The Organ Shortage Crisis in America

cover art
216 pp., 6 x 9
ISBN: 9781626165434 (1626165432)

216 pp., 6 x 9
ISBN: 9781626165441 (1626165440)

March 2018



The Organ Shortage Crisis in America
Incentives, Civic Duty, and Closing the Gap
Andrew Michael Flescher
Nearly 120,000 people are in need of healthy organs in the United States. Every ten minutes a new name is added to the list, while on average twenty people die each day waiting for an organ to become available. Worse, our traditional reliance on cadaveric organ donation is becoming increasingly insufficient, and in recent years there has been a decline in the number of living donors as well as in the percentage of living donors relative to overall kidney donors. Some transplant surgeons and policy advocates have responded to this shortage by arguing for the legalization of the sale of organs among living donors. Andrew Flescher objects to this approach by going beyond concerns traditionally cited about social justice, commodification, and patient safety, and moving squarely onto the terrain of discussing what motivates major and costly acts of human selflessness.    

What is the most efficacious means of attracting prospective living kidney donors?  Flescher, drawing on literature in the fields of moral psychology and economics, as well as on scores of interviews with living donors, suggests that inculcating a sense of altruism and civic duty is a more effective means of increasing donor participation than the resort to financial incentives. He encourages individuals to spend time with patients on dialysis in order to become acquainted with their plight and, as an alternative to lump-sum payments, consider innovative solutions that positively impact living donor participation that do not undermine the spirit of the National Organ Transplant Act of 1984. This book not only re-examines the important debate over whether to allow the sale of organs; it is also the first volume in the field to take a close look at alternative solutions to the organ shortage crisis.
Andrew Michael Flescher is a member of the core faculty, program in public health; professor of Family, Population, and Preventive Medicine; and professor of English at the State University of New York, Stony Brook. A member of the United Network for Organ Sharing Ethics Committee, he is the author of several books, including Moral Evil and Heroes, Saints, and Ordinary Morality, both from Georgetown University Press.
"Proposing market solutions to the massive problem of a shortage of organs for transplant is quite fashionable today. The transplant community needs a work challenging this approach, and Flescher provides it. The scholarship is generally superior. The work is subtle, thorough, and novel. The author is sophisticated and rich in his discussion of a complex topic. I expect this to become the definitive work rebutting advocates to market approaches to organ procurement. The author moves between academic and anecdotal style in a way that is quite effective. I was particularly impressed with the first chapter's fair and thorough representation of the position he will eventually attack. I learned a lot from the work."—Robert Veatch, Senior Research Scholar, Professor of Medical Ethics, Emeritus, The Kennedy Institute of Ethics