I don’t see the relevance of post #22. However, I’d rather see stricter measures to reduce the potential for abuse, than to let lots of people die for lack of transplantable organs whose original owners would have wanted to donate them while they were still useable. That’s abuse too — abuse of the dying person’s right to give the gift of years of additional life to others.
I do agree that there needs to be better prioritization of recipients. There’s unfortunately a situation comparable with the recipients, with waiting until things have reached a point that a good outcome is no longer possible. People don’t get to the top of the recipient list until they’re sicker than anybody else who needs a transplant, resulting in scarce organs going to people who will derive only a very short term benefit from them. If the same people had gotten a transplant a year or two earlier, they’d likely have lived a normal or near-normal lifespan.
IMO the first people to be bumped off the list shouldn’t be the healthiest ones, but rather those with self-inflicted conditions (and of course violent criminals — I remember the story of a heart going to a convicted murderer on death row). Beyond that, I think priority generally ought to patients who have the longest prognosis for survival with the transplant, which in practice would generally mean younger patients and those who have been in transplant-needing condition for the shortest length of time. It’s not “unfair” to arrange the system so as to yield the maximum number of years of life per organ.
I understand your point of view. However, based on my personal experience with the "transplant industry" I have become extremely skeptical. Boundaries are pushed beyond belief. Families are pressured into donating for loved ones. Living patients are pushed back on OR schedules (sometimes causing them harm) in order to make room in an OR for a "harvest." Harvested organs are transplanted into drug addicts who quickly destroy their "gift." All the while, money is changing hands.
Certainly a great deal of good can come of transplantation. However, using brain death as a criteria for donors is a clear line in the sand. It would go a long way in preventing abuse.