By Bob Aronson Plan by David F. Diamond
The story of the organ shortage is all too familiar; supply just can’t catch demand.
Since 1984 when Tennessee Congressman Al Gore (D) and Utah Senator Orin Hatch (R) authored and passed the National Organ Transplant Act (NOTA) there have not been enough organs. The act makes “Altruistic” donation the law of the land simply meaning that patients who need transplants must depend on the good will of others who upon their deaths will voluntarily donate their organs.
After nearly 30 years only 40% of Americans have shown that good will by registering as organ donors. If the goal was to provide organs for all who needed them then the experiment failed. I cannot believe that either Gore or Hatch would have supported a plan that would allow thousands to die.
Today there are about 120,000 people on the national transplant list and so far in the first 7 months of this year there have been only 11,600 transplants done. Obviously the system isn’t working the way Gore and Hatch had hoped.
So what to do? There have been scores of proposals put forward to change the law. Proposals which include “Opt-out” or “Presumed consent” which means everyone would automatically be considered an organ donor unless they chose to “Opt Out” (our current system is “Opt In”). Also proposed are programs that would offer transplants only to registered organ donors; mandatory donation; compensation of sorts that would pay funeral expenses or perhaps provide scholarships and outright commercial sales of human organs. All of those options have been discussed by lawmakers, medical ethicists and the people who run the national transplant program and they have all been dismissed as unethical, unmanageable or just plain unworkable and people continue to die.
When NOTA was established the authors made it quite clear that organ sales would not be allowed. NOTA specifically states “it shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.” The penalty of breaking this law is a fine of $50,000 or up to five years in prison, or both, So that readers have accurate information before them, here is that section of NOTA:From the National Organ Transplant Act of 1984, as amended through February 1, 2010 TITLE 42 > CHAPTER 6A > SUBCHAPTER II > Part H > § 274e
Prohibition of organ purchases
It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce. The preceding sentence does not apply with respect to human organ paired donation.
Any person who violates subsection (a) of this section shall be fined not more than $50,000 or imprisoned not more than five years, or both.
For purposes of subsection (a) of this section (1) The term “human organ” means the human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof and any other human organ (or any subpart thereof, including that derived from a fetus) specified by the Secretary of Health and Human Services by regulation.
(2) The term “valuable consideration” does not include the reasonable payments associated with the removal, transportation, implantation, processing, preservation, quality control, and storage of a human organ or the expenses of travel, housing, and lost wages incurred by the donor of a human organ in connection with the donation of the organ.
For the past nearly 30 years, the prohibition against buying and selling organs in the United States has been the law of the land. Efforts to provide financial incentives as a means of increasing deceased donation, for example, have failed because of what was determined as clear Congressional intent that organs not be placed in a commercial market.
When you consider the strong language in NOTA with regard to organ sales one would think the debate would be dead. Well, it’s not and that’s because of what appears to be a contradiction in public policy. The law says one thing but we seem to practice in some cases what the law disallows.
We are prohibited from selling human organs but not hair, sperm, blood, and other “replenishable” body parts. The question of commercialization of human organs remains unsettled; not so much because of a public desire to sell their organs but rather because of the explosive growth of the biotechnology industry.
Advances in that arena have generated uses and needs for body tissues that were previously unimaginable. And there’s the rub. While the law bans the buying and selling of organs for transplantation, they have not banned their use in research, education, and commercial endeavors. So the bottom line is that you can buy body parts legally but not for transplantation.
Enter David Diamond and his proposal for legalizing the sale of human organs. I met David on the internet. We share backgrounds in politics and broadcasting and in trying to save lives through organ transplantation.
By publishing his proposal I am neither endorsing nor opposing it. I am posting it because I believe in an informed public and that he has the right to be heard and have his ideas discussed.
