Organ Donation Supply and Demand

My wife is helping with a local drive to get people to register to donate organs. We thought that, as a cancer survivor, she herself would not be allowed to register. Wrong. Anyone under age 85 can register, so long as their cancer is not active and they do not have a systemic infection of any kind.

The doctor who informed us says this increases the potential supply of transplantable organs. If the demand is high enough, and the patients sick enough, the doctors will choose to use a donated organ even if the transplantation risk from the particular organ is substantial. Thus, while fortunately the price system is not used explicitly in the transplantable organ market, the choice to allow more people to register and to compare the demand to the increased supply suggests economics is currently present in this market.

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  1. Cor Aquilonis says:

    I’ve heard good things about having the default be organ donation, with the option to opt-out. That would probably be a quick, effective solution to the supply problem, and it’s already working in Europe. Find out more at http://www.iq.harvard.edu/blog/sss/archives/2008/04/do_defaults_sav.shtml .

    But, then, this is the U.S., so we definitely won’t implement sensible policy decisions that could help all of us, because working together is socialism. At least, that’s what the people on TV tell me.

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    • artemis says:

      Hidden due to low comment rating. Click here to see.

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      • Cor Aquilonis says:

        So, I proposed we look to other countries as a model for effective methods of creating policies that solve organ supply problems. I provided a link illustrating my point. I then made an attempt at humor to illustrate a cultural objection that will have to be overcome to implement that policy.

        And you respond with mockery. You ask me a rhetorical question intended to insult me, calling me conceited, and then imply , falsely, that I believe I know what’s best for the country and seek to institute tyranny.

        I notice you didn’t address the substance of my proposal.

        Troll harder next time, it might work.

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    • Enter your name... says:

      Opt-out isn’t magic. Sweden’s opt-out system produces somewhat fewer donations per capita than Germany’s opt-in system, and much lower than the USA’s opt-in system.

      What makes the Spanish opt-out system (the most famous one) work so well is the fact that they throw a lot of money at it. Spain is very aggressive at identifying potential donors, they have trained and hired more transplant specialists, and they make it a goal to recover every organ possible. Being opt-out helps, but it’s only one piece of the puzzle. Even Spain’s own transplant organization says that opt-out is one of the less-important contributors to their success.

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    • Enter your name... says:

      By “working in Europe”, you apparently mean by making sure that Sweden (an opt-out country) has an organ donor rate that is two-thirds what the USA (an opt-in country) does?

      Opt-out is not magic. Infrastructure is far more important (even according to Spain, which is touted as the grand success story).

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  2. Doug says:

    That seems like a morbid choice system – Will you choose the potentially risky organ or keep on waiting and risk receiving no organ at all? Is this a case of offering the organ to the first person on the list, then moving down the list if they choose not to use it?

    I agree with the decision to allow more people to register, and am all for increasing the demand of potential organs. I even like the choice architecture discussed in the book “Nudge” to increase donors. I just wonder how a potential organ recipient would make the decision based on the risk involved.

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  3. Classless says:

    Wow. “Thus, while fortunately the price system is not used explicitly in the transplantable organ market…”

    I’ve never heard such a murderous statement said with such moral righteousness.

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  4. artemis says:

    Why is it “fortunate” that there is no price system?

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    • Phil says:

      It isn’t. There should be a price system. People should be allowed to sell parts of their body if they so please. “Remember in a free-market an exchange only takes place if you parties benefit” – Milton Friedman

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    • Cor Aquilonis says:

      Well, I’ve heard the argument that, by providing a market for used body parts, the search for profits would encourage some people to murder others for the victims resale value. This sort of thing has a happened in the past, only instead of selling gently used organs, grave robbers and murderers were selling cadavers for medical dissection. JAMA has a great article on the subject here: http://jama.ama-assn.org/content/287/9/1183.full .

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  5. Enter your name... says:

    Age isn’t a bar in all areas. There have been organ donors over the age of 85.

    Some kinds of cancer do appear to be a permanent bar, however: your regional agency might let you sign up if you have chronic leukemia, but in practice they won’t use your organs. Unlike solid tumors, which are usually confined to specific locations, leukemia cells “contaminate” every organ in the body and are always present even when the disease isn’t “active”.

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  6. An economist says:

    To imply that economics is working here is to say that economics works when any and all labor has been banned and laborers are allocated to jobs only when the demand for workers is high enough. Economics concerns the best use of resources, not simply use alone- and independent of a price system, organs are simply distributed in the dark. This isn’t economics.

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  7. Dave Undis says:

    Over half of the 112,000 Americans on the national waiting list will die before they get a transplant. Most of these deaths are needless. Americans bury or cremate about 20,000 transplantable organs every year. Over 9,000 of their neighbors die every year as a result.

    There is a simple way to put a big dent in the organ shortage — give organs first to people who have agreed to donate their own organs when they die.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t prepared to share the gift of life should go to the back of the transplant waiting list as long as there is a shortage of organs.

    Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at http://www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

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  8. Imright says:

    Organs should be recycled like waste. I’m for the opt-out system, and only if the donor has specified that they do not want to donate their organs before they’re dead.
    As usual, religion plays a negative role as well.

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