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Marion Barry, the District’s most famous kidney transplant recipient, is a very
lucky man. If not for Kim Dickens, the friend who gave him one of her kidneys
last month, the 72 year old former Mayor would have had little chance of
surviving the years-long wait for a cadaver kidney from the national
At a Capitol Hill briefing recently, Mr. Barry looked dapper, if
frail. He said he wanted to start a “movement” to increase the number of
A noble mission indeed. In the District, only 170
transplants were performed last year; yet over 1,100 Washingtonians waited.
Nationwide, the list is up to 80,000 (with roughly another 100,000 dialysis
patients who are good candidates for transplant but, for various reasons, not
wait-listed). Everyday, thirteen in the queue die waiting for an organ that
The root of this needless suffering is confusion surrounding the 1984
National Organ Transplant Act (NOTA). The law makes it a felony to broker an
organ or to exchange it for something of “valuable consideration.” While the law
says that reimbursing donors for medical expenses and lost wages is legal, it
never explicitly defines “valuable consideration.”
happened in Pennsylvania. In 1994 the state passed a law that would permit
family members to receive a burial benefit of up to $3,000 (paid directly to the
funeral home) if their deceased loved one became a donor.
that this reward ran afoul of NOTA, the health officials in Pennsylvania would
not implement it. Did they really think the federal government intended to
punish a widow in Scranton for accepting a funeral benefit from the
The dire organ shortage compels us to revisit the meaning of
NOTA, especially in light of a 2007 opinion from the Office of Legal Counsel of
the Department of Justice. It concluded that valuable consideration “refer[red]
to the buying and selling of organs for monetary gain or to organ exchanges that
are otherwise commercial.”
In other words, Congress did not intend that
an organ donor who has been rewarded for his sacrifice be made a felon in
return. Yet no state has ever tested this interpretation by rewarding
This brings us back to Marion Barry. The long-time civil rights
warrior and current Ward 8 Councilman can best create a “movement” to reduce the
organ shortage by persuading the City Council to enact a law challenging the
1984 National Organ Transplant Act. It should enable charities or the District
government itself to offer health and life insurance to donors. Not only will
this reward donors but, critically important, it will encourage many others to
consider making the same profound sacrifice for a stranger.
ambitious pilot might offer donors a tax credit or deduction or a contribution
to their pension plan. Or perhaps a contribution to a charity of their
choice–this way, the donation of a kidney can be leveraged to improve the lives
of hundreds more.
If such benefits were offered to donors by the
District government or by approved charities–rather than by individuals–then
organs will be available to all, not just to the wealthy.
has had a tumultuous life of ups and downs. And now faces looming tax problems.
Here is a way for him to rebound yet again by aiding the medically downtrodden
who wait in vain for a life-saving kidney. Mr. Barry could make Washington, DC
the first in the country to save hundreds of lives by creating appropriate
rewards for those who are willing to make a profound sacrifice to save the life
Sally Satel, M.D., is a resident scholar at AEI.
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