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Health
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Title: The Meat Market [tackling the organ shortage]
Source: Wall Street Journal
URL Source: http://online.wsj.com/article/SB100 ... tml?mod=WSJ_hp_mostpop_emailed
Published: Jan 09, 2010
Author: Alex Tabarrok
Post Date: 2010-01-10 21:22:28 by scrapper2
Keywords: organ donor shortage
Views: 89
Comments: 4

Harvesting human organs for sale! The idea suggests the lurid world of horror movies and 19th-century graverobbers. Yet right now, Singapore is preparing to pay donors as much as $50,000 for their organs. Iran has eliminated waiting lists for kidneys entirely by paying its citizens to donate. Israel is implementing a "no give, no take" system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ.

Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one.

To combat yet another shortfall, some American doctors are routinely removing pieces of tissue from deceased patients for transplant without their, or their families', prior consent. And the practice is perfectly legal. In a number of U.S. states, medical examiners conducting autopsies may and do harvest corneas with little or no family notification. (By the time of autopsy, it is too late to harvest organs such as kidneys.) Few people know about routine removal statutes and perhaps because of this, these laws have effectively increased cornea transplants.

Routine removal is perhaps the most extreme response to the devastating shortage of organs world-wide. That shortage is leading some countries to try unusual new methods to increase donation. Innovation has occurred in the U.S. as well, but progress has been slow and not without cost or controversy.

Organs can be taken from deceased donors only after they have been declared dead, but where is the line between life and death? Philosophers have been debating the dividing line between baldness and nonbaldness for over 2,000 years, so there is little hope that the dividing line between life and death will ever be agreed upon. Indeed, the great paradox of deceased donation is that we must draw the line between life and death precisely where we cannot be sure of the answer, because the line must lie where the donor is dead but the donor's organs are not.

In 1968 the Journal of the American Medical Association published its criteria for brain death. But reduced crime and better automobile safety have led to fewer potential brain-dead donors than in the past. Now, greater attention is being given to donation after cardiac death: no heart beat for two to five minutes (protocols differ) after the heart stops beating spontaneously. Both standards are controversial—the surgeon who performed the first heart transplant from a brain-dead donor in 1968 was threatened with prosecution, as have been some surgeons using donation after cardiac death. Despite the controversy, donation after cardiac death more than tripled between 2002 and 2006, when it accounted for about 8% of all deceased donors nationwide. In some regions, that figure is up to 20%.

The shortage of organs has increased the use of so-called expanded-criteria organs, or organs that used to be considered unsuitable for transplant. Kidneys donated from people over the age of 60 or from people who had various medical problems are more likely to fail than organs from younger, healthier donors, but they are now being used under the pressure. At the University of Maryland's School of Medicine five patients recently received transplants of kidneys that had cancerous masses. Why would anyone risk cancer? Head surgeon Dr. Michael Phelan explained, "the ongoing shortage of organs from deceased donors, and the high risk of dying while waiting for a transplant, prompted five donors and recipients to push ahead with surgery." Expanded-criteria organs are a useful response to the shortage, but their use also means that the shortage is even worse than it appears because as the waiting list lengthens, the quality of transplants is falling.

Routine removal has been used for corneas but is unlikely to ever become standard for kidneys, livers or lungs. Nevertheless more countries are moving toward presumed consent. Under that standard, everyone is considered to be a potential organ donor unless they have affirmatively opted out, say, by signing a non-organ-donor card. Presumed consent is common in Europe and appears to raise donation rates modestly, especially when combined, as it is in Spain, with readily available transplant coordinators, trained organ-procurement specialists, round-the-clock laboratory facilities and other investments in transplant infrastructure.

The British Medical Association has called for a presumed consent system in the U.K., and Wales plans to move to such a system this year. India is also beginning a presumed consent program that will start this year with corneas and later expand to other organs. Presumed consent has less support in the U.S. but experiments at the state level would make for a useful test.

Rabbis selling organs in New Jersey? Organ sales from poor Indian, Thai and Philippine donors? Transplant tourism? It's all part of the growing black market in transplants. Already, the black market may account for 5% to 10% of transplants world-wide. If organ sales are voluntary, it's hard to fault either the buyer or the seller. But as long as the market remains underground the donors may not receive adequate postoperative care, and that puts a black mark on all proposals to legalize financial compensation.

