More than 55,000 people are currently awaiting a heart, lung, liver or kidney transplant in the United States. Every three hours, someone on a waiting list dies without the benefit of transplantation.
But as a transplant surgeon, I must strongly argue against "Life for a Life." Why? Even now, most transplant programs in the United States decline organs from prisoners. Unfortunately, prisoners carry a significant potential risk of having transmissible illnesses such as HIV or hepatitis. One of the most important methods to screen potential donors in addition to lab tests is a thorough and accurate social history. No blood test rules out the presence or absence of these viruses with 100 percent accuracy.
Can we assume a voluntarily provided social history is reliable if it, in effect, has the potential to save the donor's own life? I don't think so. The pressure for prisoners to hide risk factors for disease would be overwhelming. As a result, transplant recipients would be placed at significant risk.
In addition, the buying or selling of organs in the United States is illegal -- and certainly is immoral. This practice has been condemned by every recognized transplant organization worldwide. Although the "letter of the law" may not be violated in this bill, clearly the spirit is. Organ donation must be a purely altruistic, voluntary offering. There can be no coercion or secondary gain. But the implicit message behind the "Life for a Life" proposal is: "I'll save you, if you spare me."
Educational programs to explain the donor process and other initiatives to promote organ donation need our support. We also need to address the family's role in donor decisions. In parts of Europe, all citizens are considered potential organ donors at the time of death unless otherwise stated. But in America, consent must be obtained from a potential donor's family at the time of death even with an appropriate donor card. More than 75 percent of potential organ donors do not donate -- most commonly because their families decline. If this could be reversed, we would not need to coerce a few death row inmates. Other efforts to encourage donation also should be pursued, such as providing short-term disability benefits for living donors during recuperation from surgery.
If the essence of this bill is to promote organ donation, then I call upon its supporters to educate the legislature about such practical measures. We all should lead by example by volunteering to donate organs and taking this message to constituents. Society must make this a priority.
