The New England Journal of Medicine has a worried editorial in its current issue about the MatchingDonors.com website, which matches (live) organ donors with (live) would-be organ transplant recipients:
[MatchingDonors.com] currently claims to have more than 2100 registered potential donors and to have brokered 12 transplantations, with about 20 more recipient–donor pairs matched and awaiting surgery.
Although the business conducted on this organization’s Web site does not raise any fundamental ethical issues not already posed by other methods of solicitation, it does introduce a new degree of visibility that increases the magnitude of the issue. Will competing commercial Web sites begin to emerge? How will these sites be held accountable? Dr. Jeremiah Lowney, the medical director of MatchingDonors.com, recently argued that just as a dating service could not be held responsible for a bad date, his Web site has no responsibility for the outcomes of its matches. Furthermore, the Web site has no mechanism for ensuring the quality of the information it provides about transplantation and donation by living persons or for checking the accuracy of information submitted by potential donors and recipients.
Given the life-or-death consequences of the procedure, organ donation should not be governed by the ethics of caveat emptor. Nevertheless, MatchingDonors.com has clearly identified a need, and if this need is not met by a service that can address the ethical challenges, the vacuum will be filled by other enterprises. Entrepreneurs commonly open up useful new markets and services that must eventually become subject to rigorous standards and regulations.
The solicitation of organs over the Internet is probably here to stay, but it will require higher standards of responsibility and accountability than are currently in place.