The Legal Examiner Affiliate Network The Legal Examiner The Legal Examiner The Legal Examiner search instagram avvo phone envelope checkmark mail-reply spinner error close The Legal Examiner The Legal Examiner The Legal Examiner
Skip to main content

According to breaking news from The Washington Post, the United Network for Organ Sharing (UNOS), a private, non-profit organization that contracts with the federal government to coordinate organ donations, is considering new rules for kidney donation that favor those who are younger and healthier over those who are older and sicker. Kidneys are the organs in highest demand, and the idea is to more closely match available kidneys to recipients who stand the best chance of longevity with donated kidneys.

The existing rules give priority to those on the waiting list the longest, which favors older recipients who are presumably in poorer health given the time they have been on the list. The proposed rules will take into account age and health rather than time on the list alone. As one may expect, some in the organ donation community support the proposed changes while others think they will simply discriminate against the older recipient population at a time when the population is aging – think baby boomers heading into senior status. Those with this view see the proposal as nothing more or less than age discrimination.

The current statistics on kidney donations are not promising. In the U.S., more than 87,000 hopeful kidney recipients are on a waiting list for approximately 17,000 available in the U.S. each year. An estimated 4,600 of those on the list die each year because they are not matched with a donor.

First in time versus first in right based on variable standards? That seems like a slippery slope to me. For the specific concepts of the proposal, look here. One proposal that was excerpted is described as:

Under one scenario, for 80 percent of available kidneys, patients within 15 years of the age of the donor – either older or younger – would get higher priority. The remaining 20 percent of organs – those deemed to have the best chance of functioning the longest, based on the age and health of the donor and other factors – would be given to recipients with the greatest chances of living the longest with the new organs, based on criteria such as whether they are relatively young and and free of complications such as diabetes.

Because this issues is expected to continue generating public interest and debate, public comment is being sought through April 1st. To learn more about UNOS policy development, go here. If this an issue is important to you or loved ones, get involved.


  1. Gravatar for Thomas F. Hogarty
    Thomas F. Hogarty

    Please consider the impact of a ruling on the supply of kidneys. For example, suppose a young donor were promised priority if he required a kidney transplant in old age. Further suppose that he were given financial aid for medical treatment in any malady that could be partially (or primarily) attributed to his donation within a decade of contracting that malady.

    I assume that donors are fully compensated for any expense, including times lost from work, attributable to their donations. This would seem to be the least they deserve.

    In general, the rules chosen should recognize that altruism as the basis for donation fails to supply the ongoing demand, and this excess demand is sure to get worse. Since payments to donors are illegal, some other means of adding to donor incentives are required. Passive acceptance of ongoing deaths due to kidney shortages does not pass many ethical tests.

    2096 Golf Course Drive

    Reston, VA 20191-3823

  2. Gravatar for JLH

    I am middle-aged and have always been listed as an organ donor. If this rule is changed to discriminate against me, I will remove myself from the donor list and encourage everyone else to do so as well. The hell with them if they do this. AARP needs to step up on this one.

    FYI, I am not in bad health, nor do I anticipate the need for any sort of transplant. But, who are they to say my life is worth less than a 20-something?

  3. Gravatar for Jason

    I think there should be some type of new rule instituted so that people who are registered organ donors themselves (say, perhaps have been for at least five years) immediately go ahead of others on the organ donation waiting lists who are not willing to be organ donors. There could be exceptions made for younger children of course, and rules could be worked out. But if one person is in need of an organ donation, and they've been willing for years to donate their organs if something happened to them, I think they should get priority over someone who hasn't been willing to be an organ donor.

  4. Gravatar for Tim

    This is definitely not right. It should always be that the person who needs it most is the one who gets it.

    This stupid idea pretty much gives a death sentence to anyone over a certain age. Its totally not fair at all.

  5. Gravatar for Mary

    I am in the process of removing my name from organ donor status immediately until these dumba__es wake up. No, I will not be a part of an agenda that discriminates in any way. Who the hell are you to say who gets an organ. The only fair way is to allow the first on the list, most needed, to continue. I will never support a program that says someone will decide where my organs or anyone's for that matter go based on who they think is the best suited. Do you have a crystal ball? How can you know that the nurse at age 55 is not the best suited just because she's 30 years older than the girl below her on the list? Sorry - I don't know that they 25 year old will live any longer and neither do any of you. The 55 year old's life is just as important as the 10 year old, 12, year old, 30 year old. Sorry - but if this is part of the socialist agenda under Obama - you will find alot of us raising our voices by taking our names off as donors....not happening.

  6. Gravatar for john

    who signed these people up to play God? Not happening - I will not be an organ donor if this passes.

  7. Gravatar for l m shiva prasad
    l m shiva prasad

    I can donate kidney

  8. Gravatar for Bret Hanna
    Bret Hanna

    Thank you all for your comments. This proposal obviously stirs emotions and it should. The decision to donate organs, if it is made, is very personal. Donation decisions can also directly impact the lives of our loved ones in ways that we cannot imagine before a donation opportunity arises. I'm not sure what the answer is in terms of who should receive organs and when, but I encourage all who have made the decision to donate to reconsider undoing that choice because of the proposed changes to recipient priority. Even if the priority is not exactly what you prefer, your donation could save or change lives.

  9. Gravatar for Brittany

    Who is someone to decide that an older persons life is less important than a younger persons? People who often time develop kidney disease is the result of diabetes, and according to this new proposal those people would go to the bottom of the list because of that illness, well kidney failure for lots of people is due to this illness.

    Does anyone know who to contact or way to voice your opinion so the government representative will know your opinion?

Comments for this article are closed.