In or Out?

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Most of you have probably heard about the 10 year old Pennsylvania girl with cystic fibrosis who was in dire need of a lung transplant to survive. In case you missed it, she got her transplant in June, which buys her time while scientists search for longer term cures.

Some press reports focused on the rules that deny children under 12 access to the pool of adult transplant organs. There seems to be a scientific argument that this is an arbitrary rule for which there is little or no medical justification. In some of these stories, Kathleen Sebelius, the Secretary of Health and Human Services, was portrayed as the heavy for not waiving the rule in this emotional situation.

It’s a lose-lose situation for Sebelius. There’s a shortage of organs for transplants, so when this little girl got saved, someone else probably died instead. I say “probably” only because there are other issues like tissue compatibility, but people die all the time because there are not enough donors.

So what can any of us do?

A lot of you probably have little pink dots on your driver’s licenses that say “donor” on them. If so, you are part of the current system. You have opted to be in the pool of donors. The dot tells emergency room personnel that, if you die in an accident, your last act may be to help save somebody else’s life.

The problem is that some folks who’d be willing donors forget, and they don’t have a pink donor dot. So the first point of today’s column is, if you don’t have a pink dot on your license, please contact the DMV and ask how you can opt in and get one.

Now here’s the second reason for today’s column. Some experts believe we should change the system from one of  “opting in” to one of “opting out.”
Under an opting out system, everybody is presumed to be a donor unless they choose to opt out. The choice is still yours, but you’d have something on your driver’s license – let’s say a box with a slash through it  – that tells emergency room personnel you have opted out of the donor system. Could be for religious reasons, trust issues, doesn’t matter. The system would honor your choice.

Clearly the assumption is that the supply of transplant organs would go up under an opt out system and we’d face fewer tough choices like the little girl in Pennsylvania. But it’s not a fool proof alternative.

So what do you think?



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