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How to End the Organ Donor Shortage

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In the United States every ten minutes someone is added to the national organ transplant waiting list. While waiting for a transplant an average of 20 people die each day in the US,  while 450 people die annually in the U.K. waiting for an organ donation. Some 4,000 people die annually across the European Union waiting for organ donation. 

And at the same time, these statistics do not tell the whole story of how many die from not receiving donor organs in these areas. Those specifics are even more sad. There are additional people who do not qualify for being put on those donor lists at all due to being bad candidates for transplants. There are others who would want to receive an organ but who do not qualify as being among those patients with the highest need. Yet other may not qualify as the most qualified recipient according to government regulations or trade organization regulations about who should get a transplant. There are additionally people who never make it onto the donor list because the odds of them getting a transplant quickly enough are too low.  In some situations, this is a level of hopelessness that some doctors don't consider to even be worth the paperwork required to place the patient on an organ donation list, and the doctor consequently shares that hopelessness with the patient through a few choice words of discouragement. It's a far worse situation than the official numbers indicate, but the lack of much needed organs is a problem with a solution. 

Many of these people die needlessly each year because of government regulations. The deaths caused by the cartelization of the organ donation process and the prohibition of market solutions to organ donation shortages are are continued barrier to addressing the needs of potential organ recipients. On the other hand, were markets allowed to function, those most in need would often be able to receive the transplants they so badly require. 

After all, when markets are allowed to function, "shortages" are not a problem. When there's high demand for cell phones, prices increase and more suppliers step in provide accordingly. 

After hurricanes there are gasoline shortages, medicine shortages, and water shortages. If market are allowed to function, however, these shortages do not last for long.

But why do organ shortages persist? It's not because there's no money to support the cost of an entrepreneur safely delivering those products to the affected area. It's not because those products don't exist in the world. The reason is this: there are laws against allowing the market to function in order to get supplies to people. You can have the enforcement of laws regulating prices and sales or you can have those items available to you when you most need them available to you. 

But where there is government interference, and suppliers are not allowed to sell to potential customers, shortages immediately appear.

This is sadly the case with organ donors. 

In so many areas of life, government is not the solution, and people who expect more from government at such moments are demonstrating a lack of imagination, which is forgivable. They also demonstrate a woefully sad lack of understanding of the many, many failed examples of how little government can be reliably counted on. That ignorance of government failure, especially when accompanied by the simultaneous cheerleading for more government, is less forgivable. 

A perfect example of how governments interfere with the flow of esseential life-saving goods and services is found every time a person is lying sick in bed with organ failure, but others are not allowed to willingly sell organs to those most in need.  

In these cases, government could simply take no action and allow a marketplace to incentivize organ donation.  

Instead, government imposes draconian restrictions and prohibitions on these activities while simultaneously money on marketing campaigns to encourage people to feel guilty if they don't give their organs away for free to the medical establishment. It's an establishment in which every person aiding in the transplant makes a tremendous financial profit, except for the organ donor and their next-of-kin. 

The need for more transplantable organs is clearly recognized by many, but governments continue to stand in way of voluntary exchange. 

What's worse, governments attempt to deal with organ shortages by resorting to even more morally dubious positions in which explicit consent is not obtained from organ donors.

Common examples can be found in organ confiscation policies known as "opt out" or "presumed consent." While the details of such policies differ by jurisdiction, under such policies, unless clear documentation to the contrary is found, it is generally presumed that upon "brain death," while someone on life support still has a heart beat and lung function, transplantable organs are to be put immediately at the disposal of the pathologist on staff at the hospital in order to make them available for organ transplants. Your organs are presumed to be theirs unless proven otherwise. That is the way that government deals with the already oppressive policy that causes organ shortages — through more oppression that has limited impact on those shortages.

The real answer is not to add more government regulation, but to lift the exiting government regulation. 

So, not only is an individual not allowed to profit from the sale of organs, but that same individual's organs are to be seized under government order with no benefit to that individual if that person finds himself or herself in an unfortunate accident. A free market would handle this problem and allow personal choice to be the default deciding factor in who allows their organs to be made available for transplant. 

If allowed to function freely, markets actors would seek to cater to individual preferences and values. Some people might want to be organ donors, and donate at low prices, or even for free. Others might be reluctant to donate. But, if a person knew that he or she could get substantial amounts of money for one's self or one's heirs via organ donation, matters would change considerably for that person. 

Naturally, as the demand for organs rose, market prices paid top donors would rise.  

But none of this is allowed.  It's illegal. This limitation correspondingly makes it impossible to fulfill the demand for organs. In such a situation, the vital organizational function that benefits and enriches all humankind — the marketplace — is unable to function.  

To change things, we don't need a government ad campaign. We only need to let entrepreneurs, consumers, donors, and patients do what they would do if allowed their freedom. 


Allan Stevo

Allan Stevo is the best selling author of The Bitcoin Manifesto. He is also the author of Somewhere Between Bratislava and DC and the forthcoming 17 Nov 1989. He writes specifically on Slovak culture and generally on Central European culture from an Austrian-School perspective at 52 Weeks in Slovakia.

Note: The views expressed on Mises.org are not necessarily those of the Mises Institute.
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