Only one country, Iran, has eliminated the shortage of transplant organs—and only Iran has a working and legal payment system for organ donation. In this system, organs are not bought and sold at the bazaar. Patients who cannot be assigned a kidney from a deceased donor and who cannot find a related living donor may apply to the nonprofit, volunteer-run Dialysis and Transplant Patients Association (Datpa). Datpa identifies potential donors from a pool of applicants. Those donors are medically evaluated by transplant physicians, who have no connection to Datpa, in just the same way as are uncompensated donors. The government pays donors $1,200 and provides one year of limited health-insurance coverage. In addition, working through Datpa, kidney recipients pay donors between $2,300 and $4,500. Charitable organizations provide remuneration to donors for recipients who cannot afford to pay, thus demonstrating that Iran has something to teach the world about charity as well as about markets.

The Iranian system and the black market demonstrate one important fact: The organ shortage can be solved by paying living donors. The Iranian system began in 1988 and eliminated the shortage of kidneys by 1999. Payment could be made by the federal government to avoid any hint of inequality in kidney allocation. Moreover, this proposal would save the government money since even with a significant payment, transplant is cheaper than the dialysis that is now paid for by Medicare's End Stage Renal Disease program.

In March 2009 Singapore legalized a government plan for paying organ donors. Although it's not clear yet when this will be implemented, the amounts being discussed for payment, around $50,000, suggest the possibility of a significant donor incentive. So far, the U.S. has lagged other countries in addressing the shortage, but last year, Sen. Arlen Specter circulated a draft bill that would allow U.S. government entities to test compensation programs for organ donation. These programs would only offer noncash compensation such as funeral expenses for deceased donors and health and life insurance or tax credits for living donors.

World-wide we will soon harvest more kidneys from living donors than from deceased donors. In one sense, this is a great success—the body can function perfectly well with one kidney so with proper care, kidney donation is a low-risk procedure. In another sense, it's an ugly failure. Why must we harvest kidneys from the living, when kidneys that could save lives are routinely being buried and burned? A payment of funeral expenses for the gift of life or a discount on driver's license fees for those who sign their organ donor card could increase the supply of organs from deceased donors, saving lives and also alleviating some of the necessity for living donors.

Two countries, Singapore and Israel, have pioneered nonmonetary incentives systems for potential organ donors. In Singapore anyone may opt out of its presumed consent system. However, those who opt out are assigned a lower priority on the transplant waiting list should they one day need an organ, a system I have called "no give, no take."

Many people find the idea of paying for organs repugnant but they do accept the ethical foundation of no give, no take—that those who are willing to give should be the first to receive. In addition to satisfying ethical constraints, no give, no take increases the incentive to sign one's organ donor card thereby reducing the shortage. In the U.S., Lifesharers.org, a nonprofit network of potential organ donors (for which I am an adviser), is working to implement a similar system.

In Israel a more flexible version of no give, no take will be phased into place beginning this year. In the Israeli system, people who sign their organ donor cards are given points pushing them up the transplant list should they one day need a transplant. Points will also be given to transplant candidates whose first-degree relatives have signed their organ donor cards or whose first-degree relatives were organ donors. In the case of kidneys, for example, two points (on a 0- to 18-point scale) will be given if the candidate had three or more years previous to being listed signed their organ card. One point will be given if a first-degree relative has signed and 3.5 points if a first-degree relative has previously donated an organ.

The world-wide shortage of organs is going to get worse before it gets better, but we do have options. Presumed consent, financial compensation for living and deceased donors and point systems would all increase the supply of transplant organs. Too many people have died already but pressure is mounting for innovation that will save lives.

—Alex Tabarrok is a professor of economics at George Mason University and director of research for the Independent Institute.


Poster Comment:

a. "...some American doctors are routinely removing pieces of tissue from deceased patients for transplant without their, or their families', prior consent. And the practice is perfectly legal. In a number of U.S. states, medical examiners conducting autopsies may and do harvest corneas with little or no family notification. (By the time of autopsy, it is too late to harvest organs such as kidneys.) Few people know about routine removal statutes and perhaps because of this, these laws have effectively increased cornea transplants..."

Who knew this was happening? Have our American freedoms been curtailed to such a degree that our body parts are stripped LEGALLY without our prior consent?

b. "...In March 2009 Singapore legalized a government plan for paying organ donors. Although it's not clear yet when this will be implemented, the amounts being discussed for payment, around $50,000, suggest the possibility of a significant donor incentive. So far, the U.S. has lagged other countries in addressing the shortage, but last year, Sen. Arlen Specter circulated a draft bill that would allow U.S. government entities to test compensation programs for organ donation. These programs would only offer noncash compensation such as funeral expenses for deceased donors and health and life insurance or tax credits for living donors..."

