Enter as "Subject": New organ donor policies needed to reverse America's crisis

Then copy and paste from below:

Almost 100,000 dying patients are waiting for an organ today. One of them, or one who was taken off the list due to being too sick, dies every hour. Two million-five hundred thousand people die every year in the USA, yet a total of only 14,400 living and deceased persons donated organs last year. Clearly, "altruism" is failing to meet the demand for organs and failing to end this organ-donor crisis.

We are urging policy makers to begin pilot projects, in various states, of new models of consent for organ donation, including financial incentives and "Presumed Consent" (PC).  

"Financial incentives" would proceed as follows: in a government regulated system, living donors and deceased donor families would be offered their choice of the following incentives should they agree to donation: $50,000 cash payment or a decade of medical insurance (Medicare) or a $50,000 tax benefit. In the case of the living donor, all hospital expenses of surgery and follow-up care would be provided and he/she would be reimbursed for lost wages if employed. It should be noted that 45 million Americans are without medical insurance and 79 million have medical bill or medical debt problems.

Can a person "buy" an organ? No. Who pays the $50,000? Insurers. Sixty percent of transplants are kidneys. Each patient taken off of the kidney waiting list saves up to $400,000 for the payers [Medicare (60%) or private insurance companies]. A deceased donor who provides two kidneys would save these payers between $400,000-$800,000.

On 3/31/08 in an article (written on behalf of himself and not the expressed views of any of the organizations he serves) in the Los Angeles Business Journal, Thomas Mone publicly endorsed small scale trial projects to incentivize kidney donation with the government providing health insurance to a living donor. Thomas Mone is CEO of OneLegacy, the largest non-profit organ procurement organization in the USA. He is also President of the Association of Organ Procurement Organizations, and is a Director at UNOS.

Note that when the National Organ Transplant Act (NOTA) was passed in 1984 to prevent payment for organs, our government (i.e. UNOS) had no waiting list and it was not until 1989 that one was started---it reached only 19,095 patients by 12/31 of that year.

It is now time to support Senator Arlen Specter's bill, the Organ Donation Clarification Act of 2008. It would allow states to compensate donors for offering a kidney for transplant and the bill is supported by the American Society of Transplantation and the American Association of Kidney patients.

The Presumed Consent (PC) motto is, “Your Choice First.” Every American’s wish will be honored as follows: extensive publicity will notify all citizens that they will be presumed to be an organ donor and that if they object, they may "opt-out." PC is in effect in over 20 countries. The AMA and British Med. Assoc. have voiced support for PC and two reports by the AMA's Council on Ethical and Judicial Affairs recommend that "physicians should encourage and support properly designed pilot studies... that investigate the effects of [PC]." The HHS Advisory Committee on Organ Transplantation recommended a pilot study of PC to involve 4-5 states. Existing Presumed Consent bills are presently being evaluated for introduction into the Delaware, Nevada and California legislatures.  

California is signing up new organ donors with its online Donate Life Registry at the rate of 1.5 million a year. There are 34 million adults in CA, thus 20 years to sign up all. With PC and the stroke of a pen, everyone is signed up immediately except for those who opt out.

New organ donor policies would not only provide more organs, but they would also reduce the need for split liver transplantation, artificial organs, and xenotransplantation. Some believe Congress will never pass new organ-donor policies. We'll never know unless we try and we owe it to all 99,400+ to start debating these policies. As transplant surgeon, Adela Casas, MD, said, "I think it will be a hard road but a battle worth fighting for."

Please join with us and come out publicly for pilot projects of these new OD policies in your speeches and publications and by voicing your strong support to your peers.

Thank you for your time and consideration.

