Bill could boost organ donations

Bill could boost organ donations
Posted by The Star-Ledger Editorial Board February 21, 2009 5:22AM
Categories: Health, Policy Watch

Last year, when the bill was wandering through the state Senate and Assembly, Sean Kean thought about grabbing the microphone and making a dramatic speech. By revealing the ugly scar that runs from his navel to his back, the state senator from Wall Township could have provided a riveting account of how he had quietly saved his father's life by donating a kidney in 1997.

In calling for passage of legislation to promote organ donation, he could have shown he wasn't asking colleagues or constituents to do anything he hadn't.

As the measure gained momentum and rolled toward passage, Kean decided against sharing his personal account. After all, an emotional plea wasn't necessary. "Why do I need to spout off?" Kean asked himself.

But today, with 4,300 New Jerseyans awaiting life-saving organ transplants, he is willing to share his story -- because that number is simply too high.

"Donating my kidney was a difficult decision," he says. "It was scary. But I'm proud I did it. We need more organ donors."

Obviously, Kean's decision was different from that of signing an organ-donor card. But it illustrates the pressing need: His father waited several years for a transplant and, if not for his son's match and generosity, probably would have waited many more years. Or died, while languishing on the list.

Approximately 250 New Jerseyans died last year while awaiting a transplant. Nationwide, 6,000 people die annually while on waiting lists. For those in need of transplants, the clock is always ticking.

Five years after his transplant, Kean's father died of a heart attack. But that doesn't diminish the gift or produce second thoughts, Kean says. "I gave him five more years with a better quality of life than he had on dialysis. And even if I had known what would happen, I would gladly do it again."

Under the bill -- the New Jersey Hero Act, signed into law last October -- New Jersey residents applying for a driver's license four years from now will be required to consider becoming organ donors. The options are simple: They can say yes or no, or they can designate someone to make that decision for them upon death. The point is simply to recruit more donors by requiring that decision -- by making people think.

Until that law goes into effect, New Jerseyans can voluntarily designate themselves as organ donors through their driver's license or by obtaining a donor card. Information can be found on the Motor Vehicle Commission website. Donors under 18 need the consent of a parent or guardian.

The new law also makes New Jersey the first state to incorporate organ donor education into high school curriculum, beginning next school year.

While aimed at teens, organ donor education should target the middle-aged and elderly, too, because there is a belief among many that if someone becomes a donor, doctors won't fight as hard to keep them alive when they are seriously stricken.

"Believe it or not, that's a real fear out there," State Senate President Richard Codey says. "Some people who originally agree to become donors, then change their minds as they get older."

Earlier this month, the world was moved by the gathering of the five thankful survivors who received life-saving organs from Dennis John Malloosseril, a 25-year-old who was gunned down in a Clifton church in November. One man -- his life tragically ended -- saved five others with his heart, lungs, liver and kidneys.

One saves five: It's the stunning arithmetic of organ donation.

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Posted by lstamato on 02/21/09 at 10:59AM

As important as the new law and efforts at education are, organ donations will not keep pace with the need for them. We have to think about this problem differently.

We could provide incentives such as life-long Medicare coverage or even tax credits or vouchers. Through greater educational efforts, too, we could hope for a surge in altruism. Fundamentally, though, while these efforts might increase the number of organ donations, the problem will remain unsolved because the need is so great.

In "Enlarging the Societal Pie through Wise Legislation: A Psychological Perspective," authors Max Bazerman, Jonathan Baron and Katherine Shonk, look into the psychology of decision making and the impact on policy. They ask the question, "Why are organ-donor programs constrained to the point where thousands of Americans die needlessly each year?" They pose the following hypothetical:

a. If you die in an auto accident, your heart will be used to save another person's life. In addition, if you are ever in need of a heart transplant, there will be a 90 percent chance that you will get the heart;

b. If you die in an auto accident, you will be buried with your heart in your body. In addition, if you are ever in need of a heart transplant, there will be a 45 percent chance that you will get the heart.

Which do you prefer? Most people choose "a" as the benefits of the tradeoff are quite clear. Yet government policy, yielding to what psychologists term omissions bias--the "irrational preference for harms of omission over harms of action"--follows an organ donation program that favors "b."

In short, we need to switch to a 'default' system. In countries other than the United States, the default is that unless you specify that you do not want to donate your organs, you become a viable donor at death. By this simple shift in policy, organ donations would rise substantially.

This change in approach would amount to the "stunning arithmetic of organ donation" the editorial seeks.
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Posted by givmeliberty on 02/21/09 at 5:24PM

I have a question about what happens if you say that you are willing to be an organ donor. Nowadays, they have a use for tendons, skin, and bones, in addition to the heart and other organs. The harvesting of body parts must be quite lucrative, or there wouldn't be people in jail for illegally harvesting from the dead in funeral homes.

With wakes and funerals costing so much that people are starting to opt out by having loved ones cremated, a financial incentive for organ donation might be much appreciated by the surviving family members. Why should everyone benefit except the donor's family, particularly when there is quite a bit of money involved?
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Posted by givmeliberty on 02/21/09 at 5:27PM

I actually hit send before asking my question--- when a person indicates they are willing to be a donor, are they consenting to the harvesting of anything of any use to potential donors, or are they only consenting to the donation of major organs?
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Posted by lstamato on 02/21/09 at 8:28PM

It's my impression, "givemeliberty," that once there is an agreement to donate, any and all organs--that are usable--can be harvested. I looked at my own donor card and I don't see any limitations with respect to this issue. You might visit the following website for additional information: www.sharenj.org

The idea of paying for organs is seen as ill-advised for all the obvious reasons. Other incentives might encourage organ donation, as noted in my initial comment, but paying for organs is seen to be exploitative and, as a result, ethically questionable. While individuals donate organs to friends and relatives, and, on occasion, to those they don't know but learn about, there is no payment.

Recently China prohibited 'foreigners' from receiving organ transplants as it appears that foreign nationals were getting ahead of Chinese citizens on the organ donor list by paying for "the privilege."

http://blog.nj.com/njv_editorial_page/2009/02/bill_could_boost_organ_donatio.html