A rather cheap and cheesy proposal by Arlen Specter as compared to what the Singapore gov't planned to give as incentive compensation. Shish!

c. Did you know that other countries' nationals can get in the queue on US organ transplant lists? A dirty little secret that not many American citizens know.

http://www.transplantliving.org/beforethetransplant/qa.aspx#txCitizens

Some cut and paste:

Do transplant hospitals in the U.S. only perform transplants on U.S. citizens?

No. Patients from other countries may travel here to receive transplants. Once accepted by a UNOS transplant center, international patients receive organs based on the same policies as U.S. citizens.

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#4. To: scrapper2 (#0) (Edited)

some American doctors are routinely removing pieces of tissue from deceased patients for transplant without their, or their families', prior consent. And the practice is perfectly legal.

Wouldn't that go against the JUST COMPENSATION clause?

Article I, Section 13. JUST COMPENSATION CLAUSE. The property of no person shall be taken for public use without just compensation

Oh wait, that doesn't apply to us slaves:

"Are You Really Free?

....The United States is bankrupt and has been since 1933. The government has no gold or silver as required by the Constitution. The only asset left is the people. So how does the U.S. finance its daily operations?

Solution, collateralize the people for credit. How? By registering them in international commerce, and selling bonds on them. The people become the surety on the bonds, or the "pledge". The asset bonded (surety) is the labor of the people which is payable as some undetermined future date. Thus, the people become the "utility" for the "transmission" of energy. Result, a very sophisticated form of peonage or slavery and the Constitution does not apply because the government, on all levels, is thrown into international commerce, the law merchant, now known as the Uniform Commercial Code. [See Public Law 88-244 in which the U.S. Subscribed to private international law. See definition of "goods" under the Uniform Commercial Code; Section 2-105(1) and 9-105(1) in which **** animals, **** i.e. humans and their unborn offspring, become "goods" sellable in commerce!] ...."

"....When a baby is born in the UNITED STATES, a birth certificate is registered with the Bureau of Vital Statistics in the State of birth. The key word here is "registered" as registered in international commerce. The baby becomes the surety, whose energy is due at some future date. REMINDS YOU OF THE MOVIE MATRIX DOESN'T IT. When the birth certificate is registered in the U.S. Department of Commerce, the Department of Treasury issues a bond on the birth certificate ($1,000,000) and the bond is sold at some securities exchange and perhaps bought by the Federal Reserve Bank, which then uses it as collateral in order to issue Federal Reserve Notes or some other form of "debt obligation" (see 18 USC §411). The bond is then held in trust for the Federal Reserve at the Depository Trust Corp. At 55 Water Street, in New York City, about two blocks down the street from the Fed. It is a high rise office building and the sign out front reads "The Tower of Power". I. E. MATRIX

When the birth certificate is registered, a separate legal entity is created, like a mirror image of the flesh and blood human. This separate entity, or alter ego (THE ALL CAPITAL LETTER NAME) is the "strawman". (See Black's Law 6th edition dictionary). And it is the "accommodation party" of the Uniform commercial Code §3-415. The "name" is credit. (See Back's 6th "accommodation party"). Therefore the right (or the use) has been separated from the title (or deed). The "straw man" holds the title (he belongs to the government's client who bought the title) and the real live you, flesh and blood man or women has only naked possession with the limited "right" to use the thing (like your body or your alleged possessions and land). Maybe that's why our civil rights suits get dismissed out of court on Civil Rule 12(b)(6) motions. This deals with "failure to state a title upon which relief can be granted". A claim is another word for "title". So we have "failed to state upon which relief can be granted". We do not own the "title", even to our own bodies anymore. Isn't that encouraging! How free are you now? ....."

http://www.discharge-debt.com/id127.htm

The Ultimate Delusion By Stephen Ames | Love for Life
Mar 27, 2008 ... It explains how the Babylonian Talmud became the law of the land, which is now known as the Uniform Commercial Code which is private international law. The written credit agreement -- the Jewish shetar is a lien on all of the property in the world. The treatise also explains that the Jews are owned by Great Britain and that the Jews are in charge of the Baking [sic] system.

We are living under the Babylonian Talmud. It was brought into England in 1066 and has been enforced by the Pope, Kings and the various religions ever since. It is total and relentless mind control, people are taught to believe in things that do not exist. Private International Law, which is commercial law, only deals with fictions, known as persons. A person is a fictional entity at law, not a living being. See UCC 1-201.