David has not had a transplant nor is he a candidate for one, he simply has an interest in the issue that began with a radio interview. Here’s David Diamonds story in his words:“In 1984 I was doing a radio talk show in Memphis TN. My guest one day was the local director of the Organ Procurement group I asked him “Well, couldn’t people buy an organ if they wanted to?” He answered that was illegal under the new law. The authors, he said, wanted to prevent the development of a black market. I didn’t think to ask the logical follow-up question: “But won’t that seriously limit the supply.” Days and weeks and months thereafter, the question nagged at me. Finally I began to develop a solution that I thought could solve the shortage. And so I talked it up for 20 plus years, getting nowhere fast! Folks didn’t want to consider or talk about such a “ghoulish” subject. In 2008 before the Republican Presidential Primary, I had a brainstorm. I thought, “One way to get publicity for anything is to run for President of the United States but I’ll do it on just the issue of legalizing organ sales.” Well, I did it on a shoestring and sure enough I got some publicity and even got a story in the Des Moines, Iowa paper. Unfortunately John McCain got the nomination and my plan was no longer of interest to the news media. I say the idea is still good. I’ve tried to improve it along the way; tried to address all the obvious objections. But I’m sure I’ve missed a few. Now you get to give us your thoughts. Let’s work together and create a huge supply of organs.
The Federal Organ Transplant law needs to be changed.
The Federal Organ Transplant Law enacted in 1984 provides that only donated organs may be used. The following plan to increase the supply of organs for transplant was developed in subsequent years by David F. Diamond of Memphis, Tennessee.
The shortage of organs is taking the lives of almost 7,000 people unnecessarily each year. Donation is good. It is the highest altruistic step that a person can contemplate. However, for a number of reasons, many people are not willing to donate. The solution is to provide a regulated system allowing the organs of cadavers to be sold as follows:
A. A contract can provide that when a person has decided, for whatever reasons, not to donate organs, he or she (hereafter: the provider) can commit to a plan to have the organs sold if and when the provider is brain dead. This contract will also be signed by the next of kin, spouse or nearest living relative so that that party understands the purpose of the contract and agrees that they will not oppose its implementation when the provider dies. A provider’s option to cancel the contract at any time prior to the provider’s death will be included in the contract. The use of this contract will allow the provider to leave an estate to his heirs or a designated charity. A provider, with few or no assets, might otherwise have none to leave when he or she passed.
B. The sale of organs can be conducted by a broker, attorney or individual (hereafter: an agent) designated by the provider. A licensing procedure would establish that the agent would be certified as fiscally responsible and having financial integrity. Upon determination of brain death, the agent selected by the provider, using email, fax or phones, would immediately advise interested buyers of an organ’s availability and condition, etc. Time would be of the essence, of course. Appropriate compensation to the agent, such as a commission for services provided, would be set forth in the contract. Buyers whose bids were accepted would send payment by wire transfer, cashier’s check or other means approved in the law.
C. The party designated by the provider must maintain a public record (like a broadcaster’s log which is available for public viewing) specifying the individual who gets the organs, how much is being paid and the identification of the provider. The purpose of this transparency is to eliminate the need for a black market, and to stimulate public awareness. If there is a public record, as soon as organ sales begin, the news media will undoubtedly write about it pointing out how much money was involved in the transactions and stressing how much money goes to the heirs. This will persuade a lot of additional people to agree to such a contract, thus increasing supply exponentially. Through the action of the law of supply and demand, the increased supply will cause prices to decrease to a level most people will consider reasonable. Unless you allow prices to be set by the market process you put a limit on the number of organs that might become available. Any fixed price, set by government or a special agency, would diminish the supply which would defeat the goal of making the most organs available. That would cause some individuals to decide not to participate. But if they knew that the organs they might provide are going to bring whatever the market process allows, they’ll have every incentive to take part.
D. The organs would have to be sold only for transplant to U. S. citizens in order to avoid foreigners from bidding up the price and reducing the supply to Americans. Of course, if other countries should adopt model legislation such as ours then we could reciprocate and become partners with them since their organ supply could be shared with ours.
E. The poor will not be discriminated against. They will have access to organs because the law will provide that, just as in Medicare or Medicaid presently, the government will pay for any medical procedure or supplies that the patient needs, upon a doctor’s certification that it is medically necessary. The government would buy organs on the market for those with Medicare or Medicaid unless donated organs were available. The same principle will apply for those with health insurance. And the wealthy, who may choose to be self insured, would be free to arrange for organs in the same market. Of course, people would still be free to donate organs. And participation by providers in the futures contracts would be entirely voluntary.
