Savor this, because it's a rare moment of total agreement between me and The Weekly Standard, but our organ donation system is totally fucked up. It's just stupid, it's deadly. The medical community has adopted a bizarre stance of non-interference in the organ line. Here's the scenario: you have kidney failure, dialysis twice a week. Dialysis is soul-crushing stuff; hours hooked up to a machine as it cleanses your blood of poisons your kidneys aren't discarding. It's tough on your heart, bad for your life expectancy, rough on your spirit. None of your friends or family provide a kidney match, but a newspaper reporter hears of your plight and writes an article. A stranger comes forward -- she's compatible, and willing to give up the kidney. And then you get a call: the hospital won't do the transplant, it's official policy to refuse those attempting to subvert the waiting list.
Right now, most organs come from cadavers. There's no incentive structure for the average person to donate body parts. It's not that giving up a kidney hurts you, but since all you get is the warm and fuzzies, might as well keep yours close. We've stupidly disallowed payment for organs (if money can't buy you life, why keep it around?), a market that would do nothing to subvert the current cadaver-based waiting list, but would take quite a few wealthy folks off the rolls. Worse, some hospitals have extended that prohibition to organs located through publicity. A donation, if given through a friend or relative, is perfectly kosher. According to Arthur Caplan, a bioethicist at the University of Pennsylvania, "web-based donation and ads
amount to a "high-priced begging campaign," and he disapproves. After all, he says, such efforts comprise an "attempt to subvert the waiting list."' Can't have that.
Ben Hippen, a transplant nephrologist, gets the last word: "A commitment to equal treatment is key to maintaining our patients' trust," Hippen says, "but if recipients view the waiting list as simply an equal opportunity to die, we will lose that trust, and deservedly so." Organ markets and digital begging campaigns may be a bad solution, but they're better than the current regime. In this case, the perfect is being made the enemy of the patients.
