Should we be able to sell our organs? (http://www.nytimes.com/2006/07/09/magazine/09wwln_freak.html?ex=1155268800&en=6f3d817cf4fffe60&ei=5070)

A Freakonomics article about getting more people to offer up their organs for people who need them.

This article didn't quite go as far as I thought. I figured it would talk about ideas like giving money in return for your cadaver. Sort of like life insurance, but you have to give up the corpse.

Should we be able to sell our organs?
I pretty much agree with the economists they quoted: "monetary incentives would increase the supply of organs for transplant sufficiently to eliminate the very large queues in organ markets, and the suffering and deaths of many of those waiting, without increasing the total cost of transplant surgery by more than 12 percent."

That said, I would still opt to donate mine after I'm dead.

I'm not sure we want people to be worth more dead than alive.

I'd rather make all organs available for donation after death and let people freely opt out of that system.

I'm not sure we want people to be worth more dead than alive.

I'd rather make all organs available for donation after death and let people freely opt out of that system.

I agree.

In Canada (and I presume the U.S.), you have to actively indicate that you wish to donate your organs on your death. It's an exercise that most people don't bother with. I prefer defaulting to organ donation unless you actively opt out.

Do blood donors get paid in the U.S. and Britain? In Canada they don't (which I agree with). Regularly donating blood is an unselfish, feel-good activity which I look forward to.

No, you don't get paid (any longer) for blood donation. They got people donating blood who had nasty IV drug habits and such when they did.

I'm not sure we want people to be worth more dead than alive.
I thought that at first too, but then I realized that we usually are anyway what with our beneficiaries on our life insurance policies and 401k's and so on and so forth.

But in lieu of selling your loved one's corpse, I agree it should be an opt-out, not an opt-in.

I'm not sure we want people to be worth more dead than alive.
If it leads to more organs being available then more people will have a chance to stay alive. Also, you can donate some organs without being dead.

I'd rather make all organs available for donation after death and let people freely opt out of that system.
That's a good idea too but it doesn't have to be an either/or scenario.

I think there's a good argument to be made for allowing people to rent organs but that's another discussion. :)

I think there's a good argument to be made for allowing people to rent organs but that's another discussion.
*snort* Yeah, but they're usually left attached.

I just saw a medical show the other night where they left the old heart in an old dude with a bad ticker, in addition to giving him a new heart. I guess the old heart is supplying the lungs with blood and the new one takes care of everything else. Pretty amazing. They had to daisy chain the hearts together.

Personally,

I think that the status of not allowing the sale of one's organs is unethical on two fronts.

1) It is my body and I should be able to do with it as I chose.

2) The artificially mandated deficit of supply of organs.


All of the objections to selling organs can be overcome with either existing laws(ex: killing your wife to sell her liver is already illegal) or with new ones to address them.

There is a growing movement and attempt to change public opinion on this matter. I have even seen John Stossel selling this new notion. Great Job John!

We need to get more healthcare professionals involved with this campaign, get some money behind it in order to provide professional persuasion techniques in place....Do It For The Children!.

That would be an ideal place to start(all sarcasm aside), for the ratio of children donors to children recipients is the most out of whack.

The amount of usable organs that go to feed worms(or turned to ashes) is insane!

I agree it should be an opt-out, not an opt-in.Do you really want your doctor to be thinking about your "gold mine" of organs when he's trying to save your life?

That said, I too agree we should be able to sell body parts -- blood, organs, eggs, sperm, and so on, so long as it's a rational and voluntary decision. There's already a black market for such things; why not bring it out into the open?

We might get a bidding war at the beginning, temporarily stalling the supply of organs, but in the long run, there will likely be a huge glut, bringing the price down to affordable levels. Perhaps the pope can even say a few words, blessing such an action, to encourage the religious zealots to join in. Then, instead of waiting years for a transplant, a patient could get an organ easily on the open market.

Organ donors might also feel more comfortable if they were able to negotiate with, and choose, the recipient. I surely wouldn't want my organs to save the life of someone I'd rather see die.

I'm not sure we want people to be worth more dead than alive.

Well a living person is worth nothing, right now.

Second, I don't want you(or people with your opinion) speaking for 'we' or me.

Do you really want your doctor to be thinking about your "gold mine" of organs when he's trying to save your life?
I'm not quite getting where you think the doctor would make any profit on it.

I'm not quite getting where you think the doctor would make any profit on it.

They don't now.

There is a clear division between healthcare providers and the donor decision process and team now. That should not change.

The donor team does that, and that is an outside organization, from our hospital at least.
http://www.ctdn.org/

I'm not quite getting where you think the doctor would make any profit on it.If the doctor can save 5 people in his hospital with your organs, he might be less inclined to save <i>you</i>, particularly if you're in bad shape. They wouldn't profit directly, monetarily. But they would do more business, and have a high cure rate, which benefits them in the long run.

