Organ donation: A gift given or privilege taken?

By Mary O’Connor Mack
Right Care Boston

Is there a difference between someone who dies on a transplant list waiting for an organ and someone who dies in need of an organ, but was never listed because of their inability to pay? Is it more devastating when someone dies waiting on the list? Does it matter that one group never had a chance?

The average liver transplant in this country costs $813,000, with anti-rejection drugs totaling approximately $30,000 to $40,000 per year for the rest of a transplant recipient’s life. Inability to pay is a major barrier to being put on the organ donation list. And with costs being as high as they are, this barrier is much more common than it should be.

Despite the massive effort encouraging Americans to be an organ donor and “Give the Gift of Life,” we rarely hear about those who don’t meet the financial criteria for being listed. The reality is that the “Gift of Life” is reserved for those who can pay. Those who can’t are frequently not listed, and they always die. If you are an uninsured American or immigrant — with no other ability to pay– you can be an organ donor, but rarely a recipient. Moreover, a disproportionately higher percentage of “Givers of Life” are uninsured or underinsured people, compared to organ recipients. This is a grossly unjust system, steeped in inequality, where the Giving feels more like a Privilege taken. And those in power look the other way.

What can we do about this injustice? I propose that we call attention to the problem by refusing to donate organs until every resident who is eligible to donate an organ is also eligible to receive an organ, regardless of their ability to pay. We all have power in our health care decisions; the decision to not be an organ donor can highlight the immorality of the  US transplant and medical system. If you decide not to donate, make sure your family members know of your wishes not to donate – and tell them why.

Is it fair to potentially alter the outcome of an organ failure patient in need by not donating? It may be. But, it is clearly and egregiously unfair of the organ donation industry to ask everyone to donate altruistically, and then create financial barriers so only some can benefit. Perhaps this measure – extreme as it is – will put pressure on those in power to finally pay attention and force long needed reform in the healthcare industry.