Every 16 minutes a new name is added to the national organ transplant waiting list. That list now stands at roughly 60,000 names. Many of those people will never get the kidneys, livers, hearts and other organs they desperately need. As the list grows, some names disappear too. Every day, 10 people die because they do not get the organs they require. The problem is particularly acute among minorities. Nationally, minorities account for roughly 40% the patients waiting for organs but only 20% of the potential donor pool.
The imbalance between supply and demand has grown so acute that economists, such as Nobel Prize winner Gary Becker of the University of Chicago, have proposed paying the families of organ donors as a possible solution. In Hawaii, a state that suffers from a low rate of organ donation and geographic isolation, the governor has floated a similar idea. While such plans would boost the supply of donor organs, the public has not yet proved willing to accept the idea.
There is an alternative solution to the problem that is equitable, simple and inexpensive. At age 18, all American male citizens must register for the draft, usually by filling out a short form at the local post office. A similar process could be required for organ donation. At age 18 (or 21), all men and women would be required, in the presence of a witness, to sign a statement declaring whether or not they are willing to be organ donors. There would be no government pressure to decide one way or the other.
However, one criteria for being eligible to receive a donor organ would be whether or not the individual is signed up as a donor himself. Those who were not willing to donate organs would be placed lower on the waiting list than all individuals, however sick, who had agreed to be donors.
This program would solve several problems. First, it would dramatically boost the number of donors. Agreeing to "give the gift of life" would no longer be an act of pure altruism; rather, it would be an insurance policy. Even the most selfish of individuals would be willing to become donors if it gave them greater access to the hearts or livers that might save their lives.
Second, the policy has an appealing fairness. Those who benefit from organ transplants would be those who, had the circumstances been different, would have been willing to make the same sacrifice. (Those who have moral or religious objections to donating organs cannot reasonably expect to gain from something they are not willing to do themselves.)
Third, the plan would eliminate the most rational objection to paying for donor organs: The poor are more likely than the affluent to sell the organs of their loved ones. Economists may not have a problem with this disparity; most other people do. The proposal outlined above would provide the same incentive for the rich and the poor to become donors.
There are technicalities to be ironed out. Individuals should of course be able to change their minds, but those who refuse donation and then discover that they are in need of an organ must not be allowed that privilege. Also, the law may have to be changed to make the organ donation wishes of individuals more binding on their families after death.
The golden rule is a good road map for life. It might also help the thousands of people who are literally dying for donor organs.