Busting 5 Myths About Organ Transplants
Sep 11, 2009 - 2:46:13 PM
(HealthNewsDigest.com) - People often ask about the role of wealth and influence in obtaining a transplant organ. When Steve Jobs, cofounder of Apple, received a liver transplant recently, the issue returned to the spotlight. Didn’t he seem to jump to the top of the organ transplant waiting list overnight? What reason could be given, other than wealth or influence?
The issue dates to the days of Mickey Mantle, the Yankee slugger accused of receiving favoritism when he needed a liver transplant. But the reality is more complex than the myth.
In reality, no amount of money, power, or influence can get you “moved up” on the official organ waiting list. Steve Jobs could not pay to get moved up the list. But he could take advantage of the differences between the rules that govern liver transplants and the rules that govern kidney transplants. With livers, medical necessity is a critical factor. With kidneys, which account for over 2/3 of all transplants, it’s all about your time spent waiting on the list.
What’s more, Steve Jobs could take advantage of his wealth to pursue opportunities not available to others. Knowing the waiting lists vary by region, he could afford to travel to parts of the country where the lists are shortest. He could afford to ignore the limits of the typical health insurance policy and sign up for a transplant at multiple hospitals. And he could afford to get on his private jet and fly to the hospital on a moment’s notice when an organ became available.
It’s important to recognize the differences between the myths and the realities when it comes to organ transplants. Over 100,000 Americans are currently waiting on the lists for life-saving organs. About 18 die each day—that’s twice the number lost in 9/11, every year.
So let’s compare 5 common myths with their 5 realities:
MYTH # 1: You can move up on the organ waiting list through money, power, or influence. REALITY # 1: The system itself is neutral to those factors, though it is true that the wealthier a person is, the more options become available—just like any other situation under our present health care system. The deep divide between rich and poor is an everyday phenomenon, though it most often gets attention when someone with celebrity is involved.
MYTH # 2: Organ transplantation is against religious principles.
REALITY # 2: Quite the contrary. Every major religion, Western and Eastern, with the exception of the Shinto, endorses organ transplantation as a means of saving lives. In 1991, Pope John Paul II stated: “The Catholic church would promote the fact that there is a need for organ donors and that Christians should accept this as a challenge to their generosity and fraternal love so long as ethical principles are followed.” So, too, every major branch of Judaism accepts it. Ironically, Iran has become the first nation to have a fully legalized and regulated live kidney market.
MYTH # 3: Your family has the right to override your decision to donate your organs on death. REALITY # 3: The Revised Uniform Anatomical Gift Act, enacted in all fifty States though with some variations, makes it clear that your family does not have the legal right to override your decision—if properly expressed with an organ donor card or otherwise—to donate your organs on death. In practice, however, many doctors continue to seek the approval of the immediate family before harvesting the organs of their loved ones.
MYTH # 4: It is dangerous to donate a kidney.
REALITY # 4: In fact most people need only one kidney to lead normal lives. The former head coach of the Denver Broncos has lived most of his life with one. Rates of death or serious complications among live kidney donors in the U.S. are extremely low. These days a donor’s kidney can usually be removed with laparoscopic surgery, through the belly button, leaving virtually no scarring.
MYTH # 5: The world is moving toward legalizing the purchase and sale of organs.
REALITY # 5: Almost all countries have criminalized the buying and selling of human transplant organs and the trend is toward greater enforcement in Third World nations where illicit organ markets have thrived. Places like Iran, where kidney sales are legal and regulated, and the Philippines, where they are allowed and largely unregulated, are the exceptions.
Debunking myths like these is one step toward getting those 100,000 Americans their life-saving organs. Getting more people to donate is the next. Legislation has been introduced in Congress to allow the States more leeway in experimenting with programs that would give tax, health insurance, or other incentives to organ donors. Reform in the system is badly needed and measures like these could save many lives.
HARLAN ABRAHAMS is a lawyer, writer, and educator. Formerly a tenured professor of constitutional and administrative law, he is a frequent lecturer on public policy. He lives in Denver, Colorado.
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