Almost 100,000 Americans are waiting for organ transplant. Up to 60% will die before an organ becomes available. Yet Americans overwhelmingly support organ donation and most express willingness to donate. (See the book “Nudge: Improving Decisions about Health, Wealth and Happiness,” by Thaler and Sunstein, Ch 11.) What's wrong? It's the way states legally structure choice: a person has to take one or more active steps to opt into donation, e.g., by checking the box for donating on the drivers license renewal camera card form. One survey showed that of those who expressed a personal desire to donate, only 64% had that marked on their license and only 34% carried donor cards.
Many more lives can be saved by simple changes in anatomical gift laws from active opt-in to active opt-out or “presumed consent” (PC.) Under PC persons are presumed to give consent for donation unless they actively opt-out. Public education that this will occur, plus just a few words added to documents like the camera card indicating that if you do not wish to be a donor, have the “non-organ donor” designation put on your license would do it.
Each donor can help seven or maybe more people. And there is already partial presumed consent in some other states law for corneas derived from autopsy and analogies in our law about dying without a will (see “Presumed Consent for Organ Donation in Pennsylvania” 107 Dickinson Law Review 935 , Spring 2003.)
It's shameful that there are any Americans without resources to get needed transplants. But to at least stimulate more voluntary organ donation people can take an intermediate step of enlightened self-interest. “Lifesharers” is an organization that enables you to express a preference in donation of your organs to other members of Lifesharers. The United Network for Organ Sharing while not favoring this, apparently gives some weight to it in seeking a suitable Lifesharers recipient, if available, over what might be their “best match.” I'm persuaded that in current circumstances there are more ethical pros than cons to choosing Lifesharers. And after that, one can join Medcures, with which you agree to donate the remains of your body for science and education, in return for free cremation and return of your cremains to loved ones about three weeks after your body is picked up. Check out Lifesharers and Medcures on the Internet.
I am a humanist. I want to help as many other people as I can and have no place of sorrowful remembrance. No amount of money and things I can leave to relatives and charity will come close to equaling the gift of my organs and body.
