Policies
on organ allocation and transplantation are established through the
United Network for Organ Sharing (UNOS). UNOS is contracted by the
federal government to run the nation's organ transplant network. All
U.S. organ procurement organizations and transplant centers are
members of UNOS. Organ allocation policies consider, among other
factors, the patient's medical history, size, blood type, geographic
location, and time on the waiting list. Each organ type is governed
by a distinct set of rules. In theory, no preference is given to
wealthy or influential patients.
The UNOS policies sound fair, but are they? Prior to his death from liver failure, convicted assassin James Earl Ray's right to a liver transplant (under current UNOS policies) was equal to that of a lifelong philanthropist! With the demand for livers far exceeding the supply, hardened criminals like James Earl Ray should be denied this scarce and valuable resource. Many people would rather not participate in the system than risk having their organs go to someone they consider undeserving. The current organ allocation system will not honor restrictions on who may receive a specific donor's organs. The donor's wishes should be paramount, but this is not the case.
Other government policies on organ procurement and allocation have been sharply criticized by respected writers. In a 16 April 1998 Wall Street Journal editorial entitled "Sell Your Body, Save a Life," University of Chicago Law School professor Richard A. Epstein concludes that if donor compensation were allowed, "fewer people would die because of a government-created organ donor shortage." It is interesting to note that the future of UNOS depends largely on a continuing shortage of transplantable organs. Perhaps its name should be changed to Unending National Organ Shortage.
