Sounds Good, But How About Really Helping?
The October 16, 2006 issue of US News and World Report had an interesting article titled "Mix, Match, and Switch". It is about "kidney exchanges" -- a system where someone who needs a kidney and has a friend or relative willing to donate -- but who is not a blood/tissue match -- are paired up with another two people in the same situation, such that the two donors will match for the two people in need.
Because this can increase the number of kidney's available by getting more people to be live donors, it seems like a really good idea. The article notes that kidneys from live donors are nearly twice as good as those from cadavers (based on acceptance after five years). And there are so many people in need... some 67,962 on just the United Network for Organ Sharing list.
But so far this approach has been quite limited, with only 109 such swaps occuring since the first one in 2000. Why one might ask? Because to do this efficiently and on a grand scale you would need a national database of people in need of donations -- with their blood and tissue types -- and the paired individual they have located and their blood/tissue type, so that a search could be done to match the foursome together. But because an exchange of kidneys like this is considered an exchange of something valuable (duh! a working kidney)... you guessed it... it is against the law. Or at least it is very questionable, according to the ridiculous 1984 National Organ Transplant Act. This ban says that exchanging organs for "valuable consideration" is a criminal act.
As the article notes, earlier this year Democratic Senator Carl Levin of Michigan introduced a bill to eliminate the legal murkiness, by simply adding a line to it that makes explicit that it doesn't ban paired donations.
So adding that to the 1984 ban sounds good to me... at least at first. If it means a national database could be created to match pair-exchange foursomes, that would ease a lot of suffering and save lives. But I just hope that doing so wouldn't prolong any further the current kidney donation regime that bans "valuable consideration" (i.e., payment) being given to live donors. Because even if we magically had tomorrow a robust national database with data for pair-exchanges, you still need to find willing donors. Giving people financial incentive to donate a kidney -- either while alive, or at death (their families get the payment) -- is what would really open the floodgates and do the most good. Think of how much suffering could be stopped and how many lives could be saved if this ban were repealed!! And don't just think about when you are the one needing the kidney... think about it now!
If done correctly, rights could be well protected (such as the rights of the poor or anyone else that might be 'taken advantage of'), as opposed to the current ban which denies rights to everyone involved -- potential donors and those in need of the organs -- to make voluntary, freely-negotiated value-exchanges.
See also my blog posts earlier this year on the need for a market for organs here, then here, then here, then here.
Labels: health_care, individual_rights