Practice Of "'Multiple Listing" For Organ Transplants Gives Advantage To Higher-Income Patients

Main Category: Transplants / Organ Donations
Article Date: 12 Jun 2006 - 8:00 PDT

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The Philadelphia Inquirer on Wednesday examined an "organ transplant policy that gives well-to-do recipients an advantage over the poor." The practice, called "multiple listing," allows patients who require organ transplants to appear on waiting lists in several different regions nationwide. The U.S. organ transplant system divides the nation into 11 regions, and donor organs in most cases remain in those regions. Multiple listing -- which requires duplicate comprehensive medical examinations and frequent blood tests -- is expensive. In addition, multiple listing requires travel and the "sophistication to navigate a particularly complex part of the American health care system," the Inquirer reports. Supporters maintain that multiple listing provides patients with more opportunities to find an organ, but critics "say the policy violates medical ethics by skewing a system that is supposed to be equitable," according to the Inquirer. Arthur Caplan, chair of the department of medical ethics at the University of Pennsylvania, said, "People donate organs with the idea that everyone will have a fair shot at getting them. I think it diminishes people's willingness, especially the poor, to be donors." About 6,000 of the more than 90,000 patients on waiting lists for organ transplants appear on multiple lists, according to the United Network for Organ Sharing, which administers the organ transplant system under a federal contract. UNOS since 1998 has acknowledged that multiple listing is unfair (Stearns, Philadelphia Inquirer, 6/7).

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