stem-cell therapies might end the need for transplants, but that’s a very long way off, and people die in the meantime

Well if the gov would put money into research that had a future(IE Adult over Embryonic) . . . .

- The Cat

“A government system would also get built in a “blind” method, where donors and recipients never meet or know each other’s identities, to avoid the appearance of the rich buying organs from the poor.”

The only blind people here will be donors, recipients and almost anyone who might otherwise be in a position to question the political bureaucrats who will be screening and tracking both sides of the equation as well as prioritizing, and very likely means and age testing, the list of who gets what, when, where and how — the least of which may be deciding who gets cadaver kidneys and who gets live donor kidneys.

It’s entirely possible that those maintaining on dialysis could end up waiting 7 years regardless, or that anyone whose first transplant failed would end up at the back of the line on a secondary list. Would intra-family donations be subject to regulation as transactions? Almost any transaction can now be subjected to the federal dictates of interstate commerce, of course, and the step between incentives and compulsion is very small.

When it comes to exploitation, whom do you envision all these potential live donors to be? Do you really think those who are financially comfortable will be lining up in any numbers to sell their organs? I’m sorry to be blunt, but do you believe your friends would have put their kidneys up for sale to recipients they didn’t know? What about parents who might want to offer up the kidneys of minor children — for the good of the family?

That’s just a 2 minute start on the questions that occurred to me once I got over recoiling from the prospect of commercializing the sale of body parts. In this reduction to cost/benefit analyses, has the enormous cost of running dollars through the federal government really been factored in? Have you included every conceivable kind of litigation which might arise? Because it will. When we abandon altruistic donation, we will reach a host of unanticipated moral, legal and political questions sooner rather than later.

Ultimately, the sheer mass of both enabling and preventive regulation, and of subsequent government rule-making, management and oversight, will reach nightmarishly byzantine and inevitably political heights. Even from a financial perspective alone, I believe we would be far wiser to pour such resources into promising research. Alas, where government is concerned, we must confront the searingly difficult questions of financial triage, which includes measuring the relative value of kidney transplants against other forms of intervention. Where lives hang in the balance, there are no painless answers.

I had a friend, recently deceased, whose Chinese wife refused to donate his kidney-when they took him off life support- because his political views on this subject were well know. I have instructed my Japanese wife, if the opportunity arose, not to donate my kidneys-not because a rich liberal, black or Hispanic will get it but because ONLY a rich liberal, black or hispanic will get it. (PS, as you can imagine, the lion’s share of these donations will, ironically go to rich white liberals.)

Thus I would favor some sort of remuneration to the living donor or to the donor’s estate-and perhaps to some specific recipient- to avoid the Sotomayorization of kidney transfers.

We can still have the government list for the folks who can’t afford a kidney or who want to wait for an altruistic donor kidney.

If more kidneys are widely available, more people would be willing to donate or sell them. How many people are reluctant to donate incase a loved one needs the kidney later.

His bills are unreal and her family was left with nothing. One would think that if a person helps give life and helps the doctors make money, then yes they should compensate the family. Now my friend has to file bankruptcy. She got a letter letting her know that a woman, got his lungs, another got one kidney while another young girl got his other kidney. That is not all the parts that can save lives. Would help a lot of people if they would do this. There has to be a better way than Nationalizing health care.

sheebe on May 29, 2009 at 10:18 AM

God bless your friend and her family.

If God does exist, I suspect He’ll reward her mightily someday for what seems so unfair now.

I think that’s telling. People who have had to go through this terrible situation are willing to face the worries of slippery slopes to make sure that others dont have to suffer the way they did.

If your spouse or child was lying in a hospital about to die, would you refuse a life-saving kidney if you found out that the donor had been paid?

But the industry will indeed be drawing principally upon the “dregs” for live organs, and a prime guarantor of the health of a donated live organ (the altruism of the provider) will be absent.

unclesmrgol on May 29, 2009 at 11:25 AM

I’m no expert, but I’d think the prime guarantor of the health of a donated live organ would involve health tests. Someone could appear to be healthy (ie not be a member of the “dregs”), yet still not truly be healthy. I presume you wouldnt call Ed Morrissey a member of the “dregs”, but health tests determined that he was not an eligible donor.

