On the front page of today’s New York Time (also found online here) is an article regarding organ donations. As we already know, the US faces a huge shortage of organs available for transplant. The waiting lists for organs are not getting any shorter, and donors are not really all that plentiful. This article discusses a push to allow HIV infected organs available for transplantation to HIV positive recipients.
People who are HIV positive often suffer from kidney failure, meaning they will eventually require a new kidney. They could possibly even require more than one transplant. We have talked in class about personal choice, social lottery, and natural lottery in regards to burdens of disease and who should receive health resources. Some people think that former alcoholics or patients with HIV shouldn’t receive new organs because there are people on the waiting lists who haven’t “made poor choices” about their health. We know this isn’t always the case–sometimes there are social circumstances that lead to poor health. Nevertheless, there is still a shortage of organs. And yes, there is a systematic process by which UNOS determines a person’s placement on the waiting list, but that list is still really long. Allowing HIV infected patients to receive HIV infected organs would be a way to make 500-600 livers and kidneys available to those who need them. “Every HIV infected one we use is a new organ that takes on more person off the list.” In order for this to be possible, a 23 year old amendment to the National Organ Transplant Act would have to be repealed. This ban was passed during the height of the AIDS scare in the 1980s.
A few possible concerns about this proposal:
Allowing HIV infected organs to be transplanted would increase concern about healthy patients receiving the wrong organ or contracting HIV in some other way. Also, some people still feel that HIV infected patients do not “deserve” a new organ or do not have strong enough systems to accept new organs.
I think this is an interesting solution to a shortage of organs. Would it be better to have presumed consent, where people must opt out if they do not wish to be organ donors, instead of having organ donation be voluntary? This can be a very sensitive and controversial issue, so I will be curious to see how it all plays out.