The current US system is opt-in, meaning that everyone is assumed NOT to be an organ donor unless they specifically stipulate they wish to be. This directive can be vetoed by the family/next-of-kin. NY has introduced a bill to create an opt-out approach, meaning that everyone in NY is assumed TO BE an organ donor unless they say otherwise. Families will no longer have veto power.
The four opinion pieces aren’t that illuminating, and one avoids the question completely to harp endlessly on her only goal, paid LIVING donors. But the comments say a lot about where Americans’ heads are at regarding organ donation.
1. The current organ transplant system is flawed.
Very much so. Currently about 1/3 of names on the wait list are ‘inactive’, meaning the individuals cannot have a transplant even if an organ does become available. Also, over the majority of ‘deaths’ reported on the wait list are those ‘inactives’, meaning that not only is the shortage problem overreported, so are the deaths due to the shortage.
Also, as Steve Jobs demonstrated, would-be recipients can ‘multiple list’, meaning they can register in different hospitals throughout the country in order to increase their chances of receiving an organ. Not only is this the difference between buying one raffle ticket and ten, it also spotlights the problem of ‘geographical hording’, where hospitals offer procured organs to their patients first, then the larger region and then finally the whole nation, creating different wait times across the country for needed organs.
Let’s also not forget that transplants aren’t cures, so a certain percentage of people on the wait list have already been through at least one transplant. Their lives have already been ‘saved’ at least once, yet they are given the same priority as everyone else.
2. Hospitals will let me die if I’m an organ donor.
Despite the plethora of urban legends afoot, I simply don’t believe this to be true. However, there is much debate about the definition of ‘death’ due to the fragile nature of organs and the short time they can be harvested.
3. People without insurance can’t GET transplants, so why should they be encouraged to GIVE organs?
There was a study I read recently that cooroborated that very statement, essentially saying that uninsured folks were much more likely TO BE organ donors than they were to be the beneficiary of donated organs. It’s a flaw in the US healthcare system that some folks aren’t willing to overlook, and I can’t say that I blame them.
4. Everyone else makes money from organ transplants, so why not the donors?
My understanding is that the procurement hospital really doesn’t profit from the situation, but the surgeons and center where the transplant takes place does make big bank. However, that being said – where would this ‘compensation’ come from? The government – proponents of small government or fiscal responsibility would find many issues with this. The recipient’s insurance company – that’s only going to happen if we legislate it and premiums are guaranteed to rise. Secondly, compenation of any sort immediately runs the risk of coercion. Libertarians may argue autonomy, but clearly they’ve never been put in a desperate position.
5. One commenter, a former OPO employee, insists presumed consent is a bad idea because families are not told the truth about what happens to the donor or the donated organs. He cites profits as well as general treatment and otherwise distasteful topics. Obviously I can’t comment on the specifics because I’m not an expert in that area, but based on my experience as a living donor, I have no problem accepting that families are only given half the story. After all, living donors aren’t told the truth about their risks, and they have to live the rest of their lives with the reprecussions; why the hell would the hospital dispense any information that might make a family deny the donation?
My opinion on this specific bill is unresolved due to lack of information and context. However, I am a firm believer in maximizing deceased donation in lieu of the medical industry’s recent crunch to expand the living donor pool. Other countries have seen great success with presumed consent, but they have also invested in their organ donation and procurement systems, which the US has so far failed to do. There’s also the issue of their ‘universal health care’ which eliminates all discussion of outstanding medical bills and financial responsibility. The medical personnel in those countries are not blinded by profit, making it far easier to focus on ethical behavior and quality control instead.