The donor team does that, and that is an outside organization, from our hospital at least.
http://www.ctdn.org/The donor team and the hospital have the same incentive, to harvest organs, so it doesn't really matter if they're independent. There needs to be someone on the patient's side, someone whose incentive is to save the patient in spite of the organs.

The donor team and the hospital have the same incentive,
Not at my hospital. Until a patient is brain dead.

to harvest organs, so it doesn't really matter if they're independent. There needs to be someone on the patient's side, someone whose incentive is to save the patient in spite of the organs.
The donor team does not even speak to the patient's family until the patient is brain dead.
The question of donation is not even brought up, until a patient is brain dead.

Why would that be any different than it is now?

Besides Advanced Directives are commonplace and DNR decisions are made all the time, currently. This would be no different.

The question of donation is not even brought up, until a patient is brain dead.Not all patients arrive at the hospital brain dead. The acts of the doctors in saving the patient will affect how many end up that way. If the doctors know they have a carte blanche to harvest organs, and patients needing them, they may be less zealous.

Aren't transplant lists regional or national? So if you die in one hospital the organ will probably end up somewhere else. Besides, if I'm under a kidney doctor's care and I die, chances are I died of a kidney disease and this particular doctor isn't going to want my diseased old kidneys. He isn't a heart surgeon, so he is not going to make any money off my heart.

I don't know who does the harvesting but I doubt it is the same person who does the transplant.

If the doctors know they have a carte blanche to harvest organs, and patients needing them, they may be less zealous.

I work in ICU right now.

I just don't see what you are talking about happening now, with the existing donor system vis a vis patient healthcare and welfare.

At one time, before I had this experience, I might have agreed with your pessimism. I have seen the donation process in action. Doctors do not have carte blanche with anything, really. I can tell you that the role of patient advocate is very, very strong with every nurse I have encountered. And ICU is in a high mortality department. And despite any rhetoric I have on this board, patient advocacy is VERY strong with me.

If monatary motivation is your problem, the hospital makes WAY more keeping a patient alive than they would in your scenario of the time and labor of harvesting viable organs. Especially ICU. The bed alone makes the hospital 5K a day, irrespective of any treatments. TPN(pharmaceutical grade 'food' that goes directly into bloodstream) can run 2500 to 5K a day alone.

No, your objections are certainly valid to a degree, but misplaced. Concerns about familial motivations would be more obvious. Especially with divorce parents with split agendas regarding children. That would be more valid of your scrutiny.

I have encountered that already. Estranged parents of an adult child(never married) had split agendas regarding DNR. Mother wanted "limited" lifesaving, father wanted full. He became "full code", all life saving measures were to be taken.

I don't see hospitals or doctors(surgeons) profitting at ALL from organ selling, other than by decreased mortality of organ transplant recipients. They would obviously make more from recipient patients, of course. But any patients willing to drop 50K(or whatever) for a new liver or heart can afford the surgery anyway; we are afterall talking about a liver which would NOT otherwise be donated btw.

I also am making a judgement that most people who donate now will continue to donate(as in gratis) organs, to those who can not afford organs. That goodwill exists now, and there is nothing to suggest that it will vanish or wane.

Not all patients arrive at the hospital brain dead. The acts of the doctors in saving the patient will affect how many end up that way.

Increased Intra Cranial Pressure is going to kill a brain probably moreso than other direct forms of damage.

And that can be a slow process.

A the skull is a closed box with a hole in the bottom, and if you keep piping in more blood(or other fluid) into that space, it will push the brain down into that hole.

Where that hole is, is also the part of the brain where all of your base bodily functions(breathing, heart rate, temperature regulations, etc) are integrated.

Very few hospitals have the staff to be able to monitor, let alone actively alleviate increase ICP. Mannitol, which works as a diuretic of the brain, pulls fluid out of the cranial space. And helicoptoring the patient to Stanford is about all my hospital can do, anyway. We don't have Neurosurgeons(brain surgeons) on staff.

We recently had a young man(30s) who formed a clot in his carotid artery. Fully occluded, like a golfball wedged in your garden hose. Half his brain died within minutes. He donated 12 organs. I bet his new young wife and his new baby daughter could have used a little financial help from his otherwise charitable and gracious donations.

I saw something about a ermgency room doc at a small hospital in Aus. drilling a hole in the skull of a kid who had a brain injury from a fall. He had a neurosurgeon on the phone from a big hospital hours and hours away. He basically had a hand drill (not electric) and drilled through the skull trying to find where the bleeding was. His first hole didn't get the spot, but the 2nd hole did. It relieved the pressure and the kid, who was very close to death, survived without permanent brain damage. Pretty dang lucky kid.

