Clicking on banner ads enables JWR to constantly improve
Jewish World Review Jan. 8, 2003 / 5 Shevat, 5763

Amitai Etzioni

Amitai Etzioni
JWR's Pundits
World Editorial
Cartoon Showcase

Mallard Fillmore

Michael Barone
Mona Charen
Linda Chavez
Ann Coulter
Greg Crosby
Larry Elder
Don Feder
Suzanne Fields
James Glassman
Paul Greenberg
Bob Greene
Betsy Hart
Nat Hentoff
David Horowitz
Marianne Jennings
Michael Kelly
Mort Kondracke
Ch. Krauthammer
Lawrence Kudlow
Dr. Laura
John Leo
David Limbaugh
Michelle Malkin
Jackie Mason
Chris Matthews
Michael Medved
MUGGER
Kathleen Parker
Wes Pruden
Sam Schulman
Amity Shlaes
Roger Simon
Tony Snow
Thomas Sowell
Cal Thomas
Jonathan S. Tobin
Ben Wattenberg
George Will
Bruce Williams
Walter Williams
Mort Zuckerman

Consumer Reports


Values, not pay, provide best incentive to donate organs


http://www.NewsAndOpinion.com | New York's Department of Health could begin implementing as early as February some new rules approved last month for improving the care of liver donors. The guidelines, drawn up in response to the death of a donor at New York City's Mt. Sinai Medical Center last January, would set up "independent donor advocate teams," which would include doctors and social workers who could overrule a potential donor. The rules also would require increased and more experienced staffing. State officials hope the rules will serve as a national model.

New York's steps threaten to greatly limit in the short term organ donations from living persons. Those from deceased donors are far from sufficient. Indeed, thousands of Americans die each year because not enough organs have been donated. These facts have prompted some in the medical community, including the American Medical Association, to consider testing some form of financial incentive program. But before opening that tricky ethical box, we should do more to encourage voluntary donations.

A group of doctors, writing in the June 20 issue of The New England Journal of Medicine, for example, suggests measures such as reimbursing funeral expenses and providing lifelong disability insurance for living donors. They call their proposals "ethical incentives - not payment," as if cash is less green if called an "incentive."

CASH FOR DONATIONS

Two economists, Auburn University's David Kaserman and American University of Sharjah's A.H. Barnett, took the idea a step further: They favor giving each donor cash on the barrel. They figured that offering people $1,000 per donation would allow us to get all of the organs we need.

If the choice came down to paying for organs or allowing thousands to perish, the ethical judgment may lean toward a cash-and-carry system. And the shortage is very real: In the United States alone, about 6,000 people die each year while awaiting a transplant, and many more must lead a greatly diminished life.

That said, I see a danger in paying for doing things we ought to do out of moral commitment. Furthermore, when we turn organs into a commodity, we lose the sense of closeness people have when they act as family or friends rather than as traders.

TAKE A DIFFERENT APPROACH

So a different experiment should be conducted: an encompassing drive to change the moral culture. Let's start by formulating a strong statement that declares that we, as a community, hold that giving our organs to another after our passing is a moral act of the highest order. It is an act all human beings should engage in, and the community appreciates those who choose to do what is right. This statement should be presented for endorsement to people every time they visit a doctor's office or hospital.

The names of all who make the noble commitment should be listed on a Web page, both to make it easy to establish that their organs are available when they die, as well as for others to see who did make the commitment. (The listing should be done, community by community, not simply alphabetically. And people would be listed only if they indicated, via a check-off box on their donation form, that they are willing for their donation to be publicly acknowledged.)

Next, the law must be changed so that commitments to donate will be recognized as binding. Currently, securing donations is difficult not only because hospital staff are reluctant to ask for organs from the family just before or after someone passes away, but also because even if the patient has left written instructions indicating a wish to donate organs, the legal status of such a will is not always sufficiently clear, especially if the family challenges it.

Economists also rush to point out that transplants reduce the costs to all of us. For instance, the health-care costs of someone who gets a liver, kidney or even heart transplant are much lower than those otherwise treated.

If we succeed in making it widely understood that donating organs is what a good person does, we will have all we need, even if only a majority of Americans sign on. Give a gift of life.

Enjoy this writer's work? Why not sign-up for the daily JWR update. It's free. Just click here.


JWR contributor Amitai Etzioni, of George Washington University, is the author of, among others, The Limits of Privacy. Comment by clicking here.

12/12/02: Iran may present greater threat than Iraq
11/12/02: Killing Christians: The underreported story of Islamist violence around the world
10/16/02: Seeking middle ground on privacy vs. security
10/08/02: "In and out"
09/24/02: Treat driver's licenses as what they are: Domestic passports
08/27/02: How democracy is preserved
08/21/02: Why Martha 'needs' more
07/12/02: I was once a member of a "terrorist" group, show no mercy on civilian terrorists
03/31/02: Scandals will end when penalties fit crimes
02/03/02: A former White House staffer's plea to Congress: A presidency needs privacy
01/03/02: One nation, after all
12/27/01: Where children must write their PARENTS notes
12/20/01: American extremists
12/13/01: Homeland defense is best option for volunteerism
11/11/01: Can we force democracy on the Afghans?
11/08/01: How not to win the war
10/01/01: Problems with the new antiterrorist agenda is not that it is too grand, but that it is not grand enough
09/21/01: Either U.S. forces should strike back hard or we'll lose our freedoms
09/05/01: Communities, not the president, must enact morality
08/23/01: Economists fail as forecasters
08/09/01: Live from Washington it's …. "Everyone's a Criminal"
07/27/01: Condit case illustrates the need to rein in fast-talking lawyers playing verbal acrobatics with the truth
08/01/01: Shouting 'Big Brother' in a crowded society


© 2002, The Weekly Standard, from where this piece was reprinted