To the Editor.—
In the United States, there are currently approximately 11000 patients with end-stage renal disease who are awaiting kidney transplantation. At least half of these people wait more than 6 months and many more than 1 year before a suitable cadaveric donor organ becomes available. Vehicular trauma provides one of the main sources of transplant organs. Clearly, the decision by motorcyclists not to use helmets is one that will increase their risk of fatality in a motorcycle accident.Since, as Rivara et al1 pointed out in the July 8 issue of JAMA, morbidity from motorcycle trauma is paid for in great part by public funds, it would not be unreasonable to request that motorcyclists "repay" society. One way to accomplish this repayment would be to require signature on a legal document that allows for organ removal at the time of death for any motorcyclist who chooses not
Rosansky SJ. The Public Cost of Motorcycle Trauma. JAMA. 1989;261(8):1149. doi:10.1001/jama.1989.03420080063020
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