30. Organ and Blood Donations
No prohibition should exist against people donating or being compensated for selling at market rates blood, plasma, organs, or any other body parts that have value (except human eggs or sperm). Proper safeguards, of course, must be put in place to insure that donors donate or sell healthy products and donate or sell voluntarily. Virtually any factor relevant to the quality of the donated or sold body product could be factored into the purchase price listed by the seller. Such factors could include all relevant aspects of the health or behavior of the donor or seller. Purchasers of body products should be entitled to full access to a donor’s or seller’s medical records for purposes of researching the health and behavior of the donor or seller.
One of the functions of government should be to maintain a database or registry of people who have decided to be or not be organ donors and who have communicated this decision to their spouse and family. This way, hospitals and medical organizations can have quick access to such a database of information and promptly, after an accident, determine who is a donor and quickly proceed to salvage their organs.
People are Donors Unless They Opt Out
By default, people should be assumed to be organ donors unless they opt out of the donation program. This question should be asked of every individual once upon reaching the age of majority and every 5 years thereafter by their healthcare provider (most logical) or perhaps upon renewal of driver’s licenses.
Donors Receive Priority Over Non-Donors For Available Organs
Because organ donors have already agreed to make their organs available for donation, they should be rewarded by being given priority over non-donors for organs that become available for donation. This should be true regardless of the severity of the need for an organ by a non-donor. Non-donors may be able to ‘buy their way’ onto the recipient list by paying several times the market rate for the needed organ.
Donors May Influence Who Get Their Organs
Individuals who donate and sell their body parts would be allowed in most circumstances to significantly influence who the final beneficiary of the body part would be, even if they died or are incapacitated, by making such provision known in a will or other final document. Providers could specify that their products first go to help immediate family members listed on a national body parts waiting list or to relatives if they are listed as among the 90% who have waited the longest. In cases where multiple family members or relatives have a similar need for organs and if the donor is unable to make a decision as to which specific family member should receive an organ, the donor’s immediate family members (parents, siblings, children, but not minors) would vote for a prospective family recipient. If there is no need among this group, body part providers would be able to select long-time friends (friends of over 5 years) if the friend is listed among the top 50% of patients who have been on the national waiting list the longest.
However, potential transplant recipient qualifications should include how much additional living time the recipient would likely experience due to the transplant. In addition, age should play a factor. A 30 year-old should get priority over a 60 year-old. Incapacitated or deceased body part providers could also have a say in who could get their body parts by including the names of people in a will or other final document, so long as such named people meet the criteria listed above. Organs could also be donated to a chosen member of the general population if that person is listed among the 50% of people on the national list who have waited the longest for that kind of organ. The donor could even create a list of qualities or physical characteristics that he/she would wish the recipient to possess as prerequisites to receiving the organ donation. If the donor had given permission, his/her family could choose this member of the general population as a recipient. Donors could request that the top recipients in either their city, county, or state be given priority to their organs. Such requests should be honored so long as such a candidate is found to be among the top 50% of those on the national waiting list.
If no potential recipient of a body part provider is identified in any of the preceding special categories of people, then the medical healthcare providers would decide upon the most qualified and desirable recipient who should get the body part based on pure need.
Payment for Donated Body Parts
All donors, even deceased donors, should be paid market rates for the organs they donate. In the case of deceased donors, payment would be made to the spouse, family, relatives or to a person of the donor’s choice.