Now this high performing altruistic system is under threat in the Granite State. Legislation in the form of House Bill 1482 — “An act relative to the sale of human blood and organs” — is now pending in the House of Representatives and would allow for the unregulated private sale of organs between individuals within the state. Specifically, if passed into law, the bill would prohibit the state of New Hampshire from regulating, in any way “the private sale, purchase, use, possession, or donation of … organs in the state” and, further, that “no rule shall apply to the private sale … of organs.”

A donation and transplant system where “no rule shall apply” is frightening to consider.

Currently, the national system of donation and transplant is highly regulated to ensure the ethically safeguarded, safe, efficient, and equitable donation and transplant of organs. Organs from deceased donors can only be donated through federally-designated, non-profit Organ Procurement Organizations such as New England Donor Services, of which I am president and CEO. The donated organs are allocated equitably to patients on the national organ transplant list based on the waiting patients’ medical urgency, time waiting, proximity to the donor, and biological-matching criteria.

It is important to know that the primary cause of the organ shortage is not a lack of generosity, but the fact that only about 1 percent of deaths in the U.S. each year meet the medical requirement to be considered for organ donation. Donated organs (either from deceased donors or living donors) can only be transplanted at qualified transplant center hospitals that meet the stringent medical conditions required for the safe transplantation of organs and care of patients after surgery.

A “rules-free” market system for deceased donors and living donor organs may not be bound by any of the health and safety regulations that are now an integral part of the process. In such a scheme, even the most common-sense regulations could be prohibited by the proposed legislation. The transplantation of a “bought-and-paid” organ may not even be bound by minimal medical requirements for disease screening or be required to be performed by a trained and licensed transplant surgeon!

Of near equal importance to the health and safety of recipients is consideration for the ethical implications of private organ sales, especially as they relate to living donors. Such sales hold the real potential for the physical exploitation of vulnerable individuals who may be coerced into selling their body parts to address financial hardship. This will open New Hampshire’s doors to a perverse market where the most financially susceptible among us become commodities, their desperation leveraged by those with the means to pay high prices who would gain preferential access to life-saving transplant.

Instead of this misplaced attempt to increase organ donation, lawmakers should consider passing legislation that removes financial barriers and supports living donors, such as a law now being considered by the New Hampshire House (HB 1155) prohibiting discrimination in life insurance practices based on an individual’s status as a living organ donor. Also, public and private employers can offer paid time off to living donor employees to assist in making the decision to donate cost neutral to the living donor.

There is much we can do to continue increasing voluntary organ donation through promoting awareness, increasing donor registration, and maximizing the use of technology to continue improving the existing donation and transplant system. However, at its core, organ donation must be protected as a voluntary gift of life, highly regulated for donor and recipient safety and not subject to coercive unregulated market forces.