Since organ donation became the recommended treatment of choice for many patients with end-stage organ failure, the controversy over the number of available organs for transplant and the solutions to addressing the shortage of much needed organs for those on waiting lists has been an on-going discussion. Proposed solutions typically include payment for organs, denial of organs to some patients, or changing consent practices.

For example, should we open up the free markets and let people buy and sell organs? Sally Satel, a physician and resident scholar with the American Enterprise Institute and herself a recipient of a kidney transplant, said that she would have “gladly paid for a kidney,” if the laws had permitted it. Dr. Satel has recently edited a volume,When Altruism Isn’t Enough: The Case for Compensating Kidney Donors, where experts and scholars advocate for government incentives to those willing to “donate” a kidney.

Or, should we draw bright lines for those who are too sick and not allow them to be added to organ waiting lists? Wesley Smith, our CBC special consultant, writes this about the dangerous cocktail of futile care theory and organ donation:

Think about it: We already have bioethicists advocating for futile care theory, that is, the right to refuse wanted life-sustaining treatment based on quality of life judgmentalism, resource allocation, or both. Add in the motive for taking organs to this volatile field-and wary families will become even less trusting, and medical issues will become even more likely to end up in court. Square that if we ever enact explicit health care rationing, or redefine death to include a diagnosis of PVS-as many luminaries in the transplant field advocate.

And, what is back in the news again is the solution often referred to as Presumed Consent. Presumed consent states that we should presume that all people would want to be an organ donor, and we move to an opt-out system whereby individuals need to explicitly state that they do NOT want to be an organ donor versus stating that they do want to be a donor. CBC has written about all of these proposed “solutions” over the years, and we will continue to do so as these issues surface where changes in policy and practice are proposed.

Assemblyman Richard Brodsky, (D-New York), is hoping to make his state the first in the country to adopt presumed consent as their policy. Brodsky’s interest in this law is personal too, as his daughter has been the recipient of two kidney transplants. I often lament that laws get written and passed when the lawmaker has a personal and vested interest. How many lawmakers are running their re-election campaigns on their successful passage of strict, assisted-reproductive technology regulation? But I digress . . .