OK, what's "first"? Can you buy your way to the top? Will that mean that doctors put people on the list the minute they have organ failure so in case they need the transplant, they will have moved up the list? Should the organ from a 25-year-old be put in an 80-year-old?
UNOS is working on this ethical dilemma that requires the wisdom of Solomon. Here is what they are considering for kidney transplants. These factors would work together to come up with a score:
- Life years from transplant: estimated survival for the recipient versus dialysis -- that is, how well and for how long will the donor organ be used?
- Dialysis time: time spent on dialysis already -- that is, who has been waiting longer, and how do we make a just decision?
- Donor profile index: measures the quality of the donated organ; that is, which organ is best for which candidate?
There are so many factors that go into the formula, it is very difficult to game the system.
Does anybody have a better idea? I think this is a good start at allocating resources when there is simply not enough of everything to go around. No death panels.
Colin McEnroe about end-of-life care for his mother
Don't talk to me about death panels
Alliance for Health Care Reform
Comparison of proposals