The Cost of an Altruism-Only Policy

Out of all the adults in New York State, only a minuscule 13 percent are registered organ donors. Nationwide, almost three times as many have signed up. With such an abysmally low rate, how can Albany not pass the modest step of presumed consent?

Theoretically, presumed consent could generate a significant volume of livers, hearts and lungs. About 2,000 such organs are needed statewide, and a single deceased donor can provide more than one kind of organ. But at its very best, presumed consent will put only a dent in the waiting list for kidneys that totals 7,300 people, according to the United Network of Organ Sharing.

Why? There are not simply enough eligible posthumous donors. Roughly 150,000 New Yorkers die each year, but less than 1 percent, or only 1,500 people, are likely to possess organs healthy enough for transplantation. Again, this projection is extremely optimistic because it assumes that every New Yorker will agree to the default--or consent--status.

The answer to the kidney shortage is incentives for living donation. To the great credit of Assemblyman Brodsky, whose teenage daughter has received two kidney transplants in her young life, he knows that the organ shortage must be attacked on several fronts.

The assemblyman's package of bills contains a provision that would allow anyone who donates a kidney while living to receive a $1,000 state income tax credit. (Living donation is common: a little under half of all organ donors nationwide in 2009 were friends or relatives.)

While I am skeptical that a tax credit of only $1,000 would prove a sufficient incentive to promote living donation, the assemblyman's initiative is enormously important. It challenges the standard narrative that altruistic giving is the sole legitimate motive for donating.

The cost of our altruism-only transplant policy is readily measured in lives: the nearly six hundred New Yorkers--and 7,000 Americans--who die each year waiting for an organ that never comes. This is morally indefensible. Many potential donors would gladly accept a meaningful reward for saving the life of another.

Sally Satel, M.D., is a resident scholar at AEI.

Photo Credit: iStockphoto/Eraxion

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