Sweetening the pot for reluctant organ donors

Metro Detroit

By Brian Dickerson

Free Press Columnist

January 11, 2006

When their 12-year-old son died in a snowboarding accident, Tony and Karen Sisco made his organs available for transplant.

It was a life-affirming gesture, the sort of silver-lining story that rescues deaths like Tony Sisco Jr.'s from abject senselessness. But it also was an exception to the rule.

In 2004, according to the Organ Procurement and Transplantation Network, more than 6,700 Americans died waiting for organ transplants that might have prolonged their lives. At least 187 were from Michigan.

That would be tragic even if were simply a matter of the demand for transplantable organs exceeding the supply. But the truth is worse: Each year Americans bury or cremate 20,000 transplantable organs -- hearts, kidneys, livers and lungs -- that might still be functioning in someone's body if only the deceased or their survivors had followed the Siscos' example.

In a rational world, the prospect of saving lives with organs that would otherwise be discarded ought to be sufficient incentive for anyone to enroll as an organ donor, but most of us never get around to checking the boxes on the back of our driver's licenses or drafting a durable power of attorney.

Altruism may be its own reward, but in purely economic terms, it's not rich enough to coax the average American into the organ-donation game.

Now Dave Undis, a retired insurance broker in Nashville, Tenn., is trying to sweeten the pot.

Undis is the unpaid executive director of LifeSharers, a nonprofit, voluntary network that hopes to increase the supply of transplantable organs by promising those who agree to become donors first dibs on the organs of other members.

"If you or a loved one ever need an organ for a transplant operation, chances are you will die before you get it," the organization's Web site, www.lifesharers.org, warns. "As LifeSharers members, you and you loved ones will have access to organs that otherwise may not be available to you."

Medical authorities and advocates for those in need of transplant organs have so far been wary of the in-network concept, arguing that medical need should continue to be the primary basis for allocating scarce organs.

Dr. Robert Mentzer, a surgeon and organ-transplant advocate who recently was named dean of the Wayne State University Medical School, says the United Network for Organ Sharing (UNOS), which administers the national waiting list of organ-transplant candidates, is concerned about alternative allocation schemes that award preferential treatment.

"There's always a risk that people will start thinking of donated organs as commodities rather than gifts of life," he says.

But a bioethics white paper published by the UNOS Ethics Committee concedes that preferences based on recipients' participation in the organ-donating community could generate a rising tide that lifts all boats.

"It seems possible that preferred status would help facilitate a change from the present general sense of personal un-involvement to a majority that agree to opt in," the white paper concludes. In other words: Give 'em a leg up on nondonors, and the masses will pony up their pancreases.

Undis says LifeSharers has signed up 3,600 donors from all 50 states. Among its 82 Michigan members is Lawrence W. Reed, president of the Mackinac Center for Public Policy.

So far none of the network's members have died or donated organs, but 23 are on the national transplant waiting list. Undis says members must be part of the LifeSharers network for at least 180 days to qualify for benefits, a provision he said he hopes will discourage people from waiting until they're sick to sign up.

Mentzer says it will be difficult to evaluate preferential allocation systems like LifeSharers until they have more of a track record. But given the exploding demand for transplantable organs, he says, Undis' pay-to-play system "is definitely worth talking about."

Contact Brian Dickerson at 248-351-3697 or bdickerson@freepress.com.

Copyright © 2006 Detroit Free Press, Inc.

This article posted February 11, 2006.