Does anyone else see a problem with this picture? On the individual level, I’m happy for Onufer that he gets to live longer and wait around for his turn to get a heart from some dead motorcyclist or shooting victim on 41^st street (don’t worry, mom, off-campus living is totally safe). But when you stop to really think about what this means, it leads to some questions about the system necessitating such a procedure in the first place.

I’m going to assume that exorbitant amounts of time, money, and research led to the possibility of this particular type surgery. And for good reason – after all, a man’s life is saved, and no doubt countless others will benefit as well. It follows a long line of life-sustaining machines such as respirators and dialysis machines that bring patients through the times when their own bodies can’t support them and bring new hope to patients who would otherwise die during the unpredictable wait for transplant. According to Morris, “about 15% of patients will die waiting for a heart transplant.” This device will hopefully bring that percentage down considerably: in previous cases, it has sustained patients for up to five years.

Five years! Sounds great! That way, Onufer can wait around for someone with healthy heart, who happens to be an organ donor, to happen to die nearby within the next few years, from a cause that happens to not affect their heart! A lot of happenstance is going on here, I’d say.

Here’s the deal: while the artificial heart is great for patients like Onufer, the very fact that scientists and engineers had a pressing need to invent it is problematic. Onufer might very well have died had he had to wait for a heart like everybody else. The shortage of organs available for transplantation in this country is nothing short of scary. According to the United Network for Organ Sharing, as of today at 2:30 pm, 95,121 people are waiting for transplants in this country alone. That’s 95,121 moms, dads, daughters, sons, sisters, brothers, husbands, wives, girlfriends, boyfriends, and strangers with no one in the world. They are waiting because of a shortage of organs available, and there is a shortage of organs available because of a little black box on the back of your driver’s license.

You know the one. “I hereby make an anatomical gift, to be effective upon my death of any needed organs or parts.” Check. Now you’re a good person, right? If you’re ever in a car crash, your death won’t be in vain because someone, somewhere, will get your heart/liver/kidney. Good job. And if your liver ever fails you, some other good samaritan will have checked off their box, too, so you’ll be fine, right? Or maybe you’ll just be number 95,122 on the waiting list. And maybe you’ll die. Why? Because millions of people aren’t checking off that box, or haven’t even noticed it, for that matter. They’re not bad people – they’re just people who don’t know or care to know about issues of organ transplantation. They see the fine print on their license as irrelevant to their own lives, like most other fine print they come across. And yet, these very same people who could care less about the fine print could very well receive a life-saving organ at some time in their lives because someone else did care enough to check off the box. This opt-in system assumes that no one is willing to donate unless they’ve specifically indicated that they are, while simultaneously assuming that everyone is eligible to receive. It just makes no sense.

I think the donor system should be opt-out, so that everyone is assumed to be a donor unless they indicate otherwise. The box should read, “I hereby choose not to make an anatomical gift.”  Granted, this might be hard for America to accept, considering our emphasis on the value of autonomy and choice when it comes to our own bodies. People might argue that the medical establishment should not have such unfettered access to our bodies once we die without our expressed consent. But an opt-out system would not hinder autonomy; it is still every person’s choice whether or not to donate. This way, everyone’s automatic eligibility for receiving organs would be matched with their automatic eligibility for donating them, unless otherwise indicated.

Other solutions to the shortage problem have been suggested, such as allowing payment for organs, or other forms of indirect incentive to get people to donate. To be honest, I’m not sure what my stance is on that idea, even if my gut reaction might be that people shouldn’t be allowed to buy or sell body parts. In fact, as is the case with most gut reactions, I’m sure that given enough data and rational reasoning, such a proposal might end up making sense in the end. But I think that an opt-out system just works logically; if people expect to receive organs without having to explicitly specify that they want them, then they should expect to be considered a donor as well.

Last year, my best friend needed an immediate liver transplant. She was put on the list like everybody else to wait for some recently-deceased person’s liver, and like thousands of others, happenstance did not come through for her. Fortunately, her father was able to donate a part of his liver, and saved her life. But I know that most people are not that lucky; most people in her situation would have died. And trust me, once you have a personal connection to someone who needs an organ, there’s just no explanation in the world good enough to justify the backwards system of organ donation in this country that allows for such an immense gap between supply and demand.

Gary Onufer will probably live long enough to receive a new heart thanks to the fake one pumping away in his chest right now. But thousands of others will not. The solution to their plight does not lie in keeping them alive long enough to finally get the organ they need; it lies in getting them the organ in the first place. Some incredibly high percentage of 95,121 people will die soon because they never got the organ they needed; perhaps a fundamental change in the way this country views organ donation could help to change that in the future.