Lifesharers has shut down:

With a whimper rather than a bang (I just noticed it recently), the valiant, Quixotic attempt to introduce--via a private club--priority for deceased donation to those who were registered donors themselves, has ended.
(see my post from 2008: Tuesday, December 23, 2008 Lifesharers: organ donation as a club good rather than a public good

Here's the lifesharers final anouncment:

Monday, March 21, 2016

LifeSharers has shut down.

"If your durable power of attorney for healthcare mentions your agreement to donate your organs through LifeSharers, you should change it.

If you have told your family and/or your doctors that you want to donate your organs through LifeSharers, you should let them know that's no longer possible."

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It was an interesting but doomed attempt to do privately something very much like what has been done publicly in Israel -- here are my posts on priority donation in Israel.

Judd Kessler and I proposed a model which distinguished between the effective Israeli approach and the well-intentioned but inefficacious Lifesharers approach as follows. In Israel, those who register for donation gain priority for the already existing pool of deceased donors, while in Lifesharers the initial members only gain priority for each other. So, if there is even a small cost of joining, there is an equilibrium at which no one joins lifesharers, and indeed, unfortunately, it seems that Lifesharers never gained enough members to facilitate even a single transplant.

Contrast the difficulty of getting mutual donation going (with each death leading to only a very low probability of making a donation possible), with the easier task faced by the 19 Century Society for Mutual Autopsy 

Lifesharers: organ donation as a club good rather than a public good

My earlier post today drew a comment from the executive director of an organization, LifeSharers, with an interesting approach to promoting deceased organ donation. In economist-speak, they want to increase organ donation by changing it from a public good to a club good.

Deceased organ donation is a public good in the sense that everyone is better off in expectation if everyone else is willing to donate their organs when they die, but no one receives any direct benefit from donating his organs after death (and there must be perceived costs to donation, since not everyone is a donor).

Economists often worry about how to provide public goods (which is one reason for the invention of taxes: the fellow who mows the lawn in a public park is likely a city employee, but there's no problem in getting people to maintain their own, private lawns...)

In between public and private goods are "club goods," like a park or country club that is funded by members, and is only open to members and their guests. The idea of LifeSharers is that organ donation can be a club good: members indicate that they are willing to donate their organs, giving first preference to other members.

The LifeSharers site has references to some of the many articles that discuss this or similar ideas favorably in the context of organ donation. (I can't put my finger offhand on an unfavorable reference, but I recall seeing some arguments in the medical ethics literature that question whether you should always be happy giving preference to a club member in favor of a non club member, when there might also be many other features that distinguish them...)

As a practical matter, there are obviously obstacles to making a voluntary club good out of a public good that only benefits a member with very low probability. The LifeSharers FAQ includes the following:
Q. How many LifeSharers members have died and donated organs?
A. We have not yet had a member die in circumstances that would have permitted recovery of his or her organs.

Whatever your views on the market design issues, the holidays are a good time (when families are gathered) to let yours know that you would like to be an organ donor, so that they will be able to act on your wishes if it comes to that.

Society for Mutual Autopsy: Nineteenth Century solution to the cadaver shortage for anatomy studies

Michael Webster directs my attention to this post about The Society of Mutual Autopsy, a society formed to supply cadavers for more, and more scientific, autopsies.(At different times and places, cadavers have been in short supply: see these previous posts.)

Here's what Wikipedia has to say:
"The Society of Mutual Autopsy (or French: la Société d'autopsie mutuelle) was established on 19 October 1876 by members of the Society of Anthropology of Paris in Paris, France.

"Its purpose was to facilitate research on any links between personality, ability and brain morphology by creating a system whereby members' bodies, upon death, would be donated to the organization for study.
Its primary tool to organize these donations was a sort of living will which accomplished two main tasks. The first was to make clear the intention of the donor to have his or her body delivered to the organization upon death. The second was to present to the organization a description of the donor: the donor's personality, skills, habits, faults, etc. to allow for more complete research by the organization on the connection between these and brain morphology."

Apparently it was active from 1876 until World War I, and conducted quite a few autopsies.

I guess that willing your body to a scientific society is logistically a lot easier for your next of kin to carry out than is willing your organs to be donated to members of a club. As of this writing, the similarly constituted Lifesharers organization (about which I have posted here) has yet to make a single donation:

Q. How many LifeSharers members have died and donated organs?
A. We have not yet had a member die in circumstances that would have permitted recovery of his or her organs.

Israel revamps its priority system for deceased donor organs

In an effort to increase the number of deceased organ donors, Israel has revamped its allocation system to give priority to those who have themselves signed up to donate, and to their relatives and the relatives of previous donors.

New Law For Organ Donation In Israel: Increased Priority For Those Who Are Prepared To Donate

"An article published Online First and in The Lancet reports that a unique new law comes into effect in Israel in January 2010. It states that people who are prepared to sign donor cards themselves receive priority when they are in need of an organ transplant. In addition, increased priority is given to first degree relatives of those who have signed donor cards, to first degree relatives of those who have died and given organs, and to live donors of a kidney, liver lobe or lung lobe who have donated for as yet undesignated recipients. The article is the work of Professor Jacob Lavee, Director of the Heart Transplantation Unit, Sheba Medical Centre, Ramat Gan, and the Israel Transplant Centre, and colleagues. "
...
"There are different levels of priority concerning the different situations. A transplant candidate with a first-degree relative who has signed a donor card would be given half the allocation priority that is given to a transplant candidate who has signed his or her own donor card. Then again, a transplant candidate with a first-degree relative who donated organs after death or who was an eligible live non-directed organ donor would be given allocation priority 1.5 times greater than that given to candidates who have signed their own donor cards. Among candidates with the same number of allocation points, organs will be allocated first to prioritisation-eligible candidates. Regardless of the new law, patients in urgent need of a heart, lung, or liver transplant due to their serious condition will continue to receive priority. However, in the event that two such people are eligible for the same organ, their priority status under the new law would decide who receives the organ. Candidates under 18 and those unable to express their wishes due to physical or mental disability will retain their priority status versus an adult who merits priority."

This priority system is more nuanced than the one enshrined in Singapore law (see the bottom of this post). And of course legislation on a national scale gives donors a priority for all deceased donor organs, not just those from like-minded donors, which is the path being taken by Lifesharers, an interesting organization about which I posted here.

HT: Steve Leider

Update: here's a YNet followup from March 2010 Radical way to boost organ donation.It discusses, among other things, political obstacles to implementing the new law...