If monatary motivation is your problem, the hospital makes WAY more keeping a patient alive than they would in your scenario of the time and labor of harvesting viable organs. Especially ICU. The bed alone makes the hospital 5K a day, irrespective of any treatments. TPN(pharmaceutical grade 'food' that goes directly into bloodstream) can run 2500 to 5K a day alone.Are you speaking of cost, or profit? Also, if the ICU is typically full anyway, they'd likely find others to fill the space, so there's no lost profit.

On the other hand, if they can perform 5-10 expensive organ donation surgeries, that's a definite profit, assuming the procedure is inherently profitable. They will also earn more good will, assuming they do a good job.

I'd be interested to see what's more profitable -- just keeping a patient in a holding pattern, or performing procedures. My guess would be the procedures.

I don't know who does the harvesting but I doubt it is the same person who does the transplant.I'm not suggesting <i>that</i> close a connection.

Let's say you work for a company that has a portfolio of clients, all of whom are equally important to the company. You don't directly profit from each client, but successes on your part improve your image and profit your company, which indirectly profits you.

Now you're faced with a scenario where you can make 5-10 clients happy, while disappointing one, or doing the reverse. You'll likely choose to disappoint the one.

On the other hand, if they can perform 5-10 expensive organ donation surgeries, that's a definite profit, assuming the procedure is inherently profitable. They will also earn more good will, assuming they do a good job.

I don't know from first hand experience on organ removal...But I just can not assume that it is expensive inherently. You don't even really need an anesthesiologist, I suppose. You don't have to worry about dozens of things with full code patients, once the organs are harvested.

And it has to be done already for donations.

I am getting from you that you think that doctors will somehow get a percentage of the selling price(for lack of a better term now) of the organ. I can't see how that would take place. I would strongly advocate against any kind of 'kick back' with my support.

My only motivation for my stance is that it will save many, many more lives than currently. And providing my own organs are usable, it might get my Dad a trip to Cancun if I stroke out(sooner than later).

My hospital is non profit, like many are. Much of the loss is amortized by the government anyway. My hospital, with no passing to gov. or insurance cos., eats about 6Mil per year is what you might call charity cases.

I see no problem with hospitals gaining good will. That is a good thing.

I guess it would be a good thing to research how much it costs to harvest organs. I will ask tomorrow.

I don't know from first hand experience on organ removal...But I just can not assume that it is expensive inherently.What about organ implantation? Organs are highly perishable, and assuming the hospital were properly equipped, I would expect the operation to be performed there.

http://abcnews.go.com/Health/story?id=1514702

Need an Organ? It Helps to Be Rich

Interesting little article.

I could not get an answer yesterday as to how much it costs to remove organs for transplant.

Anyway the point of the article is that as many as 25% of donors are uninsured, yet because they are uninsured they would have realistically found it impossible to ever have been a recipient themselves.

http://www.cpmc.org/advanced/liver/patients/topics/finance.html#Transplantation%20Costs


Estimated First-Year Charge (1996 dollars): $314,600
Estimated Annual Follow-up Charge (1996 dollars): $21,900

That is for a liver.

What about organ implantation? Organs are highly perishable, and assuming the hospital were properly equipped, I would expect the operation to be performed there.

Transplants rarely(to the point that I have never heard of a case) take place where the donor and recipient are at the same hospital.

I don't see that ever changing.
There are only like 250 or so hospitals which can do the implantation. Donors come from all over the country. Any surgical hospital could potentially be a donor hospital.

The biggest problem I see with your reasoning, Tuda, is that if doctors are motivated to remove organs prematurely in order to make boatloads of money doing transplants, then that incentive exists regardless of whether the donor (or his/her heirs) is paid or not.

I seem to recall when the donor organ movement was young there was a lot of paranoia about that.

I imagine most of the ethical problems from selling transplant organs will surround the donor and recipient rather than the doctors.

If you are selling it, you really are not a donor, I suppose vendor may be closer to what is occuring.

The biggest problem I see with your reasoning, Tuda, is that if doctors are motivated to remove organs prematurely in order to make boatloads of money doing transplants, then that incentive exists regardless of whether the donor (or his/her heirs) is paid or not.

I seem to recall when the donor organ movement was young there was a lot of paranoia about that.

I see his reasoning to a certain degree.

If the amount of organs that are available quadruples(conservative estimate), that means that there will be 4 times the procedures done.

Meaning more money for doctors. Just because there will be more surgery hours available.

The ethical problem with that is that, those people (who would be new recipients) just happen to be dying right now.

Do you object to doctors and nurses making money off of the procedures that they do, when it means that more people actually live because of those procedures?

Denying someone from living is a awfully high price to pay to deny someone from making a living, to prevent 'some' surgeons from hanging out a shingle and implanting organs.

I mean surgeons do that already, evenn with a gall bladder removal(or any other mundane surgery). They ARE, afterall, making their money off of sick, dying, and usually poor people. They just happen to be saving lives while they are doing it.

