Organ donor quandary: Better to give or receive?

Organ donor quandary: Better to give or receive?

Column by Candace Murphy
Inside Bay Area
07/08/2007

ARE YOU an organ donor?

That's the question that went'round the table like a game of telephone when my mother's heart was failing eight years ago.

Having been diagnosed with some sort of heart virus a few years earlier, my mom's heart was finally about to give out. She was too weak for the valve replacement surgery that could have extended her life, and her doctors had literally thrown their hands up in the air.

She's going to die, they said.

But then somebody in the family, somebody around that somber table, asked the doctors if a heart transplant was possible.

Good thing. The doctors made a call to another hospital that did the procedure, and now some 81/2 years later, my mother is alive.

And she's not just alive. She has since hiked across Morocco and New Zealand and Peru. She's badgered local fish mongers for their freshest fish. She's cultivated a garden in her new Pacific Northwest home. She's looked up from reading her favorite newspaper, the New York Times, to see the 3 o'clock ferry boat from Seattle pass by her living room. And the 4:20. And the 5:30. And the 6:45.

Like I say, she's not just alive. She's continued to live.

But only because someone was an organ donor.

There aren't enough organ donors, of course. The number of people on the transplant waiting list in the United States is close to 100,000. As for hearts, well, on any given day, according to the Mayo Clinic, about 4,000 people are waiting for a heart transplant. There aren't enough though, and a lot of people die waiting. In a year, there are only enough donor hearts to provide about 2,000 transplants.

Do the math. It's not hard.

The eternal conundrum, though is that even though 90 percent of Americans say they support organ donation, only 30 percent are actually designated donors.

That's where that question my family posed to itself comes in. After my mother's doctors had made the phone call that would save her life, my family's own game of telephone revealed something frightening: Only one of us pulled out a driver's license with a pink dot on it. One. Of 10. A 10 that included my mother.

My husband was the lone donor.

It's stats like these that fuel

the argument for people like Dave Undis, a guy I've gotten to know only through e-mail. I wrote a story not long ago about a Fremont man who donated one of his kidneys to his wife, and the tale prompted Undis, the founder of a group called Lifesharers, to write.

Lifesharers, he informed me, was a free network founded in Nashville in 2002 of a little more than 9,000 members nationwide who have pledged to donate their organs when they die. But only to other members.

Undis calls people not on the list — people like my mother, I suppose — "freeloaders."

It's a curious idea, any way you look at it, this Lifesharers, which I should point out, was founded after my mother's ordeal. I agree that there are problems, severe problems, with the system of organ donation as it exists today. And I am ashamed and embarrassed that until that moment eight years ago, I was not an organ donor.

But this "I'll give you mine if you give me yours" mentality rubs the wrong way against my conscience and any Hippocratic leanings I may have.

According to Undis, a former insurance executive, the main benefit of joining Lifesharers is that it makes the transplant system more fair. As he said in an e-mail earlier this week, "About half of the organs transplanted in the United States go to people who haven't agreed to donate their organs when they die."

Hmm. Fairness. Well, what is fair, really? Maybe it's not fair that my mother got a heart. It's also not fair that the 40something-year-old man whose family gave her that heart died.

And it's also not fair that many people who may want to become donors, can't, because they may never be healthy enough to qualify. Like people from lower socioeconomic groups, since health and socioeconomic levels are linked. And even though Lifesharers says anyone can sign up as a donor with no health restrictions, you must be in good health for 180 days to be eligible to receive a donor organ.

But that's not all that doesn't ring true as being fair. Or ethical.

On the Lifesharers Web site there's a quote from a California Pacific Medical Center's Katrina Bramstedt, Ph.D., a bioethicist who says "it is appropriate to favor fellow organ donors over free riders. When it is time to allocate a scarce resource, it is fair to assign priority to people who are willing to both give and receive."

That's interesting coming from a bioethicist. In all other medical instances, the only requirement of a patient seeking treatment for an illness is an exchange of money — either the patient's own money, or money provided by the patient's insurance company. Sure there are problems with that whole set-up — we won't go there in these turbulent times of Michael Moore's "Sicko" — but, really, that's the precedent we're working with here.

To only make organs available to those who have said they'd give theirs out upon their death seems hinky in the pre-established medical context.

Yes, people need to sign up to be organ donors. But punishing them because they haven't, or haven't thought that far ahead, or are freaked out about contemplating their own deaths, or whatever the reasons for not signing up to be a donor may be, seems Draconian.

In my family's case, I like to think it wasn't a conscious decision that none of us, save my husband, were donors. It was laziness, it was oversight, it was lacking foresight.

It was stupid.

But we learned a lesson. The hard way.

You don't have to. Just sign up. Peel the pink sticker off the form the next time you get a new driver's license. Sign up online, to a national, nonexclusive, registry (like http://www.unos.org). At the very least, just tell your family that you want to be a donor in case it ever comes to pass that they're asked what you would have wanted.

Do you want a future where a doctor, wielding a scalpel over your body that's in desperate need of a new organ, asks, "Oh, wait — are you a donor?"

Contact Bay Area Living writer and organ donor Candace Murphy at cmurphy@angnewspapers.com or (925) 416-4814.

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