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My youngest sister was born with a debilitating liver condition. After a few operations and a brief period in which my mother collected her bile and kept it in the fridge (bile, by the way, looks an awful lot like limeade), Ella was put back together. Now, 24 years later, she is still going strong.

In the process of taking care of Ella, my mother ended up learning about all the resources that were available to parents of children with liver disease. She began working for liver groups and ultimately formed a nonprofit group of her own. This meant that much of my childhood and adolescence was spent staffing health fairs, attending nonprofit events, passing out organ donor cards, going door-to-door, and selling things to raise money. In fact, my sisters and I even collected and traded organ donor cards from different organizations. Along with my "Spastic Colon" t-shirt, organ donor cards were the best part of the gastroenterology conventions that we had to go to with fair regularity.

The problem with transplantation is that there simply aren't enough organs out there. Around the world, people are waiting on transplant lists for the hearts, lungs, livers, and other vitals that they desperately need. Unfortunately, most people are still uncomfortable with the idea of giving up their organs, often out of a belief that their organ donor status will be used as a consideration when it comes to giving them medical care. This, of course, hasn't been helped by urban legends about organ thieves, movies about cloning for organ harvesting, and pretty much the entire literary career of Robin Cook, who seems unhealthily fixated on the idea of taking organs out of unwilling patients. Even Monty Python got into the act with a live organ donation segment in their film The Meaning of Life!


According to The Sydney Morning Herald, Dr. Gavin Carney, an Australian nephrologist, recently addressed Australia's transplant crisis. Apparently Australia has one of the lowest organ donation rates in the world; for example, while 1,800 people are currently waiting for a kidney transplant, only 343 transplants were performed last year. Australians are, supposedly, going overseas to have transplants done in less-developed countries under conditions that are dangerously unsanitary and of questionable legality. Dr. Carney's suggestion is that the Australian government begin buying organs from healthy young donors. He suggested that the sum of $47,000 for a kidney would be about sufficient.

On the one hand, Dr. Carney's solution is horrific, and it's easy to imagine how a legalized organ trade could lead to all sorts of abuses. Moreover, while the notion of healthy young people giving up organs to support wealthy, aging baby boomers is far too easy to imagine. That having been said, I feel like Dr. Carney's plan might have some merit. To begin with, the current organ donation trade is far from fair and honest. For example, while hundreds of people are waiting for organs, Pennsylvania's Governor Robert P. Casey received a heart and a liver mere hours after signing up for the transplant program at the University of Pittsburgh. Similarly, doctors, hospitals, and insurance companies receive hundreds of thousands of dollars for each transplant, while donors receive nothing. This has become a real issue in the case of John Moore, the patient whose cancerous spleen was used to produce Interferon. Moore's spleen has generated billions of dollars, but he has never made a penny off of the produce of his body.

Regardless of its legality, it's pretty clear that there is currently a market in organ donation. Whether this takes the form of African organ sales or political figures who mysteriously rocket to the top of the transplant list, it's clear that the worldwide organ shortage is creating ideal circumstances for criminal abuse. A well-regulated domestic organ market could reduce these problems while providing compensation for donors. The question is if such a market would work, or if it would only become the staging ground for further abuses.

In the short term, I'm going to take care of my organs. Even if I never need both of my kidneys, I have a feeling that a healthy lifestyle might be a good investment; after all, I've got a little credit debt...

Bruce Watson is a freelance writer, blogger, and all-around cheapskate. He wants everyone to know that he's a liver, not a fighter.