Question

Write a summary of chapter 11 of the book "Nudge": How to increase organ donations. (minimum 600 words).

Answer 1

More than 120,000 adults and children in the United States are waiting for an organ, and every ten minutes another patient needing an organ is added to the donor list. On average, about 20 Americans die every day from the lack of donor organs. It has been projected that by 2015, more than 700,000 Americans will have end-stage renal disease and more than 26 million will have some form of chronic kidney disease specifically for kidney transplant. The most effective therapy for kidney failure is kidney transplantation, which inevitably occurs in people with chronic kidney disease. This has greatly increased quality of life, less medical complications and longer survival.

In addition, transplantation is more cost-effective than just another alternative, dialysis. Efficient kidney transplantation for donors waiting for transplants will save approximately $55,000 annually $10 billion for the life of each working transplant recipient. Therefore the number of organs available for transplantation is greatly needed. Education has been the subject of past initiatives, but these were insufficient and not cost-effective

Stepping up the number of organ donations:

Repeal the donor law of death. Adjust the metric of the United Network for Organ Sharing (UNOS), from all-cause mortality to donation-specific death. Remove disincentives, and have organ donation opportunities. Improved life can require and include donation of organs.

F the risk of death of the donor rises, the transplant center may be placed on probation or shut down. If UNOS changes this evaluation criteria, one might imagine the following situation: a patient with a chronic illness that will ultimately take their life but would have no effect on the health of their kidneys would be able to donate a healthy kidney when their physician(s) believe death is inevitable. Patients with cystic fibrosis (CF) and amyotrophic lateral sclerosis ( ALS) are clear examples of patients that qualify. Another advantage is that it gives a positive, satisfying experience and legacy to these patients at the end of their lives.

We need to do more to eliminate disincentives from live organ donation, and potentially provide rewards. Live organ donors face multiple disincentives to donation, including medical costs, travel expenses and loss of income that might not be compensated by the Family Medical Leave Act. The American Transplantation Society (AST) and the American Society of Transplant Surgeons (ASTS) recently issued a study calling for rapid movement along a "path of transformation" in the attitudes and policies of our nation toward organ donation, including the rapid elimination of disincentives and the need for speedy public dialogue on the use of incentives

To provide opportunities may include any of the following. For example, donors or their family members may be earned a lifetime "credit" at the top of the waiting lists in the future. In addition, donors may potentially qualify for reimbursements that are directly proportionate to the accepted medical costs of organ donation or receive tax credits; "valuable factors," such as one-time honorarium payments to donors, may also be implemented by controlled third party agencies. Survey data revealed a general public acceptance and increased likelihood of becoming a donor if disincentives are removed and incentives are implemented.

Additionally, the payment for egg and sperm donation is already accepted. Egg donation is not a safe procedure as it carries the risk of ovarian hyperstimulation and thromboembolic events; some also claim that a higher occurrence of ovarian cancer later in life that result from the hormonal treatment. Finally , a new cost-benefit study showed that compensating kidney donors will save $46 billion a year; this amount includes saved lives, reduced dialysis costs and greater quality of life in patients undergoing transplants rather than chronic dialysis. Taxpayers will save around $12 billion per annum of this sum.

Finally, our care system needs to strengthen and extend the preparation of end-of - life and advanced directives. Similar to organ donation, all living wills should include a provision as to what to do with their organs should they be amenable to transplantation. There are a substantial number of patients who die in hospitals with healthy kidneys that might be suitable for transplantation – although, to my knowledge, this number has not been well documented. Examples include CF and ALS patients described above. Once they hit the point of "imminent death," these patients have several years to consider donating organs.