Whose Organs Are They?
Walters, Jonathan, The Saturday Evening Post
At some point soon, the Louisiana State Attorney General plans to file suit in federal court against the U.S. Department of Health and Human Services. That's not unusual, but the subject of the suit is. It's no run-of-themill feds-versus-states jurisdictional tussle: This one is over human body parts. And what Louisiana is defending is, in its mind, pretty straightforward: its right to reserve to Louisianians organs donated in Louisiana.
If this sounds like one of the stranger twists on the states' rights battlefront, it is, but it is also one with high stakes for those intimately involved in the whole organ harvesting and transplanting world, from donors and their families to doctors and hospitals, and ultimately recipients as well.
The lawsuit-to-be is in response to a new set of rules released last December by HHS on the way organs are to be parceled out nationally. In essence, the rules would establish a national waiting list for organs, with individuals ranked in order of need. If a liver was harvested in Baton Rouge, and the number-one transplant candidate on the national list was in Pittsburgh, the liver would likely be flown up to Pennsylvania. This differs considerably from the current system, which tends to operate more regionally.
It was in anticipation of the HHS rule that the Louisiana legislature in 1997 passed its law giving Louisiana first dibs on organs donated within the state. Since then, Kentucky, Oklahoma, Wisconsin, and South Carolina have passed similar laws, all of them in response to the HHS proposal. Louisiana has special standing, though, argues Donald E. Hines, chair of the state's Senate Health and Welfare Committee, because its law was passed before HHS released the new rules. "It's our assertion that [HHS Secretary] Donna Shalala doesn't have the authority to supersede our law," says Hines; "only Congress does."
Not that Hines wants this fight. Nor, particularly, do any of the states that have passed their own organ donation laws. In fact, their argument is that the current system works fine. It is a system that has been refined through years of discussion among transplant physicians and the center they work for, in cooperation with donors' families and with patients. The system is currently administered by the United Network for Organ Sharing, and with UNOS under contract with HHS to operate the national system, HHS has heretofore pretty much avoided playing the role of transplant traffic policeman, leaving that to UNOS.
The change in federal policy appears to be part politics and part simple practicality. HHS officials' basic argument is that a national priority list is the only fair way to allocate organs, and they have a point. However, the proposal is also being pushed by a handful of large transplant centers, centers that would clearly …
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Publication information: Article title: Whose Organs Are They?. Contributors: Walters, Jonathan - Author. Magazine title: The Saturday Evening Post. Volume: 270. Issue: 6 Publication date: November/December 1998. Page number: 70. © Benjamin Franklin Literary and Medical Society Jan/Feb 2007. Provided by ProQuest LLC. All Rights Reserved.
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