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(HealthNewsDigest.com) – America needs two transplant waiting lists, instead of one: the ‘A’ list for registered organ donors and the ‘B’ list for people who have not agreed to donate. This would save thousands of lives every year by increasing the supply of transplantable organs. It would also make the organ allocation system fairer.
Every year, over 8,000 Americans die because there aren’t enough organs for everyone who needs one. And every year, Americans bury or cremate 20,000 transplantable organs. That’s about 50% of the potential supply from people who could have donated after death. Each of those wasted organs could have saved someone’s life or reduced someone’s suffering. We don’t have an organ shortage. We have an organ donor shortage.
There are over 103,000 people on the national transplant waiting list, according to the United Network for Organ Sharing, which administers the waiting list and establishes rules for allocating donated organs. More than half of these people will die before they get a transplant. In the next twelve months, about 50,000 people will join the national transplant waiting list but only about 30,000 people will receive transplants.
If UNOS allocated organs first to registered organ donors, more people would donate and thousands of lives would be saved every year. UNOS should make this announcement: “Just about everyone would accept a transplant if they needed one, but only about 50 percent of Americans have agreed to donate their own organs when they die. So beginning on July 1, 2010, UNOS will establish two waiting lists for transplant recipients. The ‘A’ list will be for people who have been registered organ donors for at least six months and for infants less than six months old who were registered as organ donors at birth. The ‘B’ list will be for everyone else. All organs will be allocated first to people on the ‘A’ list. Organs will be made available to people on the ‘B’ list only if not needed by any registered organ donor.”
In response to this announcement, just about everyone in the United States who was not already a registered organ donor would register. Just about every parent would register their minor children. The supply of transplantable organs would go way up, and thousands of lives would be saved every year. Very few people would refuse to donate their organs when they died if they knew it would reduce their chances of getting a transplant should they ever need one to live.
Giving organs first to organ donors would also make the organ allocation system fairer. It is simply not fair to give a life-saving organ to anyone who hasn’t agreed to donate their own organs, if another person who has agreed needs that organ. It’s like awarding the lottery jackpot to someone who didn’t buy a ticket. But under UNOS organ allocation rules, about 50% of all organs go to people who haven’t agreed to donate their own organs when they die.
Giving organs first to registered organ donors is a simple matter of justice. Imagine a heart is available for transplant. Imagine that two people are a good match for that heart – Mr. Donor, who has committed to donate his organs when he dies, and Mr. Keeper, who has not. Given that there is a shortage of organs, and given that Mr. Keeper’s only alternatives to donating his organs are to bury them or cremate them, should we give him the heart that Mr. Donor needs? No, Mr. Donor should get that heart, even if Mr. Keeper is sicker or has been waiting longer. Giving the heart to Mr. Donor serves the cause of justice.
Some people say organs should be given first to the people who need them the most, even if these people aren’t willing to donate their own organs. But if someone is unwilling to save their neighbors’ lives, why should we save his life first when there is such a large shortage of organs? Why should the needs of non-donors be elevated over the needs of willing donors?
What about people who can’t donate their organs? There are no such people. Everyone can offer to donate their organs when they die – no matter what their health status is. Nobody knows today whose organs will be transplantable tomorrow. Surgeons are now transplanting lots of organs they would have rejected just a few years ago. For example, organs from people with HIV are being transplanted into other people who have HIV. A few years from now surgeons will be transplanting lots of organs they would reject as unusable today.
What about people with religious (or other) beliefs against organ donation? Every major religion supports and encourages organ donation. If a person’s personal beliefs forbid donating organs and forbid receiving organs, we don’t have to worry about him. He won’t ever appear on the transplant waiting list. What if his beliefs forbid donating organs but permit receiving organs? If he demands that we respect his decision not to give to us, he should respect our decision not to give first to him.
Unlike most other suggestions for reducing the organ shortage, no legislative action is needed to give organs first to organ donors. UNOS already has the power to move registered organ donors to the front of its waiting list. In fact, UNOS already moves live organ donors up the waiting list if they need a transplant later in life. It can, and it should, do the same for people who agree to donate their organs when they die.
People who want to donate their organs to other organ donors don’t have to wait for UNOS to change its allocation rules. They can join LifeSharers. LifeSharers members agree to offer their organs first to other members when they die, if any member is a suitable match. Membership is free at 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.
LifeSharers applies the Golden Rule to the world of organ donation: “Do unto others as you would have them do unto you.”
David J. Undis is Executive Director of LifeSharers, a 501(c)(3) non-profit organ organization. LifeSharers does not discriminate on the basis of race, color, religion, sex, sexual orientation, national origin, age, physical handicap, health status, marital status, or economic status. LifeSharers has over 13,000 members, including members in all 50 states, the District of Columbia, and Puerto Rico.
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