Extra Points in Israeli Organ Donation System for Signing a Donor Card
Posted Apr 10 2012 12:00am
I started off my career in pathology as a blood banker. I have therefore been acutely aware over the years of messages from the Red Cross at various times of the year indicating that a critical blood shortage is imminent. To the best of my knowledge, the process for persuading citizens to donate blood has changed little during this time. Has it not occurred to the blood collecting agencies like the Red Cross to try something new for donor recruitment? This same logic applies to the collection of human organs for transplantation. That's why a blog note about a new approach to organ donation in Israel by economist Alex Tabarrok caught my eye (see: No-give, No-take in Israel ). Below is an excerpt from it:
In Entrepreneurial Economics I argued for a “no give, no take” system for organ donation–people who signed their organ donor cards would be given priority over non-signers should they one day need an organ. The idea has an element of justice to it but the primary goal is to increase the incentive to sign one’s organ donor card.Israel recently adopted this policy by giving extra points on the allocation system to people who previously signed the organ donor card. In the case of kidneys, for example, two points (on a 0-18 point scale) are given if the candidate had three or more years previous to being listed signed their organ card. One point is given if a first-degree relative had signed and 3.5 points if a first-degree relative had previously donated.It’s early but so far the policy appears to be very successful:
Due to the population’s surge of interest in obtaining an organ donor card, the Adi-National Israel Transplant Center has extended through March 31 the deadline to register as a donor and receive special benefits.
During the past few weeks, Adi’s phone system has collapsed several times due to the high demand.
Since Adi decided to give preferential treatment to those registering as a potential organ donor, tens of thousands of people have registered, raising the number of potential donors to over 600,000.
Until last year, the rate of registration was among the lowest in the Western world.
This seems like a relatively simple scheme to increase the number of organ donation cards in Israel. Similar to the process in this country and when you need a kidney transplant, you are assigned a priority score on the basis of a points system. Under the Israeli donor incentive system, you receive bonus points if you or your first-degree relatives have signed organ donor cards or actually donated organs. Although unstated, I am sure that such priority scores take into consideration other issues such as severity of disease.
What could possibly be wrong with this system? Well, for one, I think that there are a number of people who would argue that the receipt of an organ should be based solely on medical need and unconnected in any way to one's altruistic instincts. However, I find myself enthusiastic about the Israeli system. The card-signing points give the individual a small edge in exchange for increasing the organ supply. In other words, it grafts a little bit of self-interest onto altruism. And, to return to my original point of criticism of the Red Cross, it's novel and represents a shift in thinking about processes that may not be working well.