Estimated First-Year Charge (1996 dollars): $314,600
Estimated Annual Follow-up Charge (1996 dollars): $21,900
That is for a liver.It's ironic that you pay $315K+ in labor and $0 in parts, when you consider that the key element in the procedure is the part, not the labor. (Well, I suppose you pay a little for <i>some</i> parts, like fluids, medical devices, and medications, but that's a small number.)Denying someone from living is a awfully high price to pay to deny someone from making a livingWhat about denying the organ <i>donor</i> the right to the most zealous and aggressive treatment? The bigger the organ implantation business, the greater the incentive to extract as quickly as possible. And the donor still gets nothing in return. He can't even have a warm and fuzzy feeling, because he's brain dead.

If the doctors know they have a carte blanche to harvest organs, and patients needing them, they may be less zealous.

If the doctors don't even know if the patient in question has or doesn't have an opt-out-card until the patient is brain-dead I don't really see the carte blance here..

(god, agreeing with fyyr.. there's a first..)

I think it's all rather hypothetical to discuss this given that we don't know how any payments would be made. If a government was to offer a fixed reward to the families of a deceased donor then that would have less ethical implications than a free market in body parts.

Then again, that might face religious problems. Whilst a religion can't object to every individual's plans for their own corpse, they can object to a government policy that pays people to 'desecrate' their own corpses. Oh well.

If the doctors don't even know if the patient in question has or doesn't have an opt-out-card until the patient is brain-dead I don't really see the carte blance here..Inaction is far more common than action. Very few will take the trouble to opt out (or even be aware of it), meaning you can assume the organs can be harvested.

If a government was to offer a fixed reward to the families of a deceased donor then that would have less ethical implications than a free market in body parts.Why? I think it would be even <i>less</i> ethical, because people with sub-standard organs (typically correlated with poor people and minorities) will have an artificial incentive to donate. A free market removes this incentive.

Not to mention, why should the taxpayers be susidizing organs? If you need a transplant, you should be the one paying for it. In many cases, your negligence is the reason for needing a transplant in the first place.

Inaction is far more common than action. Very few will take the trouble to opt out (or even be aware of it), meaning you can assume the organs can be harvested.

I've read this several times, and I can't figure out why that is a bad thing from your point of view. If people don't opt out (regardless of why), there'll be tons of organs availiable. And if there's a truckload of readily availiable organs, surely that'll disuade the otherwise status-hungry, potentially murderous doctors from giving up on people too soon just to get at their organs?

Not to mention, why should the taxpayers be susidizing organs? If you need a transplant, you should be the one paying for it. In many cases, your negligence is the reason for needing a transplant in the first place.

It'll be tax payers paying for it any way you look at it. Either via taxes or via insurance. Don't think for a second that transplants (free, bought or government sponsored) will be paid for by the person needing the transplant. The cost will be shared among all regular people - either from being a regular person who pays taxes or from being a regular person who pays for insurance.

Like pretty much everything else that is (from a regular person's point of view) hideously expensive. :)

And if there's a truckload of readily availiable organs, surely that'll disuade the otherwise status-hungry, potentially murderous doctors from giving up on people too soon just to get at their organs?Even with a 100% consent rate, the demand for organs will outstrip the supply, for a long time to come. In the U.S., there are nearly 100K people waiting for organs, and the consent rate is around 50%.

...sub-standard organs...

That is another reason why we should do this.

Right now harvested organs are near perfect.


I think that there will be(there is right now) marginal, but substantial demand for less than mint condition organs.


If someone was waiting for a perfect DONOR Liver for years.

But the opportunity arose to drop, say 20K, on a less than perfect liver,,,I am sure that many would take that option.

And more importantly, they should ABLE to choose that option.

And then that next perfect donor liver can go to somebody else. There, you just saved an extra life there.

Don't think for a second that transplants (free, bought or government sponsored) will be paid for by the person needing the transplant.If the insurance company pays for the organs, it will also demand to negotiate for them. That means you'll end up getting the lowest quality organ that the insurance company can get away with without being sued or fined. Not good.

More likely, health plans will subsidize a percentage of the cost, as they do now for many extraordinary services, such as going to a doctor that's outside your network. That way, people can exercise their own choices, while still bearing only part of the financial burden.

I see no reason why the person wanting to buy my organs shouldn't have to pay for them too.

If the insurance company pays for the organs, it will also demand to negotiate for them. That means you'll end up getting the lowest quality organ that the insurance company can get away with without being sued or fined. Not good.

Weird.

"You will end up getting the lowest quality organ".

Sound like someone coercing someone into something.

Which is completely the opposite of being able to buy organs, when you can't get them now anyway. How 'increased personal freedom' equals 'forced to do something', I dunno how that jump is made.

