Dave Undis

Sunni: That story also included the sly jab that LifeSharers is a good idea in theory—the implication being that it won't work in practice. Since the LifeSharers concept remains untested so far—no member has died and been able to donate organs—that's an easy criticism to make. But I see no reason to expect it won't work, and that's when their howls of protest will really start. Have you given any thought to how to handle that?

Dave: Actually, I don't expect howls of protest. When we have the first transplant from one LifeSharers member to another, think of what the headline will be: Man Gets Life-Saving Transplant from 'Organ Club' or something like that. We'll get tons of publicity. People all across the United States will see that they can actually save their life by donating their organs, and we'll get millions of new members.

Sunni: I sure hope you're right. You know, something just occurred to me. Around the holidays, especially Christmas and Valentine's Day—which is now also National Organ Donor Day—we see extra attention being devoted to the issue of organ donation. Presumably the idea is to capitalize on our caring feelings for others. It strikes me as rather hypocritical to pull on people's emotions like that, but then to say that the actual donation process must be fair—in other words, impartial, with no feelings allowed to come into play. What do you think?

Dave: I guess I don't see the hypocrisy there. If people think the organ allocation system is unfair they'll be less likely to donate. LifeSharers is making the system more fair, and that will cause more people to donate. One more thing about fairness—the discussion always seems to revolve around what is fair to organ recipients. It almost always ignores the question of what is fair to organ donors. If you want to give your organs to other organ donors, is it fair to interfere with your decision and give your organs to non-donors? It most certainly is not. But I don't think that's going to happen. If UNOS started doing that, fewer people would agree to donate their organs. It's not in UNOS' interest to interfere with legal directed donations.

Sunni: Right; and that was kind of my point, Dave. I found this column by Amity Shlaes very interesting, both for another demolition job on the selfish libertarian stereotype, but more for the difficulties Virginia Postrel encountered. The amount of control in the organ market is astonishing.

Dave: You're right, and it might get even worse. There's a move now underway to give UNOS control over live organ donations, in addition to the control they now have over donations from the deceased. There are also people trying to take away your right to decide who gets your organs when you die. They say you should be able to direct your donation to family members, but not to friends, neighbors, or anyone else. I think it's completely outrageous.

Sunni: I agree. Why do you think so many Americans don't sign up to be organ donors? Is it the youth-worshipping, death-averse society, or lack of information on the need for organ donors and how successful donation can be, or is it something else?

Dave: I think it's much simpler than that. Thinking about organ donation is unpleasant, because it forces you to contemplate your own death. Signing up to be a donor is an easy thing to put off. LifeSharers addresses this problem. We give you a good reason to stop putting it off—a chance to save your own life.

Sunni: That makes a lot of sense. Tying this to a broader economic view, a friend recently told me that he won't sign up to be an organ donor. I found his reasoning compelling; he said that when he dies, his estate will almost certainly have accounts to settle, and he'd rather be able to direct that his organs be sold to clear his debts. Do you see that possibility ever happening in this country? Would you support something like that?

Dave: I would support any move toward more freedom to dispose of our organs as we see fit. But I don't think we'll see even small steps in that direction in the foreseeable future. Politically speaking, it's a complete non-starter. It's just not going to happen. That's one of the reasons LifeSharers is so important, by the way. It's a legal way to introduce non-monetary incentives in a world where monetary incentives are illegal.

If there was a free market in organs, thousands of people's lives would be saved every year. Even a heavily regulated and limited market would save lots of lives. For example, assume it was legal to buy organs only from dead people, not from live people. Assume only the government could buy them. And assume that the government fixed the price that could be paid – enough to pay for funeral expenses or something. Even with all those restrictions you'd get a big increase in the supply of organs. As for your friend, I recommend he read Lloyd Cohen's Directions For The Disposition Of My Vital Organs. Professor Cohen says his organs can be harvested only if his estate is paid for them, unless his organs go to family members or LifeSharers members.