Commercialization of transplantable human organs is the only sure way to end the crisis of their supply. This is best accomplished by implementing a free, non-profit, nationwide, ultimately global online auction market. It should be independent of the current United Network of Organ Sharing (UNOS) system dealing solely with altruistic donation, and of governmental, sectarian, academic, and other bureaucratic control. The operation of such an auction is described with a hypothetical example. An included provision guarantees equity for poor, uninsured, and indigent recipients. Money accrued can be substantial, and would be disbursed by established formula, with major portions going to donors' families and to special funds to be used to bid for the poor and to defray costs incurred by them. As the organ shortage eases, bid prices should drop, resulting perhaps in eventual altruistic donation. Objections to commericalization based on ethics, bodily sanctity, inequity, pecuniary greed, and the slippery slope tocsin are nullified by cogent arguments and examples. The current situation has worsened despite so-called required request laws, proposed token payments to cover funeral expenses for donor families, and extensive media advertising to spur altruistic donation. Prohibitive national and state laws must be rescinded for the sake of more than 60,000 patients now on lengthening waiting lists. A profession committed to saving lives is duty-bound to endorse, help implement, and participate in an auction system dedicated to that end.
Commercialization of transplantable human organs is the only sure way to end the crisis of their supply. This is best accomplished by implementing a free, non-profit, nationwide, ultimately global online auction market. It should be independent of the current United Network of Organ Sharing (UNOS) system dealing solely with altruistic donation, and of governmental, sectarian, academic, and other bureaucratic control. The operation of such an auction is described with a hypothetical example. An included provision guarantees equity for poor, uninsured, and indigent recipients. Money accrued can be substantial, and would be disbursed by established formula, with major portions going to donors' families and to special funds to be used to bid for the poor and to defray costs incurred by them. As the organ shortage eases, bid prices should drop, resulting perhaps in eventual altruistic donation. Objections to commericalization based on ethics, bodily sanctity, inequity, pecuniary greed, and the slippery slope tocsin are nullified by cogent arguments and examples. The current situation has worsened despite so-called required request laws, proposed token payments to cover funeral expenses for donor families, and extensive media advertising to spur altruistic donation. Prohibitive national and state laws must be rescinded for the sake of more than 60,000 patients now on lengthening waiting lists. A profession committed to saving lives is duty-bound to endorse, help implement, and participate in an auction system dedicated to that end.
Commercialization of transplantable human organs is the only sure way to end the crisis of their supply. This is best accomplished by implementing a free, non-profit, nationwide, ultimately global online auction market. It should be independent of the current United Network of Organ Sharing (UNOS) system dealing solely with altruistic donation, and of governmental, sectarian, academic, and other bureaucratic control. The operation of such an auction is described with a hypothetical example. An included provision guarantees equity for poor, uninsured, and indigent recipients. Money accrued can be substantial, and would be disbursed by established formula, with major portions going to donors' families and to special funds to be used to bid for the poor and to defray costs incurred by them. As the organ shortage eases, bid prices should drop, resulting perhaps in eventual altruistic donation. Objections to commericalization based on ethics, bodily sanctity, inequity, pecuniary greed, and the slippery slope tocsin are nullified by cogent arguments and examples. The current situation has worsened despite so-called required request laws, proposed token payments to cover funeral expenses for donor families, and extensive media advertising to spur altruistic donation. Prohibitive national and state laws must be rescinded for the sake of more than 60,000 patients now on lengthening waiting lists. A profession committed to saving lives is duty-bound to endorse, help implement, and participate in an auction system dedicated to that end.
Public and professional discussions have recently raised the question of whether the long-standing proscription against physician-assisted suicide for terminally ill patients should be eliminated or changed. In this article we first review the history of the centuries-long debate, and repeat the arguments stated for and against such a change. We present our opposition to such a change based on the adverse consequences which would occur in the patient-doctor relationship, and the very likely extension of the practice from only terminally ill patients to some who are suffering but not dying, including patients with intractable mental suffering. We review the 10-year social experiment with public toleration of euthanasia in the Netherlands, and note its considerable expansion beyond the clear guidelines. We then discuss why we believe psychiatrists should continue to oppose the legalization of physician-assisted suicide. In addition to our concern about the extension to assisted-suicide for mental suffering, we point out the adverse affect such changes would have on both the psychiatrist's and the patient's perception of the role of the therapist in other suicide situations, and the difficulty of uncovering a competent patient's motivation for a request for such assistance.