You will have more freedoms, not less. No one is forcing anyone to do anything with a rational organ commerce model.

Why? I think it would be even less ethical, because people with sub-standard organs (typically correlated with poor people and minorities) will have an artificial incentive to donate. A free market removes this incentive.


Why? If the government makes a fixed payment after an organ is used in a transplant, why would that encourage a doctor to use a substandard organ? Doctors would still be making the same clinical judgements they are now but with more donor organs available.

Surely in a free market there would be more incentive for people to hide any defects in their relative's organs so that they can sell them for more money?

Isn't this a hideous topic to talk about?

Not to mention, why should the taxpayers be susidizing organs? If you need a transplant, you should be the one paying for it. In many cases, your negligence is the reason for needing a transplant in the first place.

Well in my country the taxpayers would subsidize it and be happy to do so. We don't let people die because they are poor. We even give couples free IVF treatment now, if you can believe that.

We don't want bidding wars for organs. We don't want people to withhold organs from donors because they won't pay, or can't pay enough. We don't want agents charging brokerage fees for matching donors to recipients, and then presumably have agents bucking the market to inflate their commission. It is all very dehumanising.

Well then make laws against those things.

Not the selling of one's organs.

Selling organs would put a relative glut of organs out there, that part is undeniable.

We don't want bidding wars for organs. We don't want people to withhold organs from donors because they won't pay, or can't pay enough.

Well then make laws against those things.

hmm.. how?

If the insurance company pays for the organs, it will also demand to negotiate for them. That means you'll end up getting the lowest quality organ that the insurance company can get away with without being sued or fined. Not good.

Hey, I'm not advocating one way over another when it comes to how to spread the cost here, I'm simply saying that thinking if you open the market up for buying organs the cost will be carried by the patient is naive. One way or another, it'll be spread out and paid for collectively.

Even with a 100% consent rate, the demand for organs will outstrip the supply, for a long time to come. In the U.S., there are nearly 100K people waiting for organs, and the consent rate is around 50%.

No solution to a large problem is quick. That of course, is no reason not to solve the problem.

Why? If the government makes a fixed payment after an organ is used in a transplant, why would that encourage a doctor to use a substandard organ?Fixed government payments (a communist economic model) would encourage poor people with sub-standard organs to participate. In a free market, where price reflects quality and therefore demand, sub-standard goods would be discounted or even eliminated, and there would be healthy (no pun) competition for the prime goods.Surely in a free market there would be more incentive for people to hide any defects in their relative's organs so that they can sell them for more money?Fraud is a possibility in any transaction -- even in your labor agreement with the doctor to transplant the organs. Paying each doctor a predetermined fee, as opposed to a negotiated fee, won't change that.We don't want bidding wars for organs.There won't be bidding wars after the market settles. Organs aren't rare or unusual items. It will be just like any other commodity, such as corn, gas, or steel. The actual price will fluctuate depending on supply and demand, but two producers of a product of equal quality will get the same price. In the end, there will be money changing hands, but everyone will benefit.It is all very dehumanising.More or less so than dying because there's no matching organ available?

There won't be bidding wars after the market settles. Organs aren't rare or unusual items

That is patently untrue. We are only discussing this because of the shortage of donors at the moment.

Fixed government payments (a communist economic model) would encourage poor people with sub-standard organs to participat.

Yes, and more people with good organs. If more people participate the doctors can still make a clinical decision on which organ to use. Why would doctors choose to use the poorest?

(There are a lot of very healthy poor people out there, and very slobbish rich people, btw.)

In a free market, where price reflects quality and therefore demand, sub-standard goods would be discounted or even eliminated, and there would be healthy (no pun) competition for the prime goods

Really? As soon as the decision is taken out of the hands of doctors and put into the hands of merchants, there is no reason why the clinically superior organ will be used. The better marketed organ would be used instead. Allocating organs by price will not match an allocation by need. There are people's lives at stake and you cannot accept a small number of failures to generate a competitive market. A free market would generate more wealth for the donor, but that isn't our ambition here. Making sick people pay more for transplant organs is pretty unethical.

By the time we have convinced Tudamorf we'll have figured out how to grow new organs from cells. :p

Making sick people pay more for transplant organs is pretty unethical.Why?

You've highlighted some of the problems in a free market, all of which can be kept under control with laws, as we do for so many other free markets. But you haven't told me why paying for organs is "unethical," which seems to be your core objection.By the time we have convinced Tudamorf we'll have figured out how to grow new organs from cells.More likely, we'll outsource organs. A country with a lower standard of living, but a relatively large, healthy population (India, China, etc.) could make a fortune. (As for growing organs, that probably won't happen in the U.S. Though we have the superior technology, we have the inferior religious zealots regulating it.)

