NCPA - National Center for Policy Analysis

The Free Market and Organ Donors

July 1, 2003

LifeSharers, a group whose members agree to have their organs made available for transplant upon death, on the condition that other members of the group get preferential access to those organs, is almost uniformly opposed by the medical establishment.

The core objection advanced by the United Network for Organ Sharing (UNOS), the organization contracted by the government to administer the national organ-waiting list, is that LifeSharers creates a "restricted class" of individuals, and therefore "undermines the existing framework for organ allocation."

The strength and uniformity of opposition to LifeSharers, however, is mysterious in light of the transplant community's attitude toward other, apparently quite similar programs:

  • UNOS already has a system of rewards in place for living donors.
  • Their organ allocation formula gives four extra "points" to potential recipients who have donated organs themselves, a preference that amounts to a four year reduction in the average waiting time for an organ.
  • UNOS has even created local variances in its allocation policy for programs like the New England Medical Center's Hope through Sharing, which allows living donors to designate friends or relatives to be moved up on the waiting list.

Despite his objection to organ "commodification" and to judging the behavior or character of organ recipients, transplant ethicist Donald Joralemon acknowledges that such programs are, in essence, a reward for the risk undergone by living donors.

Ultimately, it is hard to avoid a suspicion that part of the hostility toward LifeSharers stems from a sense that amateur interlopers are encroaching on the medical experts' territory. According to Annie Moore, a UNOS spokesperson, "Lifesharers has created their own system, and they're doing it themselves. They're not acting within the system."

Source: Julian Sanchez, "Whose Organs Are They, Anyway? Morality and the transplant system," June 26, 2003.

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