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It’s time to fix the organ donor law, NOTA

Written by Diane Archer

Tens of thousands of Americans need an organ transplant, but there are not enough organs available to save most of their lives. Would you like to donate an organ and save a life? Believe it or not, there are thousands people willing to donate their organs who cannot. The National Organ Transplant Act, NOTA, forbids living Americans from donating their organs unless they can demonstrate that they have the means to pay most, if not all, of the cost. It’s time to fix the organ donor law.

Under the law, even if the transplant recipient or that person’s friend or relative wanted to pay the full cost of the transplant, the individual could not. The law prevents anyone from paying living donors to undergo the surgery. Only travel, hotel and lost wages can be reimbursed and then only by the person receiving the transplant.

Moreover, if the potential donor can afford the surgery but not the additional costs, and the organ recipient does not have the means to reimburse those costs, the person who wants to be a donor cannot serve as a donor. In order for a person to receive a transplant from a living donor, the person giving the organ must have the financial resources to cover the surgery, which is generally between $5,000 and $20,000.

The consequence of the National Organ Transplant Act is that only wealthy Americans can donate organs. Even charities cannot cover the cost. It is illegal for the donor to take money for the surgery. And, tens of thousands of people die each year of organ failure.

To be clear, the National Organ Transplant Act is well-intentioned and was written to address the shortage of organs. It sets up a national organ registry for organ matching. It is also written to prevent the buying and selling of organs, organ-trafficking. We do not want to incent people with limited means to sell their organs for a price. But, why can’t we carve out an exception that allows payment for non-commercial donations?

The NOTA law needs to be amended to permit organ donations from donors who simply want to support the people they love and save lives. And, there is surely room for it to evolve so that it simply prohibits commercialized bargained for organ donations and incents other non-commercial donations. The law has already evolved a little. In June 2012, the U.S. Court of Appeals for the Ninth Circuit ruled in Flynn that the law does not cover bone marrow donations, since it was written before the procedure was developed.

Today, 120,000 Americans need a transplant. And, there is a growing shortage of organs. The Department of Health and Human Services estimates that 18 people die each day while waiting for an organ transplant. In 2013, 4300 people died and another 3000 developed a medical condition that prevented them from remaining in the queue. The wait averages five years nationally.

If you’re wondering about all the organs available from people who die, who have checked the organ donor box on their drivers’ licenses, their organs help people less than one percent of the time. Only the smallest fraction of individuals who die each year, about 12,000 of the 2 million, are in a good enough physical condition when they die or close enough to a hospital that their organs can be donated. And, of those, only about half end up donating organs because of objections of family members.


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