Why is it unethical to make sick people pay more for transplant organs? To be honest, I'm not sure I can give you any answer if you can't see it for yourself.

Exactly how many non-sick people are in the market for an organ transplant, anyway?

Why is it unethical to make sick people pay more for transplant organs? To be honest, I'm not sure I can give you any answer if you can't see it for yourself.Because if you think about it for a moment, you'll see it's not unethical, just the <i>status quo</i>.

Because if you think about it for a moment, you'll see it's not unethical, just the status quo.

Not in my country. I don't think yours has slipped so low either. Correct me if I'm wrong.

I am sorry that I missed out on the beginning of this conversation, have been off for a couple of weeks and am just now catching up on everything. I have to say that it is always good to talk about organ donation, because it helps people to understand what the real problems are.


Why? I think it would be even less ethical, because people with sub-standard organs (typically correlated with poor people and minorities) will have an artificial incentive to donate. A free market removes this incentive.


<O:p</O:p

If someone was waiting for a perfect DONOR Liver for years.

But the opportunity arose to drop, say 20K, on a less than perfect liver,,,I am sure that many would take that option.

And more importantly, they should ABLE to choose that option.

And then that next perfect donor liver can go to somebody else. There, you just saved an extra life there.

<O:p</O:p

If the insurance company pays for the organs, it will also demand to negotiate for them. That means you'll end up getting the lowest quality organ that the insurance company can get away with without being sued or fined. Not good.

<O:p</O:p

First I would like to point out that doctors have no say in which organs are harvested. If the person is declared brain dead and has given consent to donate, the organization responsible for harvesting (each region has its own non-for-profit organization) makes the determination if the organs are suitable. None of the doctors involved with the donor get any kind of monetary benefit.
<O:p</O:p


As soon as the person is declared brain dead, the person is “discharged” and then readmitted with the agency paying for all the tests and surgery that is required. It can take anywhere from 12 to 36 hours to run all the tests necessary and find recipients. During this time, the amount of money that is spent is extraordinary – it is all paid for by the agency – not the donor. The agency matches donors with recipients based on lab values, placement on the list, and location.
<O:p</O:p


Most recipients have insurance that pays the majority of the cost for the operation for the transplant. The cost to the recipient is usually for the ongoing multitude of medications needed to keep from rejecting for the rest of their lives.
<O:p</O:p


The main problem is having the family members agree to donate. As Fyyr pointed out, children waiting to receive organs are the highest of all. There is actually a very short window in which harvesting should be done. Your brain controls everything from temperature to breathing and heartrate. The risk of infection, sepsis, lack of oxygen to the vital organs increases exponentially as soon as the person no longer has blood flow to the brain. While generally we can keep you breathing and hopefully infection free for an abbreviated time, we can’t do it forever. It is just too distressing to most families to have to make the decision in that short window.
<O:p</O:p


Most people just cannot accept that their loved one is actually dead – especially children. When you can see them lying there, breathing on a machine, they look like they are asleep and it is just too painful to accept they are gone. Actually, most doctors don’t like to have the conversation with families about brain death and possible organ donation, because its such a difficult thing to explain.
<O:p</O:p


In Indiana, the Organ Procurement Organization prefers that they approach families instead of doctors – because generally doctors have a hard time with it. They either don’t want to have to answer the question “Why?” or because they fear that the family will think that they have given up.
<O:p</O:p


The hospital I work for is a City/County hospital, very much like Cook County in Chicago. 90% of our patients are un-insured or under insured, however, we had the lowest amount of donations for the city last year. The reasons are many, but one big reason is because people don’t sign their drivers licenses, and families either can’t be found or just simply decide they don’t want their loved one “cut up”. Just because you can’t afford insurance doesn’t mean we give up on you and give away your organs.
<O:p</O:p


All the talk about making it a commodity that is actually traded is just absolutely absurd. There are many organs that are “going to waste” now because people can’t make the decision whether or not to donate.

All the talk about making it a commodity that is actually traded is just absolutely absurd. There are many organs that are “going to waste” now because people can’t make the decision whether or not to donate.Because their only incentive to donate is a selfless sense of charity. On the other hand, they have religion, psychology (fear), laziness, and just plain indifference telling them not to do it.

Frankly, if people weren't approached by that harvesting agency and pressured into donating the organs (a psychological incentive), I think almost no one would do it. Why should they?

Now, give them a good, selfish reason to give up organs, and they will be lining up to sell them, solving your problem.

Really? As soon as the decision is taken out of the hands of doctors and put into the hands of merchants, there is no reason why the clinically superior organ will be used.
Should be in the hands of the donor(seller) and his or her family.

The better marketed organ would be used instead. Allocating organs by price will not match an allocation by need. There are people's lives at stake and you cannot accept a small number of failures to generate a competitive market.
Yes, there are people's lives at stake. And many of them are dying now, because there are too few organs.

