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Friday, December 19, 2008

Don't let your corpse go to waste 


Here's an amusing ad promoting organ donation. Why give your corpse to the maggots when a human can benefit?

Suffice it to say that I favor either of two common proposals to increase the supply of donated organs and tissue. My favorite idea is to lift the ban on buying and selling human tissue. Your organs and tissue are valuable, in many cases far more valuable than conventional medical devices, and a regulated market ought to pay your estate for surrendering them. Worried about the "Coma" scenario? Don't. Even if regulation failed, payment would increase supply ("here, Ma, check this box!") and that would push prices down to the point that black market profits would vanish.

Or, if that idea is too mercenary for your tastes, we ought to reverse the donation election from "opt in" to "opt out": Your organs will be donated unless you elect otherwise by entering your name in a national registry. Force people to declare that they will feed maggots or the crematorium's fires before they will save someone else's life. And, if you say that this would offend religious sensibilities I say this: Consciously opting out is a pretty damned small sacrifice to make for your faith.

MORE: Unbeknownst to me when I wrote this post, organ transplant issues are abroad in the blogosphere this morning.

For the first time, the number of Americans waiting for an organ transplant has surpassed 100,000, and if past experience is any guide, more than 6,000 can be expected to die next year. Meanwhile, the number of people donating organs has not been increasing — it actually declined slightly last year. But there may be some help on the way for people in need of a transplant, as the Wall Street Journal notes in an editorial.

The National Kidney Foundation, which has has been one of the chief opponents of proposals to offer incentives to donors, told the Journal that it will reconsider its position at a meeting next month. And a bill being introduced next session by Senator Arlen Specter, the Pennsylvania Republican, would ease a federal restriction on providing any “valuable consideration” to organ donors. His bill would still ban direct cash payments to donors, but it would allow states to experiment with incentives like tax credits, contributions to 401K plans and tuition vouchers. In Pennsylvania, as Sally Satel has noted, the law has prevented the state from paying burial or cremation expenses for organ donors, even though it is legal to do so for people who donate their bodies to science.

Faster, please. I am not in favor of requiring people to donate their organs instead of letting them rot, but I am in favor of asking them to confront that decision rather than making it by default.

CWCID: Glenn Reynolds.

24 Comments:

By Blogger Viking Kaj, at Fri Dec 19, 08:55:00 AM:

Unless, of course, you are one of the millions of Americans who are cancer survivors like your correspondent (malignant melanoma). In that case, no one wants any part of you upon decease. I can't even buy liquor with the proceeds from my plasma.

Personally I am thinking about converting to the ancient Norse faith and demanding instant cremation without embalming, and then having my ashes scattered on the water if a suitable longship is not available. That way you return to the carbon cycle much faster.  

By Anonymous Anonymous, at Fri Dec 19, 09:15:00 AM:

Agree on an organ market, TH. Hospitals and healthcare professionals don't provide the service for free, so why should the donor have to supply the organ for free? A market would undoubtedly increase the supply, likely at prices lower than we imagine.  

By Blogger Assistant Village Idiot, at Fri Dec 19, 09:45:00 PM:

Another idea. People on the donor list go to the top of the line if they are waiting for an organ. That would give people an incentive to get on the list early, to prevent waiting - and perhaps dying - later.  

By Anonymous Anonymous, at Fri Dec 19, 11:30:00 PM:

I take a medication called Avodart which bans me from blood donation. I have the feeling it bans me from organ donation too. I have registered to donate my body to the anatomy department of a medical college. Here in Georgia you have to obtain an application form from the institution, fill it out and have it witnessed, submit it for approval. If you are approved, you get a letter and a wallet card. I gave copies of the letter to my physicians.

Considering the waste of the current system, how about execution by disassembly, rather than systemic poisoning from lethal injection ?

Sam W  

By Blogger Unknown, at Sat Dec 20, 12:45:00 PM:

feeblemind wrote: "Another idea. People on the donor list go to the top of the line if they are waiting for an organ. That would give people an incentive to get on the list early, to prevent waiting - and perhaps dying - later."

Your story about __ highlighted the tragic shortage of human organs for transplant operations.

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.

An organ market would save thousands of lives every year. So would a system of presumed consent. But until public opinion rallies behind these ideas, politicians won't embrace them. The LifeSharers solution is already legal and in place.  