At the Loma Linda University Medical Center Transplant Institute:
-- Okechukwa Ojogho, M.D., Member, ASTS, Director, Transplantation Institute; Associate Professor of Surgery
-- Pedro Baron, M.D., Member, ASTS, Director of Pediatric and Adult Liver Transplantation; Associate Professor of Surgery
-- Zeid Kayali, MD, MBA, Hepatologist; Medical Director of Liver Transplantation
-- Michel Mendler, MD, Hepatologist; Associate Professor of Clinical Medicine, Division of  GI and Liver Diseases
-- Richard Swabb, M.D., Board Certified in Internal Medicine, Board Certified in Nephrology
-- Jill Weissman, Pharm. D., Transplant Pharmacist, Loma Linda University Medical Center
-- Julia A. Nofrada, RN CCTN (Certified Clinical Transplant Nurse)
-- Leigh Aveling, DMin., MFT, Chaplain and Associate Professor, School of Religion

At Stanford University School of Medicine:
-- Waldo Concepcion, MD, Member ASTS, FACS; Chief of Clinical Transplantation, Chief of Pediatric Kidney Transplantation, Associate Professor of Surgery, Stanford University School of Medicine.

At Scripps Green Hospital, La Jolla, CA
-- Donald Hillebrand, M.D., Hepatologist; Medical Director, Liver Transplantation  
 
At the University of South Dakota, Sanford School of Medicine, Sioux Falls, SD:
-- Adela T. Casas-Melley, M.D., ASTS, Pediatric/Transplant Surgeon, Sanford Children's Specialty Clinic; Associate Professor-Academic Faculty; Member, Editorial Board, Transplant Chronicles
 
At the Nazih Zuhdi Transplant Institute at INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma:
-- Nicolas Jabbour, M.D., Member, ASTS, Medical Director

At the Cleveland Clinic:
--John J. Fung, MD, PhD, FACS, Chairman of the Department of General Surgery and Director of the Transplant Center.
 
At the Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center:
-- Raymond M. Planinsic, MD, Director of Hepatic, Intestinal and Multivisceral Transplantation Anesthesiology

At the VA Pittsburgh Healthcare System
-- Thomas Cacciarelli, M.D., Chief, VA Pittsburgh Healthcare System Liver Transplant Surgery Program
 
At the University of California – Davis Medical Center:
-- Lorenzo Rossaro, M.D., Medical Director, Liver Transplant Program, Chief of Gastroenterology and Hepatology

At the University of Southern California Hospital, Los Angeles, CA:
-- Yasir A. Qazi, M.D., Medical Director, Kidney-Pancreas Transplant
-- Kianoush Banaei-Kashani, M.D., Keck School of Medicine of USC, Division of Nephrology
-- Jay Vidhun, M.D., Dept. of Nephrology, Kidney Transplant

At the California Pacific Medical Center:
-- Robert G. Gish, MD, Medical Director Liver Transplant Program; Chief: Division of Hepatology and Complex GI; Member of the American Association for the Study of the Liver, the American Gastroenterological Association, the American Society of Transplant Physicians, and the International Liver Transplant Society

At the NYU Medical Center (New York University School of Medicine & Hospitals Center):
-- Lewis Teperman, MD, Associate Professor, Chief and Director of Transplantation Surgery; Member: UNOS Liver & Intestine Committee, Member, Board of Directors: American Liver Foundation, New York Regional Transplant Program and Latino Organization for Liver Awareness

-- Phil Berry, M.D., Advisory Committee for Organ Transplantation (ACOT) appointed by Secretary Tommie Thompson, Health & Human Services, 2001-2004; Past President, Texas Medical Association; President, Texas Medical Assoc. Foundation 

-- Leonard J. Morse, MD; Commissioner of Public Health, Worcester, Massachusetts; Professor of Clinical Medicine and Family Medicine and Community Health, University of Massachusetts Medical School; Chair Emeritus, AMA CEJA; Past-President, Mass. Medical Society (Presumed Consent support pursuant to AMA Opinion 2.155)

--James N. Eustermann M.D. FACS; Board Certified General Surgeon; Diplomat, American Board of Surgery; Fellow, American College of Surgeons; Medical Director

