Dr. Shore has posted some very interesting points on this issue. As a physician, Dr. Shore is far more informed about the medical aspect of organ acceptance and rejection than myself. Yet even with my lack of medical knowledge, I understand and agree that the organ should go to the person who has the best match and chance of acceptance. To do otherwise would be wasteful of such a valuable resource.

However, I have some very different opinions on the criteria used in the decision process, some of which have been pointed out previously, but I don't believe was given the fullest consideration.

I realize the economical comparisons that we would want the organ to perform for as long as potentially possible, but if we consider the potential life of the organ in relation to the age of the recipient as a condition we have stepped onto a slippery slope. For example, if a child of seventeen receives an organ with the life expectancy of forty years (please accept the example, I'm not aware of the mean value for transplant organs viability) instead of an seventy five year old person - we cannot ensure the seventeen year old will use the potential years better than the older candidate. What if the younger person commits murder ten years later and is sentenced to death which is carried out ten years after conviction. The organ that once had the potential life expectancy of forty years has lasted only twenty and has enabled the younger recipient to take a life. Perhaps it is not that extreme and our young recipient dies in an accident of some sort only two short years after receiving the transplant? What if none of the above occurs, can we say that the younger recipient will live out their years happier and in a more productive way (either personally or for society) than the older recipient would have been with their remaining years.

We can not see the possible futures of the recipients and for me this is the biggest concern I have using using age as a criteria, and why I do not believe recipient age should be a consideration. Obviously we would need to calculate the age of the recipient and age of the organ, because we can't expect a heart of a twelve year old child to withstand the needs of a two hundred and fifty pound - sixty year old body, but other than those types of issues, I don't see age as fair qualifier.

I've been considering if the health of the recipient should be considered, and if so, to what degree. Should a single parent who lost both kidneys be denied an organ because of brain tumors that are currently in remission, considering the known stresses the medications for both the tumors and the transplant will put on the new kidneys? What if this parent is denied and another person who is granted the organ rejects it because it was a better match for the parent than it was for them?

Should someone, who hadn't really given organ donation a fair consideration be denied an organ because they hadn't done so? Definitely not, if that were the case we would be very short on young donors who were too excited (or maybe mortified at the photo) to take the two seconds and sign the back.

Does that leave us with our current system? Perhaps, but changing a system that may not substantially address the situation in terms of need - to a system that is unfair is not an improvement. We've simply lost the devil of one detail for another.