Team Members: Nicholas Casalbore, Seth Elder, Matthew Sumpter

Advisor:

Topic/Audience: The U.S. Organ Shortage

Executive Summary

Under the current organ donation system, as defined by the Uniform Anatomical Gift Act of 1987, the National Organ Transplant Act of 1984, and the Omnibus Budget Reconciliation Act of 1986, no financial incentives may be legally offered for transplantable organs. We believe that this effective ‘zero price’ for organs has drastically limited the potential donor pool. We therefore propose in the Organ Procurement Act of 2005 to allow financial incentives to be offered in exchange for cadaveric organs. In order to maximize the effectiveness of this system, we also propose a system of ‘mandated choice’ when documenting one’s wishes about organ donation; we also propose that a National Organ Directory - a database containing information about all current donors - be established.

Legally, this new plan helps to eliminate the ambiguity caused by the current “Check Yes” documentation system for organ donation. With mandated choice, upon turning 18 an individual will be presented with a simple “Yes” or “No” decision; their wishes will be documented and available to firms and hospitals through the National Organ Directory.

Through economic analysis we explain how, by offering a financial incentive, the supply of organs will increase dramatically. For-profit firms would be allowed to offer pre or post mortem benefits in exchange for the rights to harvest organs upon death; this incentive will encourage more individuals to allow their organs to be transplanted.

By ethically analyzing possible flaws in this system, we show that counter arguments are based on flawed assumptions or needlessly extreme situations, and are therefore not applicable to our proposal; we explain how such issues as “commodification of the body” and “substandard patient care” do not provide strong enough arguments to outweigh the benefits of an open market procurement system.

An illustration of how such a system may actually work begins with a potential donor agreeing to allow their organs to be harvested upon death; with laws prohibiting financial incentives being repealed, firms such as medical insurance companies would be poised to enter the market. Insurance companies would offer a donor lower premium rates in exchange for the rights to their organs after death. Upon the death of an individual, the insurance company would be contacted by the hospital, harvest the suitable organs, and then locate a recipient using the National Organ Directory and the United Network for Organ Sharing “waiting list.” The costs of the organ would then be passed on to the recipient.

Such a system, which allows much more individual choice and personal autonomy, would no doubt be a tremendous improvement over the current system. Through ethical, legal, and economic analysis we show that an open market for organ procurement, specifically outlined in the Organ Procurement Act of 2005, is essential in the fight to save lives.