A free market would generate more wealth for the donor, but that isn't our ambition here.
The donor is dead. He or she is not gaining wealth. We are talking about WHO usually makes the decision for organ harvesting, that is the family.

First off, we have to all agree that if organs could be sold, that the number of people making the decision to sell organs would be a great number. Multiples(minimum of 4 times, conservatively) of those who donate out of charity.

Second, we have to agree that there will continue to be free, charity case organ donation, using the same system we have now even.

Third, we have to agree that the amount NOW of freebie organs is not really going to go up anytime soon. The rate of organ donation is relatively stagnant, and we can not expect it to actually go up, dispite all of our years of previous pursuasive techniques.

Making sick people pay more for transplant organs is pretty unethical.
They are not paying anything for them now. It is not a question of more.

Secondly, they aren't paying anything now, and no one says they HAVE to pay for them after a realistic commerce model is in practice. There will still be donors who donate freely. Anyone could continue to wait on the freebie list, if they so chose.

You are saying that people will NOT donate(give away free) organs. I don't know why you are saying that. People do things all the time now out of charity, even though they can make money off what they do.


If this proposal goes forward, you are looking at 4 to 10(possibly much more) times the number of organs that are available. That is a lot of lives which are saved now. The alternative now, is those people die.

And worms eat the organs.

Letting worms eat good transplantable organs is heinously unethical. Any rational person can see that.


And if you want to talk money...Dialysis costs you all 5000 dollars a week, A WEEK, per patient. 250,000 dollars a year, right now. For years.

If some rich dude with ESRD offered me 250K for a kidney, I would do it right now, even though it is illegal, for now. And our little non brokered deal would save the system(workers, companies, the government, YOU), MILLIONs of dollars. And it is my property, and I should be able to sell it if I CHOSE to. And just because a bunch of Evangelical Christians in 1984 got Reagan and a bunch of Legistators to say I should not, should not prevent me.

I was not arguing against financial reward for organ donation. I was stating a case for a fixed reward payment compared to a free market. Your post doesn't address that Fyyr.

You are saying that people will NOT donate(give away free) organs. I don't know why you are saying that.

I don't know why I was saying that. I didn't even know I had.

You've highlighted some of the problems in a free market, all of which can be kept under control with laws, as we do for so many other free markets.

I think you're very optimistic to think the market can be so easily regulated. Can you think of another market where the commodities are priceless one day and worthless the next, with no limits to the poverty or wealth of either the buyer or seller?

I think you're very optimistic to think the market can be so easily regulated. Can you think of another market where the commodities are priceless one day and worthless the next, with no limits to the poverty or wealth of either the buyer or seller?Many commodities are perishable. Meat is even traded on the commodities market, and it's highly perishable. These markets are heavily regulated and function very smoothly. I don't see why perishability is relevant.

We just need to set up an official market for organs, like the commodities market, where they can be freely traded through a centralized and regulated computerized system. Even if the supply doesn't change, I bet such a system would be superior to the existing one.

Many commodities are perishable. Meat is even traded on the commodities market, and it's highly perishable. These markets are heavily regulated and function very smoothly. I don't see why perishability is relevant.


If you need an organ urgently for a life saving operation, it is priceless. Once you've got your organ another exactly the same is worthless to you. If Bill Gates has an accident and needs an urgent transplant tomorrow then the value of a sole matching organ goes from near nothing to billions and back again in the space of a few days. If two people wanted to sell him a matching organ then the price would have just been the minimum either seller would take. How do you regulate that market?

I don't think organs would be traded like a commodity. They'd probably use the same practices they do now, except the donor's family would get a few bucks, or you could sell your kidney. But that'll only last until the first idiot sells both his kidneys. :p You'd still have to spend your time on the recipient list before you could have your new organ.

I was not arguing against financial reward for organ donation. I was stating a case for a fixed reward payment compared to a free market. Your post doesn't address that Fyyr.

Telling me that I can't get money for my kidneys is just the same as telling me how much I can get for my kidneys.

MY kidneys.

Not yours, not the state's.

MINE.

If you need an organ urgently for a life saving operation, it is priceless. Once you've got your organ another exactly the same is worthless to you.
Ya, that happens all the time when people own things.

Until a buy bid and a sell bid match no transactions take place. That is foundational. All other forms are easily called theft.

Now, I was once told the old addage "Something is only what someone is willing to buy it for". But that is wrong, because it does not factor in the seller's valuation for the property.

For example, I own a Jeep. It is not for sale now. Because I value it HIGHER than the market(buyers) are willing to buy it for. If someone walks up to me, and bids higher than market(higher than all of the other bidders), and offers me 20K for it. I would consider selling it. And the sell price of my Jeep, does not really affect anyone else(Jeep buyers or sellers), just because my Jeep sold for 20K.


