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November 2, 1994

The Most Useful Gift: Altruism and the Public Policy of Organ Transplants

Author Affiliations

Columbia University New York, NY

JAMA. 1994;272(17):1384. doi:10.1001/jama.1994.03520170096044

In the early chapters of The Most Useful Gift, a book dealing with the growth and development of the cadaveric organ supply system for the transplant community, Jeffrey Prottas states, "Congress has been at the forefront of pressing for the socialization of the organ procurement system." As Prottas illustrates, this change in public policy was sought by the transplant surgeons, perhaps for ulterior motives, but fully supported by their patients to increase the supply of organs, promote equitable distribution of a scarce commodity, and legitimize the services. The End-Stage Renal Disease (ESRD) program, itself a precedent, mandated national health insurance for a specific illness, chronic renal failure. It was thus a natural sequel that organ donation likewise be socialized.

As Prottas develops his material, based on his privately funded research into the subject, he shows how the Uniform Anatomical Gift Act in the 1960s and the National Transplant Act of

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