Last night NGC aired a documentary about the illicit market in human organs for transplant. Part of the program dealt with transplant tourism to places such as China where it appears that executed prisoners are used as sources of organs for the trade. According to the program, China executes more than 10,000 people each year. Also covered were domestic issues such as the use of imporoperly screened tissues and organs taken from cadavers in funeral homes without the knowledge of the survivors of the decedents. It seemed to me that many of the problems stemming from the illicit market were related to the fact that the market was illicit and could not be transparent.
The shortage of human organs was attributed to the unwillingness of most people to part with their organs voluntarily after death or for their families to consent to the removal of their loved ones' organs. My limited understanding of economics allows me to suggest only that the current price controls, where the price for an organ is fixed at $0, aren't particularly helpful. People die for want of organs while organs get buried or cremated.
I'm not sure why anyone would object to organ donation. Do they think that they are going to need their organs after they are dead or that God won't be able to compensate for the missing organ at the resurrection? They're going to decompose eventually, and if you're getting cremated they are going to be destroyed lickety split. What's the deal with survivors' reluctance? Your loved one is dead, and it won't hurt to remove the organs. You don't have to watch, and the undertaker will fix it all up real nice for the funeral. I have already instructed Mrs Vache Folle to try to turn a buck off my cadaver if she can and to spend nothing on disposal if she can manage. At the very least, if I have useful organs and tissues after all these years of abusing my body, she should by all means consent to their distribution.
I thought a lot about the organ shortage as I tossed and turned last night and concluded that an open market in organs would help. It would also create its own problems and incentives to murder and fraud, but those exist in the illicit market. Short of taking this step, I reckon it would be helpful to change the law to make it a presumption that, unless you have a written declaration to the contrary presentable to medical personnel, you consent to the harvesting and distribution of your usable organs and tissues for transplantation purposes. This would eliminate the awkward position of survivors and doctors and remove any doubt about the matter. It would also preserve everyone's ability to object as long as they put it in writing ahead of time. I'm betting that most people are just too lazy to bother with objecting and that having to object explicitly will make them less apt to do so.
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The current system in my state, CA, allows one to check a box on their drivers license for organ donation. I read an article about this and it is a thoroughly statist operation, with the state disrupting family arrangements and the like for the sake of a state controlled socialized organ "market." They control the body and everything else. No thanks, I'll donate privately if at all.
If presumed consent was implemented in the United States, the supply of organs for transplant operations would increase significantly. According to polls, about 90% of Americans support organ donation but only about 50% have bothered to register. If everybody was automatically registered, few people would bother to un-register.
Presumed consent can only be implemented in the United States through legislative action – Congress (or a state legislature) would have to pass a law. The chances of this happening in the foreseeable future are somewhere between very slim and none, because there is wide-spread opposition to the idea of presumed consent.
Fortunately, there is an already-legal way to put a big dent in the organ shortage – allocate donated organs first to people who have agreed to donate their own organs when they die.
Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.
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 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
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