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Why Aren’t There Enough Organs for Everyone on the Organ Transplant List?

There are nearly three million deaths in the U.S. every year, yet more than 110,000 people are still awaiting donor organs — something doesn’t add up here

In the U.S., on average, 20 people die every day waiting for an organ transplant. On the face of it, this makes no sense: According to the Centers for Disease Control and Prevention (CDC), there were 2,813,503 registered deaths in the country in 2017: That’s nearly 8,000 per day. Even if you account for the fact that many of the people who die every year don’t have organs in pristine, reusable working condition, there’s still a glaring disparity in the number of potential organs available and the number of people waiting for their miracle donation to continue living. 

According to Donate Life America, 95 percent of U.S. adults support organ donation, yet only 54 percent are actual registered donors. And when you start to look into the many odious myths around organ donation, you start to understand why. Per the Mayo Clinic, one such persistent myth that may steer people away from becoming a donor is the idea that when a registered organ donor finds themselves in the ER, the doctors there are less likely to work as hard to save their life, instead eyeing that plump liver or those juicy kidneys. 

It shouldn’t need pointing out that this is paranoid, conspiracy theory horse shit, but let’s do it anyway: “When you go to the hospital for treatment, doctors focus on saving your life — not somebody else’s,” emphasizes the Mayo Clinic. “You’ll be seen by a doctor whose expertise most closely matches your particular condition and who can give you the best care possible.”

To that end, researchers at the University of Geneva, who examined several social and psychological reasons people choose not to donate, found that mistrust and not fully understanding the concept of brain death were major barriers to donation. “A 2002 study in Australia, for example, illustrates the controversy surrounding brain death,” reports The Atlantic. “Some participants indicated that they wouldn’t donate the organs of their next of kin if his or her heart were still beating, even if they were proclaimed brain-dead.”

A Gentleman’s Guide to Donating Your Organs

According to a report in Health News Review, the concept of brain death is often misreported or misrepresented. “Here is the issue in its simplest form: if you are brain dead, you cannot be ‘alive on life support,’” writes Alan Cassels, a drug policy researcher at the University of Victoria. Cassels goes on to explain that this misunderstanding can have a great effect on a family’s willingness to agree to organ donation. “Ariane Lewis [a neurologist at NYU] cites a study from Brazil that found ‘80 percent of people would agree to donation if they were told their family member died, but only 63 percent would agree if they were told their family member was brain dead,’” writes Cassels. “In other words, by not knowing that ‘brain death’ was irreversible and the same as any other ‘death,’ people may make decisions that would reduce the rates of organ donation.”

Mistrust of the medical field can also stem from personal experience, per the same report. “One study in New York showed, for example, that next of kin who perceived a lower quality of care during a loved one’s final days were less likely to consent to donation — or from misconceptions about how the medical community treats registered organ donors,” reports The Atlantic.

My colleague Hussein Kesvani, meanwhile, tells me one reason he isn’t a registered organ donor is because of his parents’ religious beliefs. “I want to be, but there’s this huge religious controversy around it,” he says. “My dad thinks I won’t go to heaven if I donate a kidney.” 

But that, too, for the most part, seems to be based on myth, according to an article titled “Religious Aspects of Organ Transplantation in the journal Transplantation Proceedings: No religion formally forbids donation or receipt of organs or is against transplantation, it states. “However, transplantation from deceased donors may be discouraged by Native Americans, Roma Gypsies, Confucians, Shintoists and some Orthodox rabbis,” writes Paolo Bruzzone, a general surgeon in Rome. “Some South Asia Muslim ulemas (scholars) and muftis (jurists) oppose donation from human living and deceased donors because the human body is an amanat (trusteeship) from God and must not be desecrated following death, but they encourage xenotransplantation [the process of transplanting organs between members of different species, i.e. pig organ donors] research.”

Animal Parts Are the (Near) Future of Human Organ Transplants

Based on a quick office poll, it’s clear that some people aren’t organ donors simply because they’re not sure how to become organ donors. “I don’t know how to go about it,” says my colleague Tarik Jackson. “But I’d love to be.” The good news is that it couldn’t possibly be easier to register as one these days: Either you can register at your local DMV, or online through the Health Resources and Service Administration’s website. “All you need is some identification information and your driver’s license or photo ID number,” it states.

Basically then, there’s no excuse for not becoming an organ donor besides just being a selfish asshole. So maybe consider just donating that asshole, huh?