Lifesharers: An Opting-In Paradigm Already in Existence

American Journal of Bioethics, Vol. 4, No. 17, 2005

4 Pages Posted: 12 Apr 2005

See all articles by Steve Calandrillo

Steve Calandrillo

University of Washington - School of Law


Over eighty-five thousand Americans are currently on the national waitlist to receive kidneys, livers, hearts or other human organs due to the failure of their own. Sadly, over half of these people will die while waiting for the miracle of life to arrive. Some will travel to other countries to purchase organs on the black market in a last ditch effort to save their lives. All of those involved wish that finding an organ would be far easier than it is today.

Since the passage of Al Gore's National Organ Transplant Act, it has been illegal in the United States to sell human organs, although the same cannot be said for human tissues, blood plasma, ova, and sperm. Morality and distributive justice concerns form the backbone of traditional arguments opposing organ sales, as many Americans find it unacceptable to "purchase life." The poor would be exploited and pressured into selling organs to escape debt, often with little knowledge of the risks they incurred and the costs that they might later impose on society's health care system. Hence, if conscience dictates that living-donor organ sales must never occur, it is incumbent upon society to focus on other methods of incentivizing organ availability.

Basing waiting list priority on the patient's own willingness to donate may inspire millions of Americans who have previously not taken the trouble to sign up to instead choose to opt in to donation. This concept has been put into practice by LifeSharers, a nonprofit organization formed just over two years ago that aims to utilize a person's internal motivation to save their own life to save the lives of others. LifeSharers incentivizes people to become organ donors (and to become a LifeSharers member) by giving them the return promise that all members of the organization agree to donate their organs first to other members before they go into the nationwide waiting pool. In this manner, people are encouraged to opt in to donation who otherwise might not, if only from a selfish desire to increase the likelihood that they will be able to find a suitable organ should their own organs fail sometime in the future. LifeSharers' concept is an appealing one from an intuitive and distributive justice perspective: it seems only fair that people who agree to donate organs should receive priority if they ever need one.

Keywords: lifesharers, organ donation, National Organ Transplact Act, NOTA, presumed consent, opt-in

JEL Classification: A10, D78, G38, I10, I1, I18, K20, K00, K10

Suggested Citation

Calandrillo, Steve, Lifesharers: An Opting-In Paradigm Already in Existence. American Journal of Bioethics, Vol. 4, No. 17, 2005, Available at SSRN:

Steve Calandrillo (Contact Author)

University of Washington - School of Law ( email )

William H. Gates Hall
Box 353020
Seattle, WA 98195-3020
United States
206-685-2403 (Phone)


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