Assisted-suicide pioneer Jack Kevorkian recommends ending the shortage of transplantable human organs by, at least temporarily, commercializing organ harvesting and auctioning off body parts online to pay donors and provide an expense fund for poor recipients.
Kevorkian explains his idea in an article titled "Solve the Organ Shortage: Let the Bidding Begin!" that appears in the latest issue of the American Journal of Forensic Psychiatry. The entire 80-page issue is devoted to the article and to reactions from a dozen transplant surgeons and psychiatrists.
The journal is published quarterly by the American College of Forensic Psychiatry, an association for psychiatrists who testify in legal cases.
"Commercialization of transplantable human organs is the only sure way to end the crisis of their supply," Kevorkian writes in the article. "This is best accomplished by implementing a free, nonprofit, nationwide, ultimately global on-line auction market."
Organ harvesting should be done independently of the United Network of Organ Sharing's altruistic donation system and of "governmental, sectarian, academic, and other bureaucratic control." UNOS manages the U.S. transplant waiting list and matches donors to recipients.
76,000 Wait for Organs
There were 75,863 patients on the list as of April 7. Kidneys and livers are the replacement organs most in demand.
Kevorkian's plan would use a formula to disburse money raised via organ auctioning, with proceeds going to compensate sellers or their survivors and to special funds being established to guarantee "equity for poor, uninsured, and indigent recipients."
Organ sellers should receive more money than transplant surgeons because organs are in shorter supply than surgical skill, Kevorkian says.
"Therefore, in any commercial arrangement the price of a vital organ should be higher — much higher — than the surgeon's fee," he writes.
Kevorkian says as the organ shortage eases, bid prices should drop, perhaps ultimately resulting in a return to altruistic donation.
UNOS spokeswoman Anne Paschke said for Kevorkian's plan to work, the entire transplant community would have to embrace it, "and it's probably extremely unlikely that that would happen."
"There are a lot of ethical considerations that would have to be taken into account," Paschke said. "Of course, it's also illegal to buy or sell an organ, so laws would also have to be changed in order for something like that to happen."
Joel A. Moskowitz, who provided the journal with a favorable reaction to Kevorkian's proposal, said while several important issues would have to be worked out, selling organs could possibly work.
"I do not object to the concept of compensating individuals whose organs are recycled to help another," said Moskowitz, a retired physician certified in both psychiatry and pediatrics who lives in La Jolla, Calif.
Serving 10 to 25 for Murder
Kevorkian, 72, a former pathologist, was convicted of second-degree murder in Oakland County Circuit Court in 1999 and sent to the Egeler Correctional Facility in Jackson. He was sentenced to 10 to 25 years in prison and must remain there until at least 2007, unless released on bond or appeal.
The conviction came after the 1998 injection death of Thomas Youk, 52, who had amyotrophic lateral sclerosis, more commonly known as Lou Gehrig's disease. The death was videotaped and shown on CBS's 60 Minutes.
Kevorkian has asked a federal judge in Detroit to release him on bond pending an appeal of his conviction, promising not to assist in any more deaths if released. U.S. District Judge Paul Borman will act May 22 on the request.
Edward Miller, executive director of the American College of Forensic Psychiatry, which is based in Balboa Island, Calif., said he received Kevorkian's unsolicited article in the mail last summer.
"It just — boom! — there it was," Miller said today. "I just looked at it and there was no question in my mind that I would publish that."
In the early 1990s, the journal published a paper that Kevorkian wrote about physician-assisted suicide.