The Organ Shortage and Public Policy

(Note: The following is an edited version of a speech by David J. Undis at the Mackinac Center for Public Policy’s Oct. 12 Issues & Ideas Luncheon in Lansing. Undis is founder and executive director of LifeSharers, a nonprofit network of organ donors.)

You can donate your organs when you die, you can bury them or you can cremate them. Those are your only choices. If you agree to donate them you may save several lives. If you don’t, several people may die.

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Sadly, only 30 percent of Americans are registered organ donors. We bury or cremate 20,000 transplantable organs every year. Each of those organs could have saved someone’s life. Instead, we have a large and growing organ shortage. Over 50 percent of the people who need a transplant in the United States will die before they get one.

The organ shortage is the result of bad public policy. It is illegal to buy and sell human organs in the United States. The only available organs are donated organs. Imagine if it was illegal to buy or sell food. Does anybody think we wouldn’t have massive food shortages?

Public policy also undermines and discourages organ donation. Organ donation is undermined by failure to enforce first person consent laws (which make organ donations legally binding) and by letting families stop transplants from registered organ donors. Organ donation is discouraged by allocating organs to people who haven’t agreed to donate their own organs. Let’s face it – if you had to be a registered donor to be eligible for a transplant, just about everybody would register and thousands of lives would be saved every year.

What are the prospects for a public policy solution to the organ shortage?

The shortage could be eliminated if buying and selling organs was legalized, but that’s just not going to happen. The whole subject is much too controversial for most legislators.

The shortage could be reduced by enforcing existing first person consent laws. But nobody wants to deal with a grieving family trying to stop an organ donation and nobody has to deal with the people who die when they succeed.

The shortage could be reduced by changing organ allocation policy. Here the prospects are brighter, because no legislative action is needed. The United Network for Organ Sharing, which sets national organ allocation policy, has the power to give organs first to registered organ donors.

UNOS hasn’t chosen to do this yet, but UNOS doesn’t have a monopoly on organ allocation. The law says you can decide who gets your organs. If you want to give your organs to registered organ donors, please join LifeSharers.

LifeSharers is a national network of registered organ donors. Our mission is to save lives by increasing the number of organ donors. We are a nonprofit organization staffed by unpaid volunteers. Membership is free and open to all at

When you join, you agree to donate your organs to other members after you can’t use them anymore. In exchange, you get preferred access to the organs of every other member. That could literally save your life, so this is a very good trade.

LifeSharers helps increase the organ supply by creating a pool of organs available first to registered organ donors. The existence of this pool creates an incentive for people who are not registered organ donors to register and join the network. This incentive becomes stronger as our membership grows. Every time somebody joins LifeSharers your chance of getting an organ if you ever need one goes up – but only if you are a member.

LifeSharers also makes organ allocation fairer, by giving organs first to registered organ donors. Without donors there are no transplants. But about 70 percent of the organs transplanted in the United States go to people who haven’t agreed to donate their own organs when they die. That is just not fair.

I hope public policy makers will soon make reducing the organ shortage a priority. After all, public policy created the shortage. But we don’t need public policy changes to reduce the organ shortage. We just have to stop throwing away organs that could save our neighbors’ lives.

Americans are dying at the rate of one every hour while waiting for organ transplants. Please help save their lives. Joining LifeSharers is a great place to start. You’ll help reduce the organ shortage, you’ll make organ allocation fairer, and you’ll increase your chances of getting an organ if you ever need one.


David J. Undis is founder and executive director of LifeSharers in Nashville, Tennessee. Permission to reprint in whole or in part is hereby granted, provided that the author and the Mackinac Center for Public Policy are properly cited.