If Bill Gates has an accident and needs an urgent transplant tomorrow then the value of a sole matching organ goes from near nothing to billions and back again in the space of a few days.
That was the value for that particular organ. And rich people don't become rich paying billions for something that they can buy for 100K.

Transplant recipients are rarely URGENT!, like some episode of ER or something, STAT!. Most of the time, they are slowly progressing disease processes.

If person is so unstable that they need an organ tomorrow to live(without all of our machines), they are a poor candidate for surgery in the first place.

If two people wanted to sell him a matching organ then the price would have just been the minimum either seller would take.
Of course.

How do you regulate that market?
You let the seller and buyer come to an agreement as to its worth.

Some guy with a bad ticker, says, "Honey we are going to sell the Tahoe cabin, and put in a bid on a heart". Sells the cabin, puts in his bid for say 60K for a "commerce" heart. So be it. He still stays on the 'freebie' donor list, and will get his free one when it comes up anyways, just as he would have already. No harm no foul.

A commerce heart come up available, Guy drops the 60K. He's off the freebie list now. Gets a new heart, and the freebie heart which WOULD have gone to him goes to some poor kid in Chicago early.

I don't think organs would be traded like a commodity. They'd probably use the same practices they do now, except the donor's family would get a few bucks, or you could sell your kidney. But that'll only last until the first idiot sells both his kidneys. :p You'd still have to spend your time on the recipient list before you could have your new organ.

Absolutely.

And obviously, as more and more organs are available, less and less people will be on the wait list.

And the price will drop just because you will have run out of people willing to pay a lot of money, they will have already gotten them.

And the price would stablize down low, probably less than the price of a used car, or a years rent. Maybe just a few years, and most of the people will be off the waiting list entirely. And the number on it, then in the future, will be a small fraction of currently.

But the really good thing is that for those years, there would have been a collective community change of opinion about organ transfers. Especially religious reasons against organ donation, there will have been years of collective pressure to change those opinions.

In the end, you will have hearts going for 5K a piece. But 1000 times as many available. And like I said, in terms of medical dollars 5K is nothing. A bed in ICU for a day...a week on dialysis.

Telling me that I can't get money for my kidneys is just the same as telling me how much I can get for my kidneys.

Fair enough. Lets just agree that we've hit a transatlantic culture gap.

NO!,

It is a freedom liberty choice gap.


You feel all right in telling me what I can do with my body, and taking my freedom and choice from me.

I just don't think you should be able to.



Has nothing to do with water. Fair enough?

If you need an organ urgently for a life saving operation, it is priceless.So is the operation itself, yet we negotiate a price for that. If Bill Gates needed an operation, he wouldn't pay $1 billion for it, he'd pay around the same price you or I would.

Remember, there will be tens of thousands of organs on the commodities market, and organ providers will be in direct competition with one another, putting huge competitive pricing pressure on them. If anything, prices will end up being much, much lower than you expect, due to this pressure.

So is the operation itself, yet we negotiate a price for that.

You might do, if you're uninsured. I don't. My treatment is fully paid for and I don't have to pay a penny. As I said, there is a transatlantic culture gap here.

You feel all right in telling me what I can do with my body, and taking my freedom and choice from me.

I just don't think you should be able to.

I don't think you should tell me to pay for an organ if I need one in a transplant. I don't want the choice of paying money or suffering illness. I can choose, with my willing countrymen, to contribute to a taxation based system that covers everyone.

You might do, if you're uninsured. I don't. My treatment is fully paid for and I don't have to pay a penny. As I said, there is a transatlantic culture gap here.
I am uninsured. I have no coverage but my own wallet.

How many Brits are on waiting lists for donated hearts?
How many of those Brits get new hearts per year?
How many Brits die waiting for a new heart?

I don't think you should tell me to pay for an organ if I need one in a transplant. I don't want the choice of paying money or suffering illness. I can choose, with my willing countrymen, to contribute to a taxation based system that covers everyone.
You can still be on the donation list. Am I talking to a wall here? You don't HAVE to pay for an organ if you don't want to. Wait your turn in line, that will NOT change.

People donate organs now with no thought of financial gain. Those people will still continue to do so. Because they are all Frank Capra'ish and Jimmy Stewart like.

What I am talking about is a method to keep the organs that NOW feed worms, to get those organs into people where lives can be saved.

I don't know why you support the current worm feeding system...I really don't. All those organs are going to waste. And one way to stop them from being wasted is to buy them, that's all.

Sounds simple and practical to me.

My treatment is fully paid for and I don't have to pay a penny.Of course you do, you pay additional taxes, which buys you the equivalent of health insurance. We have a similar, if somewhat less organized, system. But that's besides the point, which is that the individual/insurance company/government agency negotiates a reasonable fee, even though a life-saving procedure is "priceless," as you put it.