Tuesday
14Nov2006
Organs For Sale
Tuesday, November 14, 2006 at 5:38PM
The American Enterprise Institute launched a new magazine today called The American. The introductory issue contains a fascinating combination of articles, but none more compelling than Dr. Sally Satel's Organs For Sale.
Writing the article that I wish I could have written, our favorite AEI Resident Scholar (and kidney transplant recipient) neatly encapsulates the state of the current organ shortage, the lunacy of relying solely upon altruism to secure transplant organs, the organizational inertia that defines the transplant bureaucracies, and the costs, in dollars and personal health, of continuing dialysis treatments for 69,000 patients.
The solution to this tragic mess?
She then offers four specific solutions that could resolve the current organ shortage, dealing with both living donors and deceased donors. Each of these solutions introduces market incentives to attract more donors and save thousands of lives each year. They are carefully thought out, reasonable and promise levels of success that are unattainable by our current system. And as Sally concludes:
Writing the article that I wish I could have written, our favorite AEI Resident Scholar (and kidney transplant recipient) neatly encapsulates the state of the current organ shortage, the lunacy of relying solely upon altruism to secure transplant organs, the organizational inertia that defines the transplant bureaucracies, and the costs, in dollars and personal health, of continuing dialysis treatments for 69,000 patients.
The solution to this tragic mess?
The best answer is by creating a market arrangement to exist in parallel with altruistic giving. Within such a framework, any medical center or physician who objects to the practice of compensating donors can simply opt out of performing transplants that use such organs. Recipients on the list are free to turn down a paid-for organ and wait for one given altruistically. Choice for all—donors, recipients, and physicians—is enhanced. And it is choice in the greater service of diminishing sickness and death.Sally deals convincingly with the opposition's usual suspects: donors will be exploited, incentives won't attract more donors, money would taint the purity of the current system and we will be commodifying the human body. She quotes from transplant surgeon and UNOS board member Dr. Benjamin Hippen that “The current system has degenerated into an equal opportunity to die on the waiting list.”
She then offers four specific solutions that could resolve the current organ shortage, dealing with both living donors and deceased donors. Each of these solutions introduces market incentives to attract more donors and save thousands of lives each year. They are carefully thought out, reasonable and promise levels of success that are unattainable by our current system. And as Sally concludes:
There is no denying the political and practical challenges that come with introducing payment into a 20-year-old scheme built on the premise that generosity is the only legitimate motive for giving. Yet as death and suffering mount, constructing a market-based incentive program to increase the supply of transplantable organs has become a moral imperative. Its architects must give serious consideration to principled reservations and to concerns about donor safety, but repugnance and caution are not in themselves arguments against innovation. They are only reasons for vigilance and care.
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