Walter G. Wasser

The Urgent Case for a Market for Kidneys

Dylan Walsh, a freelance journalist specializing in science and the criminal justice system, recently shared a profoundly personal story in The New York Times. He recounted his life’s trajectory, intricately intertwined with kidney disease and transplantation, underscoring the critical need for reform in organ donation policies.

Walsh’s narrative starts with gratitude towards his father, who underwent a monumental surgery where a kidney was harvested from him and transplanted into Walsh’s body. This lifesaving procedure, undertaken when both Walsh and his brother were teenagers suffering from congenital kidney disease, highlights the stark realities of organ shortages and the dire consequences for those waiting on transplant lists.

The statistics Walsh presents are sobering. Over 100,000 Americans are waiting for a kidney, with thousands dying annually due to the unavailability of organs. Dialysis, while sustaining life, falls short of offering a true quality of life. Walsh paints a vivid picture of the human toll exacted by the current organ donation system.

He delves into the complexities of creating a market for kidneys, acknowledging historical hesitations and ethical concerns. However, Walsh argues persuasively for a reevaluation of these views. One proposed approach involves the federal government becoming the sole purchaser of kidneys, ensuring fair compensation and ethical standards.

The economic rationale behind this proposal is compelling. Kidney transplants are not only life-saving but also cost-effective compared to long-term dialysis treatments. By incentivizing organ donation through monetary compensation, the burden on public healthcare systems like Medicare could be reduced significantly.

Walsh confronts legal barriers head-on, citing the National Organ Transplant Act of 1984 as a major impediment to implementing a kidney market. Efforts by organizations like the Coalition to Modify NOTA are aimed at legalizing compensation for donors, backed by proposals such as the End Kidney Deaths Act, which seeks to provide financial incentives to donors through tax credits.

Various other initiatives at both federal and state levels are also highlighted, reflecting a growing awareness and momentum for change in organ donation policies. Walsh addresses concerns about coercion and exploitation, emphasizing the need for safeguards and responsible implementation of compensation mechanisms.

Moreover, he sheds light on racial disparities in organ donation and transplantation, advocating for compensation as a means to address systemic inequities. Public opinion polls indicate increasing support for compensation systems administered by public agencies, signaling a potential shift in societal attitudes towards organ donation.

In closing, Walsh reflects on his own journey post-transplantation, grateful for the extended years of life he’s been granted. He envisions a future where more individuals can benefit from such life-saving interventions, underscoring the urgency of reforming organ donation practices.

Walsh’s poignant narrative and insightful analysis serve as a compelling call to action, urging policymakers and the public alike to embrace innovative solutions that can alleviate the suffering of those in need of organ transplants. His article resonates as a testament to the power of transformative policies in saving lives and fostering a more equitable healthcare system.

Quote: Dylan Walsh shared in The New York Times on April 4, 2024, “I owe the last 25 years of life to my father, who dozed under general anesthesia as a surgeon cut eight inches from stomach to spine, removed one of his kidneys, placed it on ice and sent it to a nearby operating room where it was fitted into my abdomen.”

Source: Walsh, Dylan. “The Urgent Case for a Market for Kidneys: A Path to Saving Lives.” The New York Times, 4 April 2024.

About the Author
The author is a specialist in nephrology and internal medicine and lives with his wife and family in Jerusalem.
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