The Meat Market
Wall Street Journal. (Eastern edition). New York, N.Y.: Jan 9, 2010.
[In a race to prevent thousands of needless deaths a year, countries from Singapore to Israel are launching innovative new programs to boost organ donation. Alex Tabarrok on paying donors for kidneys, favoritism on waiting lists and the shifting line between life and death.]
Harvesting human organs for sale! The idea suggests the lurid world of horror movies and 19th-century graverobbers. Yet right now, Singapore is preparing to pay donors as much as $50,000 for their organs. Iran has eliminated waiting lists for kidneys entirely by paying its citizens to donate. Israel is implementing a "no give, no take" system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ.
Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one.
To combat yet another shortfall, some American doctors are routinely removing pieces of tissue from deceased patients for transplant without their, or their families', prior consent. And the practice is perfectly legal. In a number of U.S. states, medical examiners conducting autopsies may and do harvest corneas with little or no family notification. (By the time of autopsy, it is too late to harvest organs such as kidneys.) Few people know about routine removal statutes and perhaps because of this, these laws have effectively increased cornea transplants.
Routine removal is perhaps the most extreme response to the devastating shortage of organs world-wide. That shortage is leading some countries to try unusual new methods to increase donation. Innovation has occurred in the U.S. as well, but progress has