CHICAGO, June 14 (UPI) -- A committee of the American Medical Association recommended Monday urging states to enact new laws to obtain more donor organs to save the lives of thousands of people waiting for kidneys and livers and hearts.
"We have to do something to change the system," said Dr. Stephen Schwartz, a psychiatrist in Huntington Valley, Pa. "We are standing by idly while people are dying. We can't stand by and let them die."
According to statistics from the United Network for Organ Sharing, about 6,000 people in the United States -- 17 people every day -- die because they cannot get an organ that could keep them alive.
Schwartz, at the annual meeting of the American Medical Association's House of Delegates, proposed that the United States use the organ donor system in effect in Belgium, Spain and other countries and assume a person who has died would have donated his or her organs so others could live.
The process is known as "presumed consent for organ donation." The resolution calls for the AMA not only to accept the process as its policy, but also to advocate the procedure as national policy.
Currently, organs are donated if the dying individual specifically had asked for his or her organs to be donated, or if a close family member makes the organs available if the dead individual had made no pronouncement prior to death. Under presumed consent, the organs are harvested unless an heir objects or the patients had previously objected.
Schwartz said adoption of the resolution by the AMA would not necessarily make organs available immediately, however. "Adoption of presumed consent will serve to generate nation debate," he suggested, and might bring more attention to the need for organ donation.
"There is no doubt there is a need for organs," said Dr. Michael Williams, a neurologist at Johns Hopkins University Hospital in Baltimore. He opposed presumed consent, however, saying the concept of mandated consent might be a better option.
Under mandated consent, when a person obtains a driver's license, for example, he or she would be required to note either allowing organ harvesting or opposing it. At present, in many states, people can allow their driver's license to be stamped "organ donor," but there is no requirement for a definitive answer. By mandating an answer, doctors and hospital authorities would be more at ease in obtaining organs from a patient who had specifically approved such a procedure.
Presumed consent, however, would be a hard sell to minority groups, said Dr. Owen Garrick of Benicia, Calif., from the AMA's Minority Affairs Consortium. He said minorities already are distrustful and mistrustful of the medical system that has used African Americans in the past in highly-publicized, ethically questionable scientific studies.
"We feel that presumed consent is not the most acceptable approach," he said, adding he would oppose the measure
Dr. Willarda Edwards, an internist from Baltimore who works with the National Association for the Advancement of Colored People, agreed presumed consent would not be accepted in the minority community because of a long-standing mistrust of the medical community.
Ethically, either presumed consent or mandated consent systems could meet standards set by the AMA's Council on Ethical and Judicial Affairs, said Dr. Robert Sade, a thoracic surgeon in Charleston, S.C., and a member of CEJA. "However, mandated consent is preferable. Presumed consent could be problematic," Sade said.
The committee recommended referring the matter to the AMA Board of Trustees for further action. The board is likely to turn the matter over the organization's Ethics Committee to develop a position on the matter. The House of Delegates Monday accepted the recommendation to refer the matter to the Board of Trustees.
"We want to be fair," said Dr. Joyann Kroser, a gastroenterologist in Philadelphia. "But we have to move forward now. Too many people are dying."
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Ed Susman covers medical issues for UPI Science News. E-mail [email protected]
