In some well-publicized recent cases–including the first one arranged via the Internet (how quaint that we are still seeing first-over-the-Internet stories–and still ones that might not be accurate)–people have successfully advertised for donated organs, avoiding, as USA Today reported,
the waiting list maintained by the United Network for Organ Sharing, the nonprofit group that works under government contract to allocate all organs donated from the dead. It doles out organs, in part, according to which patients need them the most.
Even though 17 Americans die a day while waiting for donated organs in the current system, a Denver Post story on some possible attitude changes in our national organ-donating system points out:
Human-transplant advocates defended the practice of some privately arranged procedures in the wake of the nation's first Internet-brokered organ transplant.
Any sweeping prohibition on private arrangements between potential organ donors and their recipients would cost lives because the national waiting list has ballooned beyond the pool of identified donors, several organ recipients and advocates said Monday.
With such a mounting human need, those requiring kidneys, lungs, livers and other organs said they support any mechanism—aside from the buying and selling of organs—that would save lives.
Petty half-measures–like $300 burial donations for relatives in Pennsylvania, donations to charity in donors' names, or "medals of honor"–are in play, but the organ donating community still refuses to add some market discipline to the procedure–the only thing that might guarantee that willing donors and needy patients can actually strike deals that satisfy them both, and save lives.
A Nov. 1998 Reason article by James V. DeLong discusses the mucked-up realities of our centrally planned organ donation system at length, and notes:
Another point so well accepted that it's rarely mentioned is the assumption that organ donors should not be paid. Even though everyone agrees that donation rates need to be raised, few are willing to consider how financial incentives might serve that cause. A lively debate on the issue is heating up in the academic literature, including the pages of the prestigious British medical journal Lancet, and is beginning to spill over into popular discussion.
The idea that it's offensive to discuss transplants in financial terms is droll, since the system is awash in economic calculations by medical centers, surgeons, health insurers–everyone except the donors.