- The Washington Times - Friday, June 8, 2001

For a great many Americans, organ donation is a question of life and death. Unfortunately, the issue is one that most people shrink from contemplating until it stares them in the face, either because of their personal medical need or that of a friend or loved one. As of April 17, the day when Secretary of Health and Human Services Tommy Thompson launched his organ donation initiative, there were 75,863 people waiting to receive organs. Last year, more than 5,500 Americans died waiting for transplants. There is an urgent need for more donors, and simple awareness of how to donate could save thousands of lives this year. The secretarys initiative aims to increase knowledge about organ donation in places such as schools and businesses. He is also partnering with transplant surgeons to increase research to help those needing organs. Worthy as the cause is, however, Mr. Thompsons initiative has been controversial, mainly due to misinformation about what the plan involves.

The first piece of misinformation is that the secretary is pushing for living donors to be organ providers. While Mr. Thompson is aware that the number of living donors is increasing, he recognizes a need for caution, an HHS official said in an interview with the editorial plage. Around 500 patients in the United States have received liver transplants from living donors since 1997, with one death of a donor reported. In the case of liver transplants, the donor gives up to 60 to 70 percent of the organ, which replaces itself within around a month. This poses a greater risk to donors than in the case of kidney transplants, where only 3 in 10,000 have died.

While Mr. Thompson plans to launch an initiative in the future which would review potential federal responsibilities for monitoring the safety of living donations, he has no plans for the government to take over a job he believes is best done by the transplant community itself. Private organizations like the American Society of Transplant Surgeons and the United Network for Organ Sharing ensure that doctors, hospitals and transplant programs are qualified to practice the procedure.

Another myth is that the initiative would pave the way for patients who are just unconscious, but not dead, to have vital organ removed prematurely. In this litigation-happy society, however, it is usually not enough for doctors to confirm that the patient is irreversibly brain dead. The donor also has to have indicated that he would like to be an organ donor, and the consent of the family must be given. Nor would Mr. Thompson´s campaign to raise donor awareness lead to an organ market, as long as the medical division of labor remains in place as it is now.

"There has to be a clear firewall between the people who are taking care of people and the people who make the determination of death," John Nelson, the director of the office of special programs at HHS´ Health Resources and Services Administration, said in an interview. Another firewall would be needed between those who make the determination of death and those lobbying for organ donations.

And, finally, many people have the misconceived notion that checking the box "Y" to be an organ donor on a driver´s license application is all one needs to do to become a donor after death. In all but 16 states, however, that "Y" doesn´t mean a thing. In the other 34 states, there is no organized registry to keep track of who has responded "yes" to such a question. Mr. Thompson´s plan provides more funding to such registries, and promotes awareness of them in the health care community, the legal community, the corporate world, in religious organizations, and on college campuses. Of families of deceased who are asked whether they will donate a loved one´s organ, only about 50 percent agree, though most Americans polled say they support donation, according to the HHS web site. One can easily sign up to be a donor by going to www.organdonor.gov and clicking on the donor hand at the bottom of the page.

For this page, donor statistics aren´t just numbers any longer. Our friend and colleague, deputy editorial page editor and op-ed columnist Kenneth Smith has been waiting for a liver transplant for more than five months. By agreeing to be donors, we can all give others a chance to have their lives back. There can hardly be a more worthy cause.

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