The Conundrum of Organ Donation

OSAREMEN OKOLO

I’m still deciding whether I will become an organ donor in the future; the blind spot all humans have surrounding their own death seems to be holding me back.

Free Topic, Osaremen Okolo GatewayOrgan donation remains an oxymoron. We marvel at the advancements of modern medicine, yet we distance ourselves from the actual process of donation itself. An estimated 90% of Americans support organ donation, yet only 42.7% of adult US residents have registered to be organ and tissue donors. Why the discrepancy?

The most important factor affecting the amount of registered donors is the manner in which one becomes a donor in the United States. According to the current system, would-be donors can either check ‘yes’ to organ and tissue donation while filling out their driver’s license applications, or they can fill out a donor registration card. There is no doubt that quite a few US license-seekers simply skip over the organ donation section, eager to get their long-awaited cards. There are also US residents who can’t be bothered to seek out donor registration cards. But that still doesn’t account for an almost 50-point difference between the organ donation approval rating and the actual donation rate. I’d guess that most teenagers or other first-time license applicants do take the time to consider organ donation as they go through the transformative moment of becoming a licensed driver. But for one reason or another, many people are simply passing up the chance to have that red heart icon on the corner of their newly printed licenses.

My best friend signed up to be an organ donor when she was only sixteen. This summer, she was biking across the country with a group when she was struck by a driver, texting at the wheel. The next day she succumbed to her sustained injuries and was declared brain dead. Each of her organs was donated to the highest match on the United Network for Organ Sharing (UNOS) list. Even after death, she saved so many—I marvel that the selflessness that marked her eighteen years persisted even beyond the very end.

I myself, however, am not an organ donor. Under Massachusetts law, I needed parental consent to check off the box on my license application, and my mother and father would not approve of any status that might “encourage” declared death should, God forbid, a brain damage-inducing accident ever occur. I’m still deciding whether I will become an organ donor in the future; the blind spot all humans have about their own deaths seems to be holding me back. What if a surgeon discovered one last procedure to potentially restore neurological function just after they shut the ventilator off to begin organ harvesting? What if my kidney was rejected by the transplant recipient, leading to his death when he could have still survived on dialysis?

Given doubts like these, I do see a tremendous upside to the organ donation method proposed by New York Assemblyman Richard Brodsky in 2010. Under this system, already practiced by many European countries, people are automatically registered as donors unless they choose to opt out. Opting out of organ donation through written consent would certainly be less likely for most than not opting in: donation would become a societal norm and simple convenience. Furthermore, my next of kin—alive and alert with the ability to gauge the situation—could say “no” to donation were a no needed. And if that no were unnecessary, my fear wouldn’t outlive me and prevent potentially lifesaving transplants. I suppose my next prayer should be for a calm, mature next of kin to be my palliative decision maker.

Still, we must remember first and foremost that there is no intrinsic downside to saving a life. States should not push to register every resident as an organ donor without consent; the controversy and potential litigation (I’d expect to see ‘Land of the FREE’ and ‘Don’t Tread on ME’ on quite a few placards surrounding our nation’s statehouses) could be so explosive that it might not only overshadow the positive nature of organ donation, but also temporarily prevent donation all together. Instead, each state should embark on a public relations effort to alleviate the worries surrounding organ donation. As I read UNOS’ statements relating that “the need for organs and tissues is vastly greater than the number available for transplantation,” “all major religions in the United States support organ, eye and tissue donation and see it as the final act of love and generosity toward others,” and “an open casket funeral is possible for organ, eye and tissue donors; through the entire donation process the body is treated with care, respect and dignity,” I inch closer and closer to checking that box when I next renew my driver’s license.

Inundate the public, but don’t coerce. That’s the difference between maintaining the 90% approval rating of organ and tissue donation or turning donation into another story of the government overstepping its boundaries. And perhaps once over 50% of United States residents are registered as organ and tissue donors or the needs of the UNOS list are more efficiently met, our government can move towards encouraging Americans to also consider donating their bodies to research as well. After all, modern medicine could one day advance to the point where organs can be regularly prevented from failing at all.

Osaremen Okolo is a Brevia staff writer. She can be reached at osaremenokolo@college.harvard.edu.