A Not So Modest Proposal

It has recently come to my attention that the kidney transplantation committee of the United Network for Organ Sharing has issued a proposal to change the way in which donated kidneys are distributed to those who are currently waiting for kidneys. Apparently the current system is as much of a lottery as… well, the lottery, only the winners in this lottery receive a few more years of life, while the losers receive a lovely floral arrangement. The new system looks to improve this by extending the total number of years of life saved, and perhaps even reduce the number of lost donations.

While I understand this is an admirable goal, I feel it is incumbent upon myself, your humble public servant, to point out the logical fallacy in this plan. While they are at least considering improving the efficient use of the resources at hand, they are not in fact addressing the core issue: the scarcity of viable kidneys, and by extension the further scarcity of other organs, tissues, and various donations that up to this point have only been left behind by that handful of Good Samaritans who are willing to sacrifice for the greater good.

Now, far be it from me to suggest something so vulgar as to taint the system by introducing monetary recompense for the donors. Certainly the doctors, the hospitals, and others involved along the way need to have their palms greased with filthy lucre in order to entice them to participate in what would otherwise be a noble calling, but the very idea of incentivizing people to participate in organ donation after they pass on is so far beyond the pale as to not deserve further mention. Even if it would relieve the burden on the system and enrich some few souls along the way, life itself is far too precious a commodity to put a price tag on, unlike something common like food, shelter, or health insurance.

No, I believe the answer is instead to appeal to the better nature of our fellow citizens, and instead follow in the path of our recent Supreme Court decision regarding health care. If it is mandatory that we all participate in the health care of our nation by carrying health insurance, surely it is no great leap to suggest that we make it compulsory to participate in organ donation? Just think of the benefits! No more long waiting lists, no more years desperately hoping for a match; just one bad pile-up on the highway and everyone is a winner (well, except maybe the poor souls on the highway, but you can’t make an omelet without breaking a few eggs).

I understand there may be a few initial objections to my plan, but they can all be easily addressed. After all, our country has a long and distinguished history of compulsory service in the military for young men, and that’s hardly ever given us any trouble. For those who may have religious objections, while I can understand their hesitation, I’m afraid we simply cannot oblige. In days of yore when a corpse was no more than the husk of a departed soul the disposition of such was irrelevant, but science moves ever forward, and while there may have been a time when we could indulge quaint flights of fancy and superstitious notions, those days are long gone. For those who would claim a “right to privacy”, I say the body public has a use for the body private and it must not be denied.

If you think my solution unjust, if you believe my methods unfair, I ask you: is it just to leave people on machines for years on end, hoping against hope to beat the odds? Is their suffering worth nothing? Do we, as a society, not care? What other alternative do we have? A few extra years is not enough; why save one when we can save them all?

In summary, I leave you with a paraphrase of the great John F. Kennedy: “Think not what your country can do for you, think what your organs can do for your country.”


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