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Blog of Adam Daifallah -- author, journalist, law student. Lover of politics, writing, golf, curling, fitness, fashion, bacon and maple products -- not necessarily (but probably) in that order. Partisan of the Anglosphere. Contact me via email at adam@daifallah.com. This summer I am joined by Keir Wilmut and Omar Soliman.
Friday, August 03, 2007
Let's have a two-tier system for organ transplants
Following BC’s lead, Ontario is going to begin reimbursing living organ donors for donation-related expenses. It’s a move in the right direction, but nowhere near far enough: Canadian provinces should adopt a two-tier system for organ transplants – but the tiers shouldn’t be based on the ability to pay.
Canada suffers from a fundamental organ transplant problem: simply, not enough people are donating organs. Although more than 3,700 of us are on a waiting list to receive an organ, fewer than 14 Canadians per million have donated an organ. As a result, 147 Canadians died last year because a suitable organ was not available in time.
Altruism, it seems, isn’t enough to motivate people to sign their donor cards.
Under the new program, Ontario will reimburse up to $5,500 for any pre-approved travel, accommodation, food, or lost income expenses.
But living donors can only provide kidneys and livers - no help for those waiting for a heart or a lung. Such programs also don’t offer much of an incentive; if you aren’t currently willing to donate one of your kidneys, would a $5,000 stipend to cover some of your wages lost while recuperating change your mind?
Some have gone even further, arguing that Canadians should be able to pay out of their own pocket to buy organs from living donors.
Again, this would only help those in need of kidneys or livers. More problematically, it would establish a two-tier organ transplant system. In a country where paying to see the doctor faster when you have the flu is seen as incompatible with our national values, there is no chance that the trade in organs will be legalized. Rich Canadians would not just be buying better health care than the poor, they would literally be buying the health of the poor.
A better solution would be to introduce a two-tier organ transplant system where the tiers are based not on ability to pay, but rather on willingness to donate.
Under such a system, a patient in need of an organ transplant would be placed in one of two queues: if she had previous signed an organ donor card allowing her organs to be harvested in the case of her death, she’d be placed in a priority queue. If she had not previously signed an organ donor card, she’d be placed in a secondary queue. Those in the secondary queue would only receive an organ donation if the organ was incompatible with everyone in the priority queue, or if the person in the secondary queue was on the verge of death and everyone in the priority queue could safely wait.
Such a system would have three benefits. First, it would dramatically increase the number of organs donors, and hence the number of organs that could be harvested. We’d no longer be relying on altruism to get people to sign an organ donor card; instead, people would register to be an organ donor so that, if they ever needed an organ transplant, they’d be at the front of the line.
Second, it would avoid both the public cost of having the government pay the expenses of donors, as well as the extreme moral questionability of letting the rich harvest organs from the poor.
Finally, this system is fair: if you are unwilling - for moral, religious, squeamishness, or any other reason - to donate your organs after your death, you shouldn’t be permitted to receive an organ before someone who is willing.
Organ donation is the gift of life. This gift should be first given to those who have demonstrated a willingness to give it themselves.
# posted by Keir Wilmut : 2:43 PM
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