Why Is There a Shortage of Organ Donations?
I was watching a show on CNN about people in need of organ transplants going to China for organ donation tourism. China harvests organs from prisoners it executes, sometimes without their consent, and then offers them to “tourists” who come in need of transplants.
The show focused on the immorality of China’s practices, but I kept thinking about how needless all of this would be if we didn’t have such silly organ donation policies in the United States. The Department of Health’s website for organ donation provides the following statistic: “Each day, about 74 people receive organ transplants. However, 18 people die each day waiting for transplants that can’t take place because of the shortage of donated organs.” That’s about 6500 people who die every year in the United States waiting for an organ donation — two times the number dead in the 9-11 attacks. Why aren’t we doing anything about it?
About 2.4 million people die each year in the United States. Only a fraction are organ donors. Why are so many life-saving organs being thrown away?
One solution is to switch the default rule — to have the presumption be that people consent to donating their organs upon death unless they indicate otherwise. In other words, we could change organ donation from opt-in to opt-out. This might strike some as unfair, as there may be people who are uniformed who don’t realize their rights to opt-out. On the other hand, the value of saving thousands of lives each year is quite high. Those who have strong moral objections to organ donation will likely be informed about their opt-out rights because it is an issue that matters a lot to them.
Another idea is to have people check a box each year on their tax forms that they will be an organ donor (for the period of that tax year) and they will receive a tax deduction ($100 or $500 or some other amount). This would allow people to change their preferences — if they suddenly decide they no longer want to donate, they can not check the box the next year. For efficiency purposes, there would not be testing to see whether a person could actually donate or not; everybody willing to donate organs would get the deduction. One potential objection to this policy is that the less wealthy will be more inclined to donate organs, since the deduction means more to them. But I don’t see why organ donation after death is a bad thing. In fact, I think it’s a great thing, and it should be encouraged.
I remain quite baffled why little has been done to raise incentives for organ donation after death. There are some problems that are very hard, but this one seems to have some relatively easy solutions, unless I’m missing something.