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Book Review of On the List: Fixing America's Failing Organ Transplant System

On the List: Fixing America's Failing Organ Transplant System
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Helpful Score: 1


On the list: fixing America's failing organ transplant system is part medical memoir and part outline of the massive shortage in organs available for transplantation. It's hard to keep in mind that this is written by two authors since most of the book is in the voice of the first author, Steve Farber, who frames the book in terms of the personal experiences of the peasant and power broker, two people who happened to undergo surgery on the same day.

When Farber, a wealthy lawyer and political fundraiser (the "power broker") developed kidney failure, his options included dying on the waiting list, accepting a kidney from his son, buying a kidney transplant in Turkey, or dialysis. Meanwhile, on the same day, Guatemalan refugee and landscaper Ernesto Delaroca (the "peasant") donated a kidney to his younger sister Sandra who was decompensating despite years of dialysis. Throughout Farber's decision-making process, he tells the story of how globalism, law, and economics have lead to black markets for organs abroad, and makes an argument for compensated donation and stem cell research to help the many people waiting for organs.

Steve's personal story involves a lot of melodrama, as his wife wants him to buy a kidney in Turkey to spare his son the risks of donation. However, we know from the start how he gets his kidney, and there's also a lot of unnecessary name-dropping along the way. His arguments for compensated donation aren't particularly well-reasoned, only that the system needs deep reform and the alternatives,free markets and presumed consent, are not palatable. Although a good consciousness-raising piece, this book does not do this complex moral, economic, and political issue justice.