Saturday, June 2, 2007

Hoax or Outrage?

By now, most folks are probably aware of the recent Dutch "game show" wherein ESRD patients vied for new kidneys from a terminally ill donor. The idea was that, by presenting themselves as the "most worthy" (or whatever), one lucky contestant would win a new set of kidneys, and thus a new lease on life.

As it turns out, the show was actually an elaborate hoax, designed to point out some of the shortfalls of the Dutch organ donor system. The "terminally ill donor" was, in fact, an actress; the patients, though, really were transplant candidates, who agreed to debase themselves for the sake of ratings (and, perhaps, a few Euros). The fact that this was staged, however, only exacerbates the moral issues at play.

In Holland, as here, organ transplants are tightly regulated, with the added complication of relevant EU regulations thrown in. The show points up some pretty significant ethical problems, and a few insurance ones, as well:

For one thing, there is the tension of the greater good versus the wellbeing of the individual. As we saw with the Zero Premium Life kerfluffle, there is a very real danger of "non-voluntary donors." The urban legend about waking up in a hotel room sans kidneys may be merely a myth now, but absent rigorous safeguards, is it all that unlikely?

From an insurance standpoint, most major medical plans cover transplants (often restricted to "Centers of Excellence") which pay both the donor's and recipient's medical costs (although the donor also incurs additional, unreimbursed expenses, as well). But such procedures are done under strict guidelines, and carriers generally have special claims units specifically for these types of claims.

Still, there is no question that there are a lot of folks who need kidneys, hearts, livers, corneas...the list goes on. So why don't more folks donate their organs (either while they're alive, or arranged for posthumous harvesting)? Well, some may pass for religious reasons, others may never have even considered it. And, as with life insurance and wills, there are a certain number of folks who just don't want to even think about their own mortality, and thus choose to ignore the issue altogether.

Which brings us back to the little Dutch "stunt." The producers claim that its real purpose was to increase awareness of the need for more donors. Based on the public outcry the show elicited, I'd say they made their point. The question is, however, whether more people were convinced, or turned off.


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