The author of an article published in Bioethics challenges the assumption that increased organ procurement will save more lives, explaining that although additional organs will save the lives of organ transplant recipients, procurement and transplantation will divert time and money from other treatments that could have saved many more people.
Hospital resources are limited, and many lifesaving interventions that are more cost-effective than organ transplantation compete with transplantation for resources. Time and money spent on organ transplantation consumes resources that could be used to save a greater number of lives if directed toward treatments for patients with other illnesses.
Govind Persaud, the 2018-2021 Greenwall Foundation Faculty Scholar in Bioethics and assistant professor at the University of Denver Sturm College of Law, reviewed empirical data on the cost-effectiveness of organ transplantation and compared them with data on medical interventions for other illnesses, presenting evidence he believes should motivate anyone with the primary goal of maximizing health benefits across the population to doubt the merits of expanded organ procurement. He argues that there is no reason to prioritize the medical interests of transplant candidates, and that giving more consideration to cost-effectiveness does not require sweeping priority changes nor does it require adopting any specific, controversial metric for the assessment of cost-effectiveness.
The author concludes, “When we compare the costs and benefits of transplantation to those of other interventions, rather than treating it as a sui generis gift of life, its virtues are less unique, and the problems it presents are starker. If offered the opportunity to provide a new medical intervention that would cost upwards of $50,000 per [quality-adjusted life year] and require departing from informed consent, changing the definition of death, or introducing markets in lifesaving medical care, many physicians, hospitals, and governments would reply ‘No thank you: we’ll spend our money somewhere else.’ They would be right. Before we search for more organs, we should ensure the provision of cost‐effective care.”
Persad G. Will more organs save more lives? Cost-effectiveness and the ethics of expanding organ procurement [published online April 24, 2019]. Bioethics. doi: 10.1111/bioe.12587