Tuesday, December 02, 2008

Politics and Organ Donation

Senator Arlen Specter (R-Pennsylvania) is circulating draft legislation called the Organ Donor Clarification Act. The bill would make clear that federal law does not forbid states from sponsoring non-cash incentives for organ donation. Such incentives might include tax credits or health insurance for living donors, or funeral benefits for deceased donors.

I have skin in this game – literally. In the summer of 2007, I donated a kidney to an in-law. We’re both doing fine, but many others are not. Over 100,000 people are on the waiting list to receive an organ, more than three-quarters of whom need a kidney. Some of them may die before their names come up. The proposed legislation would save make it easier for them to get transplants.

A 1984 law, the National Organ Transplant Act, forbids trafficking in human organs. Although its language is unclear about noncash incentives, most state officials think that this law prohibits them. Recognizing widespread concern about the marketing of body parts, Senator Specter’s bill keeps the ban on organ sales. It merely clarifies that the government may lawfully provide non-cash incentives to honor and reward organ donation.

The American Association of Kidney Patients backs the measure. Curiously, the National Kidney Foundation opposes it. The Foundation says: “Providing any form of compensation for organs may be an affront to the thousands of donor families and living donors who have already made an altruistic gift of life and it could alienate Americans who are prepared to donate life-saving organs out of humanitarian concern.”

To that statement I reply: “Not in my name.” This living donor most certainly does not regard the proposal as an affront. I think it’s a great idea.

For me, donation was relatively easy. As a college professor, I had plenty of free time during the summer. (The old joke is that the three best reasons to join academia are June, July, and August.) For several weeks after surgery, a donor must limit physical activities. But those limits hardly affected me at all. Academic research is not exactly strenuous, especially in the era of the Internet. I was surfing the Web within 24 hours of the operation.

Other would-be donors have a tougher time. Studies have found that most living donors worry about financial consequences of lost worktime, childcare, job security and future health insurance coverage. Even when insurance covers the surgery itself, a donor’s out-of-pocket expenses may run into the thousands of dollars. (In my case, for example, preliminary tests required several flights to the hospital where the transplant would take place.) Such concerns keep many potential kidney donors from going through with the surgery.

Even modest noncash incentives could counterbalance some of these concerns and encourage many people to donate. The Specter bill would save lives.


Arbitrista said...

I think this is an extremely dangerous area. I'm not closed to the idea of noncash incentives, but I worry about how easily any such incentives could be made equivalent to cash, creating a pseudo-market in organs that turns poor people into organ farms.

Dave said...

Here is a non-cash incentive that is already legal -- allocate donated organs first to registered organ donors.

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.

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.

Doug said...

Anyone who needs a kidney (or whatever) is unlikely to be healthy enough to be considered for donation of his or her own organs. Forcing him or her to register as a donor at that point would be no big win for others in need...

Anonymous said...

I am a recent recipient of a kidney that was donated by a friend. I was at Stage V of kidney failure, perhaps months shy of requiring dialysis. I feel like the luckiest man alive.

My donor and I are interested in promoting the concept of live kidney donors receiving college tuition credits in return for their donations (along the lines of Obama's plans for national service--Peace Corps or military service--resulting in a 'free ride' through college). In order to qualify, the donor would have donate to whoever was the best match (not a friend or relative). In other words, it would be an anonymous donation, though donor and recipient could be put in touch with one another.

Consider that a kidney transplanted before a recipient needs dialysis will sidestep years of decreased productivity on the part of the recipient. Not to mention preventing years of physical PAIN, malaise, dietary restrictions, the cost of blood tests, blood pressure (and myriad other) medications, and, of course, the time, cost, and unpleasantness of dialysis itself!

So from both fiscal and moral perspectives, this is a NO BRAINER.

We've dubbed our campaign KIDNEYS FOR COLLEGE. If roughly 1000 colleges around the country could offer an average of five scholarships each (based on size, with perhaps some subsidies from the federal govt), the waiting list for kidneys would be down to nothing in six to eight years. Then it would just be maintenance for new kidney patients........

Please visit our blog & join in the conversation (kidneytwin.wordpress.com).