Organ Donation and Imminent Death

This blog occasionally discusses organ donation. Over the years, there has been increasing government control over organ transplantation. It is not an area where supply and demand can meet in the normal economic sense, because there is a fixed supply of organs that is not adequate to satisfy demand. Many libertarians have proposed that anybody who wants to sell one of his organs should be free to do so. (Currently, we are not.)

Joshua Mezrich and Joseph Scalea, two organ-transplant physicians, make the case in The Atlantic that we should not have to wait until bran death to donate organs. Every minute the organ sits inside a deceased person reduces the likelihood that it can be transplanted effectively. Instead. they recommend that a patient whose death is “imminent” should be free to choose to have his organs harvested. Discussing their patient, W.B., they report that:

Initially, W.B. had assumed that he would arrange for his organs to be procured when he died, but then he read that kidneys from a living donor work better and last longer than kidneys from a deceased donor. For one thing, the death process takes a toll on organs, between the decreased flow of blood and oxygen and the release of inflammatory proteins. For another, kidneys that are removed after death inevitably endure “cold time”—when they are outside the body, on ice, without any blood flow at all.

“Why not fork out a kidney before it becomes compromised by all the meds I am taking?,” W.B. asked us when we met him in June. But he didn’t stop there. Beyond a kidney, he explained, he wanted to donate the rest of his organs once his condition deteriorated so much that he could no longer breathe on his own.

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