The data is murky, but according to one transplant expert I spoke to who has applied for pediatric patients like Sarah to receive adult lungs, outcomes for children who receive a lung transplant from an adult might be worse than in adult-to-adult transplants cases. Adult-to-child transplants can be complicated by size differences between an adult organ and a child’s organ cavity, among other factors. According to the same expert, it could be three to five years until the medical community has enough data to accurately rank kids next to adults based on the complex algorithms used to place people in an order that is considered most fair. Experts are divided as to whether a patient like Sarah would have a longer, healthier life than the adult recipients Judge Baylson has pushed behind her.
Barro uses the story to argue that we should be able to buy and sell organs:
People are morally squeamish about the idea of paying for organs. They fear that a legal market in organs would exploit the poor and only benefit people wealthy enough to pay market prices. A well-designed market should overcome these concerns.
One such option is a proposal from Matas. Under his plan for kidneys, organs would not be traded person-to-person; insurance companies or the government would set prices and buy them like any other medical supply. Combined with a system of universal coverage, this would ensure that transplanted organs would not be a luxury for the rich.
It is highly likely that live organ sellers would tend to be poor. But the prognosis for donors giving in the legal market is good: A mortality rate of just 0.03% for kidney donations. That is still a risk, but people make all sorts of life choices that entail added risk for added money, including entering dangerous occupations; legal organ sales would simply make one more such option available.
He also praises Singapore, which has “a system of ‘presumed consent’ where all people are organ donors unless they affirmatively choose to opt out.”