Dave Undis

Sunni: Was it difficult to traverse all the laws across the country that might apply to organ donation?

Dave: We got help from some lawyers and law professors to make sure that what LifeSharers is doing is completely legal. And organ donation law is actually relatively simple. All 50 states have adopted the Uniform Anatomical Gift Act, so the law is pretty much the same everywhere, with some minor differences. And there's not a whole lot of federal organ donation law.

Sunni: Did you try to work with existing organ donation organizations, like UNOS? If so, what kind of response did your ideas get?

Dave: I guess I should explain what UNOS is. UNOS is a private organization that has a contract with the federal government to manage the national organ allocation system. UNOS doesn't, however, have a complete monopoly. Your organs belong to you, and you can decide who gets them. It's called directed donation, and it's legal in every state and under federal law. LifeSharers members use directed donation to offer their organs first to fellow members. UNOS' official position is that it does not endorse the LifeSharers approach, but it will not interfere with legal directed donations. And as I've mentioned, directed donation is legal in every state and under federal law.

Sunni: One thing that surprises me from those who don't like the program is the charge that LifeSharers is unfair. A recent Wall Street Journal op-ed that spoke positively about LifeSharers highlighted the issue in my mind by saying that UNOS' watchword is fairness, and that equality among sick people is morally attractive. How do you deal with those charges? I just don't get how it's somehow unfair to ask someone to be willing to do something that they want others to do for them.

Dave: You left out the next sentence from the article. Let me quote from it: The principle of equality among sick people is morally attractive. An even greater good would be saving more lives with more transplants. I think the point they were trying to make is that UNOS has elevated fairness above other more important goals. In my opinion, the primary goal of the organ allocation system should be to save as many lives as possible. Fairness is also important, but that should be a secondary goal, not the primary goal. Having said that, LifeSharers is completely fair. It is, in fact, more fair than UNOS' allocation system. Most of the organs allocated by UNOS go to people who have not agreed to donate their own organs when they die. That's not fair. It's like giving the PowerBall jackpot to someone who didn't buy a ticket. Besides, if UNOS adopted the LifeSharers approach, it would double the supply of organs and save thousands of lives every year. How could it possibly be unfair to save thousands of lives?

As far as I'm concerned, LifeSharers occupies the moral high ground. Giving organs to organ donors produces more organ donors. That saves lives, and it does it in the fairest possible way. Anyone can join LifeSharers, and it's free. We don't discriminate against anyone. As for equality among sick people I agree that it's morally attractive. LifeSharers treats everyone equally. We say to everyone I'll give you my organs if you'll give me yours. Why should I give my organs to someone who's not willing to do the same for me?

Sunni: Exactly, Dave. I was thinking that absolute equality in the system is difficult, because there are so many variables that go into ranking patients on the list. A news story out of Connecticut that I found on your press coverage page highlights another angle of the fear-mongering by the fairness freaks: that somebody really ill will be overlooked. But everyone on the organ donor waiting list is pretty ill ... and don't they move up as they get sicker?

Dave: People on the transplant waiting list aren't worried about being overlooked. They're worried about dying. Over 91,000 people are on the U.S. transplant waiting list, and more than half of them are going to die waiting. And the waiting list keeps getting bigger. Over 40,000 people join the list every year. The waiting list has become a waiting to die list. By the way, that's not just me saying that. Dr. Robert Metzger said that three years ago. At the time, he was the President-Elect of UNOS. LifeSharers doesn't overlook anyone. Our members just ask that their organs be offered first to fellow members. If there's no suitable match within our circle, then we offer our organs to the general public. The last thing we want is for our organs to go to waste.

You're correct when you say that everyone who needs a transplant is ill. And you're correct in saying that a person moves up the waiting list as they get sicker. But that's just one of several factors UNOS uses to decide who gets the next organ. Other factors are blood type, age, time spent on the waiting list, location, and ability to pay. But they don't take into account whether the people who need organs have agreed to donate their own.