Now before you scream that the UCC is unconstitutional I'm sorry people, you are not a party to any constitution. Read the case cite below.

"But, indeed, no private person has a right to complain, by suit in court, on the ground of a breach of the Constitution. The Constitution it is true, is a compact, but he is not a party to it." Padelford, Fay & Co., vs. Mayor and Aldermen of the City of Savannah 14 Ga. 438, 520 You have to understand that Great Britain, (Article six Section one) the United States and the States are the parties to the Constitution not you. Let me try to explain. If I buy an automobile from a man and that automobile has a warranty and the engine blows up the first day I have it. Then I tell the man just forget about it. Then you come along and tell the man to pay me and he says no. So you take him to court for not holding up the contract. The court then says case dismissed. Why? Because you are not a party to the contract. You cannot sue a government official for not adhering to a contract (Constitution) that you are not a party too. You better accept the fact that you are a Slave. When you try to use the Constitution you are committing a CRIME known as CRIMINAL TRESPASS. Why? Because you are attempting to infringe on a private contract that you are not a party to. Then to make matters worse you are a debt slave who owns no property or has any rights. You are a mere user of your Masters property! ......

Here are just a couple of examples:

"The primary control and custody of infants is with the government" Tillman V. Roberts. 108 So. 62

"Marriage is a civil contract to which there are three parties-the husband, the wife and the state." Van Koten v. Van Koten. 154 N.E. 146.

"The ultimate ownership of all property is in the State: individual so-called 'ownership" is only by virtue of Government, i.e. law amounting to mere user; and use must be in accordance with law and subordinate to the necessities of the State. Senate Document No. 43 73rd Congress 1st Session. (Brown v. Welch supra)

You own no Property because you are a slave. Really you are worse off than a slave because you are also a debtor......"

http://loveforlife.com.au/conten...ate-delusion-stephen-ames

"....For one to regain title to his body, the Birth Certificate must be secured and attached and recorded in the private UCC-1 filings with the Secretary of State in the democracy. Once the living soul has redeemed his Birth Certificate and filed notice of the redemption by a UCC-1 filing with the Secretary of State, then the living soul has the right of property ownership in himself through his straw man who now belongs to the living soul. Furthermore, the bond created and sold in the market place for the straw man now becomes the property of the living soul. The living soul now has the capacity to own real property by allodium and to own private chattel property by the process of the passover, redemption, chargeback, and discharge of public debt.

What's in a name? Very simple. A name is CREDIT. For any unauthorized person to use your Name or the straw man's name (when they do not own the title to the straw man) is to violate the laws of "slander of credit". Once you have redeemed the straw man and own him, then any further commercial process done by any person (like an attorney, a judge, or law enforcement office without your consent) is slander of credit against your straw man. This is a federal criminal securities violation that means prison for them.

Until you redeem your straw man and register his title to you, the living soul, then your straw man becomes the source of the credit for the UNITED STATES to the public affairs of the nation through the "pledge" or gift of your property ) *** your body and energy) to them for their use."

http://www.discharge-debt.com/id127.htm

pardon my cut and paste prattling....I thought it might be important because....

Noachide Judges and Courts will Replace the Existing Court System
.... if a Jew needs a liver, it is permissible to take the life of an innocent non-Jew to obtain that liver. "Jewish life has an infinite value,"...http://www.cephas-library.com/nw...ts_will_replace_ours.html

Now the Government Can Legally Kill Christians by Congressman Bill Dannemeyer.
Your U.S. government can now legally kill Christians ..... All gentile children are animals. Abodah Zarah 36b.....Talmudic Doctrine: Non-Jews are not Human. The Talmud specifically defines all who are not Jews as non-human *** animals, and specifically dehumanizes Gentiles as not being descendants of Adam...... http://www.takebackourrights.org...ristians-full%20page.html

I saw where this was all headed when they left no stone unturned to murder Terri Schiavo, and the so-called "privacy laws" protect the perps who can carry out the harvesting of the organs of the particularly vulnerable indigents and those with no family around under cover of "darkness", not to mention the children whom the "State" steals from families on trumped-up charges and then "loses" in the system...... "All gentile children are animals." ....See definition of "goods" under the Uniform Commercial Code; Section 2-105(1) and 9-105(1) in which **** animals, **** i.e. humans and their unborn offspring, become "goods" sellable in commerce!

AllTheKings'HorsesWontDoIt  posted on  2010-01-11   19:32:02 ET  Reply   Untrace   Trace   Private Reply  


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