This fascinating article and video by Gautam Naik for the Wall Street Journal tracks the recent developments in bioengineered organs, aka “replacement parts for the human body.” Whenever the discussion of artificial organs arises, it is important to differentiate between organs that can be harvested from donors vs. those that cannot. Why? Because public policy can essentially dictate the availability of those organs to patients in need.  Imagine if, when you went to the DMV to renew your license, you were required to choose whether or not to become an organ donor.  This model, called mandated choice, has support from the American Medical Association and has been rehashed and researched by the likes of Richard Thaler and Cass Sunstein in their ode to libertarian paternalism, Nudge.

At a recent Columbia Postbac Premed Surgery Club event, liver and kidney transplant surgeon Dr. Susan Lerner noted her frustrations with the lack of available organs in New York City and the troubled methodology of equitably distributing the available organs. The sickest patients get the available livers, yet the sicker they are, the more difficult (if not impossible) the recovery.  A statewide mandated choice model would undoubtedly increase the number of organs available to transplant surgeons like Dr. Lerner.

Changes to organ donation policy look increasingly attractive when one confronts the price tag on bioengineered organs.  For organs that cannot be transplanted from donors, the investment is appropriate. For those that can, the mandated choice model is a far more reasonable and cost-effective approach – though it’s certainly not as cool.