I just got back to work after vacation with a few folks from other countries -- Chile, Sweden and Norway to be exact. We've had a lot of interesting exchanges about how things are there vs here. Fun discussions. We didn't get to the notion of organ donation (not good dinner conversation!) but I see that a lot of people like Steven J. Graham have been writing some very thoughtful letters to the editor because they are concerned about the organ-transplant scandal at UCLA. Seems some very seedy characters with reputed gang ties were given transplants while upstanding Americans died on the waiting list.
This wouldn't be such an emotional issue if there were more organs available to transplant. After all, no one cares if mafia leaders get open heart surgery because it's now available to everyone. That reminded me of a book that came out a few years ago that encourages people to think in new ways. It's by Barry Nalebuff and Ian Ayres and it's called "Why Not?" They say the problem with the U.S. approach to organ donation is not that there are too few people willing to donate; 75% of people say they would be willing to donate their organs. The problem is they do not get around to putting their preferences in writing nor do they tell their relatives. The relatives are asked by the hospitals, but often they don't know what to say in the emotion of the moment because there has been no conversation.
That's a problem that's been settled in many ways around the world, they found. In Belgium and Spain, which have no waiting list for transplants, there is "presumed consent" unless the person formally indicates otherwise. It's also known as "opt-out" organ donation.
If that seems like just too much change, consider Sweden, Denmark and Brazil, which have mandated choice laws, where stating your preference is a requirement. When Sweden passed its law in the mid-90s, there was an immediate increase of 600,000 potential donors.
In California, there is an opportunity to indicate willingness to be a donor as part of the license renewal for our drivers licenses. That has to be helping a lot. But some version of opt-out would save thousands more lives. There is also a modified version of opt-out being used very successfully by Norway, Italy, Greece, Finland and Singapore. In this version, consent is presumed, but next of kin can object and prevent the donation.
No matter what is done legislatively, have you written down your preferences and made your wishes known to your loved ones? To find out more information from the California Transplant Donor Network, click here.
If people had to opt out of being an organ donor rather than opting in, the supply of organs for transplant operations would increase significantly. About 90% of Americans support organ donation but only 50% have bothered to register. If everybody was automatically registered, few would bother to un-register.
This idea can only be implemented through legislative action. There is no chance of this happening in the foreseeable future because there is wide-spread opposition to the idea.
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.
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
I expected more than one comment on this topic. It seems that in Belgium and Spain becomig an organ donor is taken for granted unless one opts out. Actually killing someone or just letting die for a heart would be impossible in Austria, one of the wealthier nations in the EU. The legislator foreclosed that adequate medical treatment might be withheld from a poorer patient to giving the heart to a wealthy patient.
I guess rich Austrians must go to another country to get a heart. The fact that a heart is being needed from a live individual stopped us from being donors. And if we would have to opt out, then so be it. Conversly enough, I am a cardiac patient myself.