By Blogger PoliticaObscura, at Sat Dec 20, 02:44:00 PM:

There is no evidence that paying for dead people's organs would increase the supply. In fact, there is a logical stream of thought that MORE people would refuse to sell a loved one's body parts like a commodity and it would lead to significantly less donation. Further, with a monetary incentive one would increase the possibility the family members might lie on a medical/social history questionaire in order to get the money, thereby putting the recipient at great risk for disease or death. The "opt out" idea is likely to lead to more donation than the "market" approach. However, it is pretty tough to tell the working poor that they are default "donors" while not offering to pay for a transplant if they needed one. You can't have universal donorship without universal access to transplants.  

By Blogger Jack Diederich, at Sat Dec 20, 02:46:00 PM:

re: "Opt Out" NO NO, and again NO.

An opt-out system implies that the state owns your body. I find that morally repugnant; once you cross that line what of yours doesn't belong to the state?  

By Anonymous Anonymous, at Sat Dec 20, 03:02:00 PM:

"An opt-out system implies that the state owns your body."

If that were the case, you wouldn't be able to opt out, would you?  

By Anonymous Anonymous, at Sat Dec 20, 03:10:00 PM:

I find that morally repugnant

What I find "morally repugnant" is the fact that so many people refuse life saving treatment to sick people for essentially no reason?

I mean, you're dead, what's the problem?  

By Anonymous Anonymous, at Sat Dec 20, 03:54:00 PM:

I like the idea of a free market in organs... but the opponents will point out it favors the wealthy, who will be willing to pay whatever the price for the organ they need...


RE: Viking, if you sell your organs before having the cremation, you will be able to use the procedes to purchase the longship to be cremated in, and if your lucky, have pleny left over for the attendees to partake in the traditional viking funeral rites...

Personally, I want my funeral to be a multi-day spectacle of debauchery and blood sport leading up to a massive funeral pire... that isn't going to be cheap  

By Anonymous Anonymous, at Sat Dec 20, 04:19:00 PM:

I would be more enthusiastic about organ donation if I knew I had some choice about where my organs go. I don't want my kidneys or whatever weren't going to some convicted killer or other life-sentenced prisoner. Even dead, I want my organs guaranteed to go to a more deserving ill person. For example, Charles Manson's life prolonged even one minute isn't what I want my body part to be doing even after I'm dead. Seems to me if the organs are so desperately needed, such a guarantee would be easy to assure. Otherwise, I'll just take my parts intact to the maggots.  

By Anonymous Anonymous, at Sat Dec 20, 06:45:00 PM:

Through Medicare and Medicaid and who knows how many other programs paid for by taxpayers, we the ppeople pay an awful lot of money to keep sick people waiting for transplants, and often times not getting them. Let the government offer a credit of (say) $5,000 to the family of each deceased donor, or $7,500 to the family of each deceased donor who signed the proper form during their lifetime (no waiting for consent, no delay, no deteriortation of organs). The credit would be applied first to reasonable funeral expenses, then medical expenses, then tax debts still due, and then refunded to the family (and let that part be controlled by the deceased's will). By letting the ill transplant receive an organ transplant earlier, the sick recover sooner, and get back on the tax rules sooner, or get off expensive, Medicare-paid treatments. The credit/ payment pays for itself. Since there is no bidding, no mega-rich person jumps to the front of the line (let them go overseas), even though I would not criminalize their sweetening the pot.
Offering a credit promoted by PSAs and hospital staff could promote a quick decision in circumstances where time is more precious than money  

By Blogger PoliticaObscura, at Sat Dec 20, 08:35:00 PM:

Monty, that is ridiculous. If you think organs are going to mass murderers then you obviously don't have a clue about much of anything.  

By Anonymous Anonymous, at Sat Dec 20, 08:43:00 PM:

Monty is correct if he lives in California. California courts have ruled that inmates have the same legal rights to organ transplants (at state expense) as everyone else. Based on that ruling, I decided not to be a donor. When the courts reverse that stupid decision, I will reverse mine.  

By Blogger Jack Diederich, at Sat Dec 20, 09:43:00 PM:

@Tom B
If that were the case [the state owning your body], you wouldn't be able to opt out, would you?

Exactly. The opt-out system implies the state is doing you a favor by giving you a choice. By default they own you but by their good graces you can reclaim your corpse. The legislature owns me because 51% of the population voted for them? IIRC we fought a civil war about something similar.

@Anon What I find "morally repugnant" is the fact that so many people refuse life saving treatment to sick people for essentially no reason? I mean, you're dead, what's the problem?

It is your choice to be an organ donor (I am). Feel free to donate to Ads promoting organ donation. Feel free to hector your friends into signing their card. Don't feel free to impose your choice on everyone by law. Charity by force ain't charity.  

