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Chapman, Spira & Carson - Disscusion

Date: 5/13/99
Time: 9:35:48 AM
Remote User:


Recently the New York Times' had been running almost a daily "letters to the editors" talking about the solution to the lack of organ donors in the United States. Most people complained about the fact that Pennsylvania was offering what they concluded to be a bounty for body parts. On the other hand, other remedies were really not on point at all and for the moment that seemed to be where the matter was left.

We sent in our solution to the Times and got a small card in reply that it was nice that I thought to send something to them and I should continue to read their paper. I am not sure what it meant but it may be that they get a lot of weirdoes sending in strange letters.

Our firm is hired by prestigious organizations and paid substantial sums of money to come up with concepts that can be helpful in solving problems. We think that we have come up with the answer and we offered it for nothing. (I assume that if we had sent in a bill along with our proposal, the Times would have expressed interest in it). While we certainly are the first to admit that it is very raw around the edges, there is no question that it will work.

Our solution, simply put states the following, if you agree upon your death to donate your organs, then you will be first in line to receive them should the need arise while you are alive. There are other points that make the plan more sophisticated but, as I said it still needs a lot of work. If there is some organization that is willing to run with this, we will provide whatever knowledge and assistance we can to make it work.

I am a firm believer in the fact that, if a person or family believes that body parts should not be tampered with when they are dead, then they certainly shouldn't be tampered with when they are alive. The rich can go to China and have a prisoner executed in order to obtain a transplant, what is the middle class and the poor going to do?

I challenge you to come up with something better. If you do, we hereby offer a prize and the publicity of helping mankind. What more can we do?

Robert A. Spira Chapman Spira and Carson LLC

Chapman, Spira & Carson LLC Suite 1022 45 Wall Street New York, NY 10005 Tel: 212.425.6100 Fax: 212.425.6229 E-mail,

Robert A. Spira Wednesday, May 7, 1999 Chairman

Howell Raines By Fax: 212-556-3690 Editorial Page Editor The New York Times 229 West 43rd Street New York, New York 10036-3959

Re: A simple idea

Dear Mr. Raines;

As a person that has been diagnosed as having Hepatitis "C" along a few other assorted medical problems I have read with interest your op-ed series on organ donation, or purchase as the case may be. I served in the Korean War and in those days, among the troops, it was de rigiour donate blood for the war effort. Anti-rejection drugs had not been invented yet so organ transplants were still limited. Long after the Korean War and the Vietnam War were over, I continued to donate. I recall my consistent amazement over the fact the great majority of people that I knew had no interest in sharing their precious blood supply with others notwithstanding the fact that we were all assured that donations were totally safe as well as the humanitarian thing to do. The former turned out not to be the case.

My will and that of my father before me has always included a clause giving my organs to whoever may need them and when New York State started formalizing the process on drivers licenses, I stepped up to the plate again. I have encouraged my children to do the same and they have followed my lead.

My generosity was rewarded with a case of hepatitis "C", the result probably of a dirty needle. In retrospect though, I would not have changed one thing. The disease had lain dormant in my system for many years and it along with some other unpleasant maladies were only discovered recently. Thankfully, I am in no immediate danger and do not need a transplant, but because of my cognizance of my own condition, I have read the remarks of your readers with a great deal of interest. I have found that each proposal leaves something to be desired and whether they deal with tax benefits or state credits, one way or other, there is still that a monetary incentive attached to this giving, polluting the solution.

My strategy eliminates this problem. Here then is the way I see it; every person in the United States (or the State of New York) has an optional box on their income tax form. Fittingly, it should be located next to the discretionary political donation check off box. This box would contain three options, the first, a willingness to donate any and all organs in case of the death of the donee. This option has a value in my system of 5 points for every year the donor remains in the system. The subsequent option box allows for the donation of particular specified organs and is worth 3 points a year. The third option is a willingness to donate blood whenever there is an emergency. For acting as a standby, the donor gets one point a year, but if called upon to donate and for whatever reason does not fulfill his requirement, he or she loses all their previously donated points relative to this option. The active donation of blood will get the donor 1 1/2 point for each donation. If the blood banks are full and the blood is not needed, the active donor would revert to receiving the one point a year as a standby credit . This system of check-offs would necessarily be enacted into law so that they take precedence over contrary language contained in wills and subsequent family pronouncements.

However, there are several inequities in this system, the first is that children can't be donors and thus, how can they receive organs? In the instance of children, we have devised the family donation award system. Points may be donated by parents to their children (or to each other) until five years after they have reached the age of majority or they marry, Furthermore, points may be willed, but only to those in the immediate family discussed above. Thus, with the system, those with the highest donee ratings will be given transplants in advance of equally sick people having a lower number of points.

We are left with the problem of a single person who for medical reasons can not donate blood. If this person produces medical evidence of the fact that his blood can not be used, is infected or there is some other problem, this person by taking the option of donating all of his organs will receive an extra half point per year.

Upon the death and or marriage of all family members, the points revert back to the state for use on needy orphans, aliens or others that could not have either not joined the program or to whom it is unavailable. In order not to waste these resources, both the hospitals and the doctors must be certified on an ongoing basis. Thus, both the hospital where the transplant takes place as the performing surgeon would have to be at the top of their games. Minimum requirements for both hospital and doctors involved in transplants must be established early on because of a number of reasons. Among of things, as the science evolves, those with points may covet cosmetic changes that are not intended to be part of this plan whose existence would be based only upon life certified life-threatening medical problems. Waste of organs could be considered a capital crime and the offending parties should be made to pay an equivalent price.

The technology currently exists within the social security system to carry out this program now. Simply put, the participating donors would be issued a new social security card containing this donation record. The card would be renewed each year that donees participate, reflecting the number of point accrued in the system. Obviously, we are quickly heading for the time when our medical histories will be on a smart card anyway, and I would think, that the sooner the better in this instance. While there entrance to the system would be entirely voluntary, there would have to be restrictions against withdrawal. This might best be done contractually and it should go something like this, "In exchange for the receipt of ________ organs, I hereby agree to remain within the system until my demise." Thus, once having become a recipient, the future donor cannot opt out of the system

The system, either State of National sponsorship will bridge the gap until science is able to provide genetically engineered replacement parts that don't require demonic anti-rejection drugs. We so no bar to joining this endeavor and those that don't think enough to help their neighbors should not be first in line when they are faced with a problem.

I am in some awe that no one has proposed this type of organ donation system earlier, considering the problems with the other plans. This is simple and it addresses those contingencies, which at least, are highly visible to me.

Robert A. Spira

P.S.As an addition but only for discussion purposes, I would allow convicts to use the same point system to give back what they took from society. For every seven point they accumulate I would deduct one-year from their sentence up to a total of an overall reduction in time to be served to 10%. How would we deal with those convicts that upon their release opt out of the system? Not to sure about that one but lets see what others have to say about it.

Last changed: March 17, 2000