Thursday, March 3, 2011

UNOS proposing new, discriminatory kidney allocation system

I've recently ran across several articles concerning a policy change by UNOS (United Network for Organ Sharing). The change would greatly effect the way kidneys are allocated for transplantation. I'm combining today's Transplant Thursday post with tomorrow's Freedom Friday post, and the reasons for doing so will become very obvious to you as you read through this blog entry. This blog entry will summarize the information in the three articles below and couple it with my own opinion, analysis, and commentary.
UNOS is a non-profit organization that facilitates donated organ placement in the U.S. via a contract with the Federal government. Currently, there are over 110,000 Americans on the national waiting list for a life-saving organ transplant and about 75-80% of them need a kidney. UNOS' present kidney allocation policy gives placement priority for donated kidneys to patients who are either the sickest or have been waiting the longest. The proposed change would give priority to younger, healthier patients. Specifically, the new system would grade and segregate both patients and donated kidneys into groups. One group would be the youngest and healthiest 20% of the patients and donated kidneys. The other group, the remaining 80%, would then be broken up into sub-groups. These sub-groups would be comprised of patients and donated kidneys where the age difference is +/- 15 years or less. For instance, a 50-year old patient could only receive a donor kidney from someone between 35 and 65 years of age.

The purpose of this proposed allocation change is to try put "the best kidneys" with people who will receive the most benefit from them for the longest period of time. However, as a heart transplant recipient and an American, I do not like it for two reasons. First, the proposal is age discrimination pure and simple. We have laws in this country against discrimination on the basis of age, race, sex, religion, disability, etc. We have worked for years and made great strides against ending discrimination, but obviously, we still have a long way to go. Lives have even been given for that cause. The elderly have given of themselves for years working long and hard to keep our country vibrant and competitive. Many of them have served in the armed forces or as police officers or fireman, but yet UNOS is proposing that we thank them by discriminating against them when it comes to a kidney transplant because of their age. In fact, Lainie Friedman Ross, a physician and bioethicist at the University of Chicago, said in regards to the UNOS proposal, "The best kidneys are from young adults under 35 years. No one over the age of 50 will see one of those (kidneys). There are a lot of people in their 50s and 60s, who with a properly functioning kidney, could have 20 or more years of life. We're making it harder for them to get a kidney that will function for that length of time. It's age discrimination." In my opinion, that's just wrong - period. Since UNOS is a federal contractor, wouldn't U.S. anti-discrimination laws apply to them, too ? The answer is yes, they do. What's next ? Is there gonna be a proposal to discriminate in organ transplantation based upon race or sex ? Can you imagine the ruckus if that happened ? We should be complaining about this injustice, too.

Second, in my opinion, the proposed new kidney allocation system smells of a mixture of eugenics, health care rationing, and "the complete lives system." Eugenics and "the complete lives system" are theories by which arbitrary values are placed on human life. These theories are pure evil. For instance, these theories place more value on the the life of a young person versus an elderly person and would consider the life of someone healthy more valuable than the life of someone who is chronically ill. These theories have been advocated by people such as Margaret Sanger, George Bernard Shaw, and Adolf Hitler as a way to eliminate people considered "defective." For instance, Sanger proposed using eugenics in immigration policy because immigrants might have "conditions" that could be "... detrimental to the stamina of the race," and Hitler, of course, was in favor of using eugenics as a way of "controlling" the Jewish population. The Declaration of Independence guarantees all Americans the right to "Life, Liberty, and the Pursuit of Happiness." It doesn't matter what race they may be, how old they are, or whether they are healthy or ill. It would be wrong to begin allocating donated kidneys based upon the perceived value of someone's life or who would "get the most bang for the buck." If they start doing this with kidneys, how long will it be before a similar policy is instituted for patients who need a heart, liver, or other organ transplant ?

The main reasoning for the new kidney allocation system proposal is because there are not enough donated kidneys to go around. I agree that there is a shortage of organ and tissue donors. That is a fact. Nineteen Americans wouldn't die everyday waiting on a transplant if it weren't. However, there is a better way to eliminate the organ shortage problem. It doesn't involve discrimination, rationing, or other un-American allocation methods. It involves Americans of every race, socio-economic class, political affiliation, faith, and age working together for a common cause - saving lives. It's very simple. All we need to do to end the shortage of organs available for life-saving transplants is for all of us to sign up to be organ and tissue donors. Please visit the Donate Life America website (click here) today for more information about organ and tissue donation. Then, sign up to be an organ and tissue donor in the state where you live.

Furthermore, UNOS is accepting public comment on their new allocation system proposal until April 1, 2011. If the new allocation system is implemented, it could go into effect as early as June 2012. If you agree with me that this new system is not the answer, then please take the time today to e-mail UNOS and tell them that their new proposal for allocating donated kidneys in discriminatory and should be scrapped. Tell them to either come up with a better and fairer proposal or to just leave the present system alone. Their e-mail address for such comments is I sent them an e-mail expressing my own displeasure with the proposed policy earlier today. I hope you'll take the time to do so, too.

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Dale said...

Surely the new atmosphere in health care doesn't mean we will have rationing? But then, it is happening just like you warned it would. Thanks for the update and the documentation. Reckon I will have to scrape off a bumper sticker.

The Second Chance Sheepdog said...


That was one prediction I was truly hoping to be wrong on. However, I really didn't think I would be. It was not a matter of if but only a matter of when.

The Sheepdog