”
I might not be particularly in favor of any of these behaviors, but the reliance on altruism to relieve serious social ills is manifestly a failure. That failure is the reason we have many gov’t programs and special compensation schemes in so many other areas. It’s the reason we have tax deductions for charitable contributions.
Thanks.
mp
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naugiedoggie–
Saying that I have a right to have an abortion is not saying that my body is a commodity. It is saying that it is a living entity that I have a right to control–and that that the fetus is not yet a sentient human being.
Saying that I have a right to serve as a surrogate mother is not saying my body is a commodity–most women who volunteer to carry another woman’s baby are not paid except insofar as they are paid for the expenses of pregnacy. (Typically a surrogate is paid $15,000 for the time and sacrifice of the pregnancy.) In other words this is not a high-profit business. And I can’t imagine too many women doing it simply for the $15,000. Many women like the idea of helping out a woman who can’t get pregnant–even if it’s a stranger.
And it is illegal to sell babies (or children).
Finally, as others have commented if we make it legal for people to sell body parts, inevitably, the poor will
be exploited.
I’m not ready to give up on altruism as a complete failure. And I think pay it forward schemes have a lot of potential because of the multiplier effect.
I really feel the desperation of someone hoping for an organ donor, but I do often wonder about whether they themselves had ever donated an organ. Before they became ill, what was their reaction to pleas such as they are now making?
Peggy–
Thanks for weighing in.
You wrote: ” I really feel the desperation of someone hoping for an organ donor, but I do often wonder about whether they themselves had ever donated an organ. Before they became ill, what was their reaction to pleas such as they are now making?”
I’m sure that many people realize how important organ donation is only after they need one. We all tend to live in our own little worlds, preoccupied with things that aren’t terribly important–until something happens that stops our lives and makes us realize what is really important.
I don’t think you can really blame people who never bothered to fill out a donor card until they themselves needed a transplant. That’s just all too human.
But recently I heard of a program that would require everyone to make a decision about whether or not they are willing to donate an organ when they apply for a driver’s license.
No one would be forced to say “yes”–but everyone would have to fill out the card, saying “yes” or “no” and the answer would be on their drivers’ licenses.
This seems to me a splendid idea for making everyone stop and think about donating organs.
Then, if hospitals were required, by law, to honor what you said on your driver’s license (despite any objections from grieving relatives), we would have many more donors.
Don’t even think of asking me to “donate” an organ until you have VOTING RECORD that says I would be able to receive one.
Currently, I am under-insured*, most of my contemporaries are in the same boat or are unable to change jobs due health insurance concerns. Neither I, or anybody I know, could afford an organ transplant. So unless Sally Satel, [ a 49-year-old psychiatrist in need of a kidney transplant ] can show that she worked tirelessly for a universal national health, I owe her little pity and much derision. In good times and in bad, I have voted and lobbied for National Healthcare. Asking somebody to donate an organ, when they could never benefit in same manner, or for the right wing American Enterprise Institute, to argue for the “creation of a free market in organs”, when US medicine [drugs and doctors in particular] is the beneficiary of the strongest market protectionism/subsidies in the world today is beyond hypocrisy.
Employment based health insurance just plain SUCKS, because, for the feeble minded folks at the right wing American Enterprise Institute, when you get really sick…wait for it…you can’t work…and unless you are wealthy, you will lose you insurance. And don’t even get me started on the insurance industry standard of switching sick people to new plans where their current illness suddenly becomes a preexisting condition.
With one exception, everybody I know who has been at the receiving end of a major sickness has been forced to quit working, lost all their possessions and died in debt.
So for rich hypocrites out there, if you want me to check my license as a donor, there had better be in place and practice a national health insurance that is NOT employer based.
And that…is my final answer.
S Brennan
S. Brennan–
I agree, it doesn’t make a lot of sense for insurance to be tied to employment.
Most employers don’t have any particular expertise in choosing and negotiating health insurance–and, more importantly, as you point out, it’s the unemployed who are more likely to be sick and in real need of insurance.
Whether or not one has a job should have no effect on whether or not you can get insurance. Everyone should be able to be part of a very large group made of people who are young and old, sick and healthy, and get the relatively low “group rate” that comes with being part of a very large group sharing the risks of sudden illness
PERSONAL EXPERIENCE — My father was an organ donor. In 1997, an investigative reporter for The Chicago Tribune called me and asked if I was aware that my father’s organs had been sold by the hospital he died at in Florida, to an organ bank in Gainsville Florida, which then sold the organs to a facility in Europe, which then in turn sold them right back to a facilty in the U.S. which then sold them to a hospital for transplant. I said “no” I was not aware of this, which led to a televised debate on how to increase organ donotions and the credibility of the organ banks that facilitate the transplant process for profit. It appears that this 1983 law you reference, prohibiting the sale of organs, has been put in place to protect the market share and bottom lines of the organ banks which are already profiting!!! What else can be said about the little old lady living on welfare outside Orlando Fl who received a $100,000+ hospital bill for the care of her deceased husband, only to find out that the hospital ALSO billed the organ bank in Gainsville FL for the sale of her husband’s organs???
Does it not make sense to at least offset the hospital bills by the sale of the deceased person’s organs — for the benefit of the needy and dying???
While this IS a serious issue — it is NOT a new issue.
SOLUTION: Give the decision-making “power” back to the people (general populace) — under medical supervision.
MEDICAL RESEARCH THESIS: “Of all the people admitted into the hospital through the emergency room, the people who receive the best and quickest care are those that are NOT organ donors and have insurance.”
I Love u guyz
donald–
This is a shocking story. I’ve done a little research, but haven’t come up with any further information.
Could you send me more details? Did the Chicago Tribune publish a story? Was a story published in Gainesville?
Thanks very much — mm