Editorial: Thinking the unthinkable on paying organ donors
With demand greatly exceeding supply for life-saving organs, it's time for the U.S. to consider a legal system of compensation.
By The Denver Post

The idea of selling human organs conjures up all sorts of visions, most of them ghoulishwhich no doubt helps explain why such sales are illegal under federal law.

Meanwhile, though, the list of Americans who need a kidney transplant nears 100,000, the waiting period grows longer and longer — with many patients fated to die before receiving help — and the total cost of dialysis skyrockets.

Isn't it time to admit that urgent pleas for voluntary donors will never fill the demand and to consider other ways to reduce the backlog? We think so, and were pleased to see evidence of shifting attitudes in reporter Michael Booth's article on organ transplants in Sunday's Denver Post.

Booth quoted Dr. Igal Kam, chief of University of Colorado Hospital's transplant surgery, and Dr. Arthur Matas, a leading transplant surgeon in Minnesota, as both favoring some sort of compensation system. "It's our job to maximize donors," Kam said. "So we as a society need to look at how to create compensation for the donor families."

Opponents of compensation inevitably object that any such system will expose poor people to exploitation. Those who can't afford life's basics or who find themselves deep in debt will sell a kidney just to survive or pay their bills, the critics say.

But no one is proposing a market free-for-all in which strangers sell organs to the highest bidder.

Under any conceivable system, donors would be carefully vetted — just as they are now. And their compensation could be limited to specific benefits (such as education assistance) that drive away those who might be looking for a quick windfall of cash.

Twenty-five years ago, Booth reports, the average waiting list nationally was only about one year. Today, it is five years in Colorado and the Midwest and nearly 10 years on the coasts. Desperate patients who can afford it sometimes go abroad for transplants.

Earlier this year, state Sen. Lucia Guzman, D-Denver, sponsored an "opt-out" organ donor bill that would have designated anyone with a Colorado driver's license or ID card an organ donor unless the person initialed a statement opting out of the program.

Guzman killed the bill after controversy erupted, but even if it had passed, it would not have resolved the donor shortage.

There simply aren't enough hospital deaths in which a donation is possible to alleviate the dire shortage. Living donors are a necessity.

Fortunately, healthy people can donate one of their kidneys without long-term side effects, studies have repeatedly shown. The only question is whether society can motivate enough people to make the sacrifice.

Relying on altruism alone simply hasn't done the job.

It's time to consider the unthinkable and start moving toward a system of compensation.

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