-- Sally Satel, MD, Staff Psychiatrist, Oasis Drug Treatment Clinic, Washington, D.C.; Resident scholar, American Enterprise Institute; Coauthor of One Nation Under Therapy and author of PC, M.D.; editor of When Altruism Isn't Enough: The Case for Compensating Kidney Donors (AEI Press, 2009) and many other publications in favor of new OD policies

-- Diane Furchtgott-Roth, former chief economist, U.S. Department of Labor; senior fellow, Hudson Institute

-- Charles J. Goodacre, DDS, MSD; Dean of the School of Dentistry, Loma Linda University; Past President, American Board of Prosthodontics; Board Member, American College of Prosthodontists; Redlands, CA

-- Richard Darling, DDS; Past National Public Citizen of the Year (NASW); Author: Coma Life, an autobiographical memoir of three liver transplants

-- Dave Courtney, Vice President and Director of Public Relations; The Presumed Consent Foundation

-- Bill Remak, Chairman, California Hepatitis C Task Force; Secretary, National Association of Hepatitis Task Forces; Member, Board of Directors of the Pharmacy Council on Hepatitis and Liver Disease.
 
-- Ralph H. Treiman, Past-President, American Liver Foundation, Greater Los Angeles Chapter

Senator Specter's bill: the ‘‘Organ Donation Clarification and Antitrafficking Act of 2008"

Thomas Mone's article and subsequent discussion with him by Dr. Darling regarding incentivizing living kidney donation with governmental health care insurance may be accessed here.

The policy of governmental and insurer reimbursement to living kidney donors was originally derived by the public announcement/support of this new OD policy by Arthur J. Matas, MD, who is professor of surgery, Director of the Renal Transplant Program at the University of Minnesota and former President of the American Society of Transplant Surgeons. Dr. Matas CV. Dr. Matas informatively answers questions on ABC News.

A portion of this letter was prepared utilizing language from the American Liver Foundation's resolutions: http://www.liverfoundation.org/about/advocacy/organdonationpolicy/

The Presumed Consent Foundation http://www.presumedconsent.org/membrshp.htm

Donation benefits as proposed by many eminent professionals and citizens, including Mr. Richard DeVos, heart recipient and co-founder of Amway:  http://fairfoundation.org/organdonation/donation_benefits.pdf   

USA organ-donor waiting list http://www.optn.org/. One dies every hour here.

AMA CEJA Opinion 4-1-05 is at http://www.ama-assn.org/ama1/pub/upload/mm/369/ceja_opinion_2_155.pdf
Opinion 7-A-05 http://www.ama-assn.org/ama1/pub/upload/mm/369/ceja_7a05.pdf.
AMA Opinion 2.155 is referenced in the former.

The Lancet is the European counterpart of the American Medical Association's "Journal of the American Medical Association." A 6/8/07 Editorial in the LANCET states, in part,
"“…although ethically and morally suspect, the case for legalising and regulating the commercial sale of human organs may appear to have the upper hand." Full Editorial is here: http://fairfoundation.org/organdonation/LANCET.htm

The British Medical Association's support for PC and endorsement of PC by Britain's Chief Medical Officer is at http://fairfoundation.org/organdonation/BMA_on_Presumed_Consent.pdf

In regards to the debate over Donation Benefits to a deceased donor family, it may be noted that companies such as Genzyme Biosurgery, LifeCell, LifeNet Health and others are expected to have gross revenue of over $200 million dollars by 2012. Their business is providing human cells, tissues and organs for transplant. Full story. Some of UNOS’s organ procurement organizations are also now entering this lucrative business. Is it ethical to allow businesses and OPO’s to profit/receive financial gain from patients' cells, tissues and organs, while patients and their families are not allowed the same benefit?

When the National Organ Transplant Act was passed in 1984 to prevent payment for organs, UNOS had no waiting list and it was not until 1989 that one was started---it reached only 19,095 patients by 12/31 of that year. With close to 100,000 dying souls now waiting, can we morally justify preventing patients and their families from donation benefits while others reap substantial profits from their body organs, tissues and cells?

79 million Americans with medical debt problems, full story. 46 million without health insurance, full story.