By Anonymous Anonymous, at Sat Dec 20, 09:48:00 PM:

You all do realize that the post with my name was about viking funerals, and that the person complaining about prisoners was by Anonymous...

As far as I'm concerned, my organs would go to the highest bidder. Mass murderer, War Criminal, Canabal, if they could win the auction, its thiers to do with as they please... - Monty  

By Blogger Jack Diederich, at Sat Dec 20, 09:49:00 PM:

BTW, I'm a big fan of for-pay markets in organs. If it makes you feel better it is the ultimate progressive tax (or at least flat).

Warren Buffet's liver is the same as anyone else's. The poorest will leave the same organ inheritance to their kids as the richest. People who would otherwise leave little to their heirs could leave the down payment on a house. For the rich, meanwhile, organ donation would be a blip.  

By Anonymous Anonymous, at Sat Dec 20, 11:55:00 PM:

EXPLORE THIS WEBSITE

http://www.donate-for-life.com

COST OF TRANSPLANTATION

http://www.donate-for-life.com/files/the_chart.html  

By Anonymous Anonymous, at Sun Dec 21, 01:31:00 AM:

Easier solution: Irrevocable checkoff on drivers license applications. Get $5 off the license fee if you check the organ donor box and no family permission is needed.

Big incentive and get rid of the legal hassles of dealing with families  

By Anonymous Anonymous, at Sun Dec 21, 01:41:00 AM:

Dave you must be a Democrat. Only a Dem would use your kind of logic.

"There is no evidence that paying for dead people's organs would increase the supply. In fact, there is a logical stream of thought that MORE people would refuse to sell a loved one's body parts like a commodity and it would lead to significantly less donation."

Yeah Dave you're right, I can't find any examples of free markets increasing supply and driving down cost.

If the loved ones find the idea of selling a organ distasteful, they could always donate it, just like they do now. In fact, their charity would even be more noteworthy under a market based system.

But no Dave, we will just keep it the same way while thousands of people die for your anti-market ideaology.  

By Anonymous Anonymous, at Sun Dec 21, 03:09:00 PM:

Another idea. People on the donor list go to the top of the line if they are waiting for an organ. That would give people an incentive to get on the list early, to prevent waiting - and perhaps dying - later.

Is there any such list? As far as I know, all I have done is checked a box that shows up on my DL as a 'Y' under 'Donor.' If the paramedics find my barely alive body in some car wreck somewhere then the doctors who sign my death warrant can alert UNOS that my body parts are ready, willing and able.

You'd have to create such a list. And an individual would have to do it before they developed the disease that would eventually lead to them needing an organ.

And, FYI, the politicization of various donor organizations is not encouraging. The National Marrow Donor Program has shut down donor testing clinics because they weren't collecting samples from a "diverse" clientele, and gives free typing to various minorities while I had to pay $52 for mine.

The stories about the Japanese mob boss coming to the US and getting a transplant, or the illegal alien who got 4 US taxpayer-funded transplants are also quite discouraging.  

By Anonymous Anonymous, at Sun Dec 21, 03:18:00 PM:

No need to create a market - just a flat fee. $5,000 each for heart, liver, corneas, etc. Nothing that makes the breaved feel queazy but that at the same time makes it clear that they will be justly compensated for their contribution to humanity.

Michael Jordan gets hundreds of mils for putting a ball through a hoop, doctors who save lives earn hundreds of thousands, but organ donors' survivors get squat. It's bizarre what behavior gets rewarded and what behavior we say it is immoral to reward.  

By Anonymous Anonymous, at Sun Dec 21, 11:46:00 PM:

Not really, there are very few humans who can do what Jordon does.
There are only a few 100,000 doctors who can perfrom that kind of procedure.

There are 12,000,000,000 kidneys.

I don't see the point in a flat fee. More money should be paid for better organs. People who lead healthier lifestyles should be rewarded.  

By Anonymous Anonymous, at Sat Jan 17, 06:40:00 PM:

I am conducting a quick poll, trying to understand the challenges that patients have when faced with decisions on organ transplants. I created a short (6 question) online survey at: http://www.surveymonkey.com/s.aspx?sm=f_2b3YnTItZx9ACmKLG_2fSerA_3d_3d

I am collecting as many responses as possible in a short period of time. I will need to close the survey on Feb 1, 2009. If you or anyone you know has ever had to face the difficult choice in deciding on an organ transplant clinic, please take my short survey, and share with me and others in your experience!  

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