F. Presently those uninsured or poor, not covered by Medicare or Medicaid, have to raise tens of thousands of dollars before hospitals or transplant surgeons will help them. The added cost of an organ can also be raised in the same way, or the law can require our government to cover that cost, since it will be less costly over time than dealing with whatever the patient’s medical expenses would be otherwise.
G. The plan will require providers to have their medical records maintained by their doctors beginning at least as soon as a futures contract is signed. It would be made available immediately to any parties potentially buying an organ from that cadaver. The purpose, and the result, would be to assure a better, safer organ supply. This plan does not contemplate any sale of kidneys or parts of livers from a living person. There are risks in having such surgery and for that reason and others, we set that aside and take no position on that question. Sometimes, under current law, it is the right thing to do, depending on the circumstances. But in point of fact, the need for such organs will be adequately supplied with adoption of my plan.
The proposal I’m offering will be, of course, subject to improvement and modification by the federal legislature. Meanwhile, I welcome and will entertain seriously any changes so long as they do no damage to this essential requirement: We have to let the law of supply and demand work in order to maximize the number of organs that will be made available.
David Diamond 82, lives in Memphis, Tennessee. He is a retired TV and radio commercial spokesman, an actor, a freelance broadcast sports producer, and a marketing and public relations consultant.
Following four years of service (1953-1957) as a Russian language technician in the U.S. Air Force, Diamond studied foreign affairs at George Washington University in the late 1950’s. He also worked for Maryland state senator Newton I. Steers, Jr: as congressional and state senatorial campaign manager.
Other endeavors include:· Serving as executive assistant and deputy commissioner in the Maryland Insurance Department; · Legislative assistant in the state capitol in Annapolis. · Office manager for U.S Senator Charles McC Mathias. · News anchor for WTAE radio; radio/TV · News director for the 1973 National Boy Scout Jamboree; · Managed a successful congressional primary campaign for Robert Casey · From 1982 to 1991 he was the national commercial voice for the Levitz Furniture chain.
Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 3,000 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.
You may comment in the space provided or email your thoughts to me at firstname.lastname@example.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.
Please view our music video “Dawn Anita The Gift of Life” on YouTube https://www.youtube.com/watch?v=eYFFJoHJwHs . This video is free to anyone who wants to use it and no permission is needed.
If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. JAgain, write to me and ask for “Life Pass It On.” I will email it to you immediately. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will also send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to email@example.com and I will send the show and book ASAP.
Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative (OTI). The more members we get the greater our clout with decision makers.
Bob Aronson de Newheart de Bob es un centro receptor de trasplante 2007, el fundador de la Iniciativa de Facebook cerca de 3.000 miembros de trasplantes de órganos y el autor de la mayoría de estos blogs de donación / trasplante.
Usted puede dejar un comentario en el espacio proporcionado o por correo electrónico a sus pensamientos a mí en firstname.lastname@example.org. Y – por favor difundir la palabra acerca de la necesidad inmediata de más donantes de órganos. No hay nada que puedas hacer lo que es de mayor importancia. Si se convence a una persona para ser un donante de órganos y tejidos puede salvar o positivamente afectará a más de 60 vidas. Algunas de esas vidas puede haber gente que conoces y amas.
Por favor, vea nuestro video musical “Dawn Anita The Gift of Life” en YouTube https://www.youtube.com/watch?v=eYFFJoHJwHs . Este video es libre para cualquier persona que quiera usarlo y no se necesita permiso.
Si quieres correr la voz personal sobre la donación de órganos, tenemos otra presentación de PowerPoint para su uso gratuito y sin permiso. JAgain, escribir a mí y pedir “Life Pass It On.” Voy a enviar por correo electrónico a usted inmediatamente Esto no es un espectáculo independiente,. Necesita un presentador, pero es producido profesionalmente y objetivamente sonido Si usted decide utilizar el archivo. demuestro que también le enviará una copia gratuita de mi libro electrónico, “Cómo obtener un Standing” O “que le ayudará con habilidades de presentación. Sólo escribo email@example.com y enviaré el programa y el libro lo antes posible.
Además … hay más información sobre este sitio de blogs de otros temas de donación / trasplante. Además, nos encantaría que te unas a nuestro grupo de Facebook, la Iniciativa de Trasplante de Órganos (OTI). Cuantos más miembros que tienen la mayor influencia en nuestra toma de decisiones.