The U.S. is suffering from a dire shortage of organ donors, and it will almost certainly get worse before it gets better. Tom Clynes, writing in The New York Times Magazine, observes that as American life grows safer — e.g., as safer vehicles reduce the number of traffic fatalities — the supply of organ donors shrinks as the demand for organ donors, which stems in part from longer lifespans, relentlessly increases. To address this shortage, Clynes reports, researchers are advancing the frontiers of xenotransplantation, or the transplantation of organs from non-human animals, and in particular pigs, to humans. Given the difficulties involved in convincing the human immune system that pig organs are salubrious, the progress that’s been made on this front is remarkable, thanks in large part to Crispr gene editing.
It is worth noting, however, that while xenotransplantation is a really impressive way to address the shortage of organ donors, there is another more straightforward approach, which has the advantage of not requiring any major scientific breakthroughs: As Sally Satel of the American Enterprise Institute has often recommended, we could offer organ donors vouchers and other incentives. Under the 1984 National Organ Transplant Act (NOTA), offering “valuable consideration” to organ donors is strictly prohibited. This, in turn, has made it far less likely that people will sign up to become organ donors in the first place. In “The Dearth of Donors” (National Review, June 27, 2016), Satel sketched out a reimbursement plan that could change this dynamic for the better, and not by encouraging the desperately poor to sell their organs for quick cash:
Donors would not receive a lump sum of cash; instead, a governmental entity or a designated charity would offer them in-kind rewards, such as an income-tax credit, a tuition voucher, loan forgiveness, lifetime health insurance, a contribution to the donor’s retirement fund, or a contribution to a charity of the donor’s choice. In case of post-operative complications, term health and life insurance might also be on offer.
Xenotransplantation is all well and good, and one hopes we’ll see further advances in the field. But surely we can start by offering modest incentives to encourage people to donate organs before they’re at death’s door.