That said, you make a valid point. I just dont think altruism is the prime guarantor of organ health.

Sorry, everything is marketed somewhat. It can be done right and make a huge difference.

Mr. Joe on May 29, 2009 at 9:37 AM

Excellent point. As this is a right-leaning blog, I would think that most folks here would be for a free market with limited governmental intrusion.

So government will pick up the tab and selling will be based on an anonymous and approved need list.

clnurnberg on May 29, 2009 at 11:07 AM

So if I have a kidney that is in short supply due to some special qualities is the government going to negotiate with me? Are they ging to develop a price list offering a base price for a common kidney and a premium for one with just a few years on it? If I’m entitled to “sell” my organs why shouldn’t I get top dollar for them?

My hope is that someday relatively soon, cloning technology will advance to the point that we can grow needed organs in a lab. Perhaps another word would be better for this sort of technique, as “cloning” tends to scare people.

But even if that happens (and that’s a big “if”, considering the technological and political obstacles), it’s several years off.

For now, I dont see why we shouldnt allow payments for organs. It’s your body; you should be allowed to decide what you do with it. People sell their hair to wigmakers (or donate it to cancer-related charities). People sell their blood as well. Granted, these are renewable and kidneys are not, but in my opinion the same priciple applies.

Obviously safeguards would have to be put in place to ensure that the “woke up in a bathtub full of ice” story remains an urban legend. And probably that could be mitigated somewhat by ensuring that the payout for a kidney would be large enough to be an incentive, but small enough so that it’s not worth it for a black market. (5 or 10 thousand is a lot for a person, but not necessarily enough for the black market, considering all the risks and the number of people who would have to be paid to make it work. For one thing, you’d need a surgeon to take out the kidney, and they likely wouldnt sell their services on the black market cheaply.) And frankly, in this day of DNA testing, it shouldnt be too difficult to make sure that the person who claims to have given a kidney is telling the truth.

There are slippery slope issues and potential for horror stories, but I think this is the right way to go.

When I look at all the rcent stories of people killing their children, I just see paid donations as an incentive to do this MORE often and more cleverly.

Also I imagine people will be pressured to sell.

What will the legal age of consent for this be?

Every surgery, even one to “harvest” an organ entails risks and pain. Young people eager for cash are not good judges of risk, even short term risk, and I’m not sure that they can look down the road and see that a kidney given today cannot be given to a child down the road or might be needed in the event of an accident or disease down the road.

Those who participated in the once-legal sale of blood tended to be drug users, alcoholics, and others who had no steady employment. One would have expected the industry to assure the quality of what it provided, but it did not, and as a result, thousands of recipients of sold blood contracted AIDs through their transfusions.

Recently, the LA Times ran a story on the sale of donated cadaver body parts:

The conspiracy was uncovered when a state health investigator grew suspicious that Nelson was fraudulently claiming that the parts had been screened for infectious diseases before selling them.

Perhaps my use of the word “shouldn’t” is too strong. But the industry will indeed be drawing principally upon the “dregs” for live organs, and a prime guarantor of the health of a donated live organ (the altruism of the provider) will be absent.

different concerns have changed my mind, particularly hospitals where employees jump the gun.
maverick muse on May 29, 2009 at 10:57 AM

It’s absolutely your choice whether to put the “donor” info on your license, and I agree with some of what you say. This quote, though, I don’t see.

I’ve been pretty close to the process in more than one hospital, and at least in my experience, employees “jumping the gun” just doesn’t seem to happen. If you have any concrete examples, I’d be happy to consider your concerns.

Rich man needs a kidney, He can afford to pay for it

Poor man needs a kidney, He doesn’t have the $$ to buy one.

katiejane on May 29, 2009 at 11:03 AM

Solution: Tax Middle Class into extinction so there are only rich governing classes and impoverished, unheard classes…