The downside of self-driving cars: fewer organs for transplants?

January 2, 2017

Self-driving cars will change the world, and according to most analysts, those changes will be for the better: fewer traffic accidents, fewer fatalities and injuries, smoother-flowing traffic, better fuel economy, and so on.

However, there are a couple of downsides. For example, autonomous cars could reduce a family's need to own more than one vehicle, since self-driving cars can be used by multiple people throughout the day. Some estimates project that self-driving vehicles could cut new-car sales in half.

Autonomous cars will almost certainly change auto insurance, too, as premiums become much, much cheaper, making companies less profitable. That's not a downside for most of us, but for thousands of people who work in the insurance industry, it's a big change. 

Darker side of autonomous cars?

And there's another issue looming: according to two fellows at the R Street Institute--a conservative think tank that aims to promote "free markets and limited, effective government"--autonomous cars could spell doom for many people waiting on organ transplants.

That's because roughly 94 percent of all fatal collisions in America are caused by human drivers. By taking human drivers out of the equation, autonomous vehicles could nearly eliminate traffic accidents. 

While that's great news for the 35,000 or so people who die each year on U.S. roads, it's bad news for anyone waiting for an organ transplant, because roughly 20 percent of such organs come from people who've died in collisions.

What's worse, organ donations are already on the decline, meaning that demand for organs would increase even without the advent of self-driving cars. For organ donations to continue falling just as the supply of organs trends sharply downward...well, that's a perfectly awful storm for the 123,000 or so Americans currently waiting for an organ transplant. It's especially bad for the 6,500 people who die every year due to the shortage of organs.

R Street's analysts suggest a number of ways to address the problem, including the vaguely disturbing notion of launching a market to allow organs to be bought and sold. That seems like a terrible idea (one that Kazuo Ishiguro explored in his 2005 novel, Never Let Me Go, if you're interested).

A better idea might be to make organ donation an opt-out process instead of opt-in. That could dramatically boost the rolls of organ donors in the U.S . as it's done elsewhere in the world--though of course, that wouldn't do much to address the declining number of viable donors dying in auto accidents.

The analysts also propose federal incentives, like those offered in Israel. There, folks in need of an organ can acquire priority status if a family member signs up as a donor. The Israeli government also provides certain benefits to organ donors, including free health care for a limited time.

Our take

Like any prediction, R Street's is a guess, but it seems like a good one, based on the data that we've seen used by government officials, automakers, and others involved in making, testing, and regulating self-driving cars. 

Even if we were to set aside the issue of self-driving cars, the problem of organ donations and transplants is very, very real. If, by some miracle, the medical community was able to maintain the status quo, that would still mean 6,500 deaths each year due to organ shortages--not to mention 4,000 related deaths of people who've been taken off the transplant lists because they've been deemed too ill. That's a crisis.

Sadly, the status quo is likely to get worse. Though some medical conditions requiring transplants may be reduced or eliminated in the future by gene therapy and other advances, others won't. The growing problem of diabetes, for example, will likely require more transplants than today.

None of this is meant to diminish the importance of self-driving cars or the good they'll do. It's only to say that, though they'll undoubtedly save lives on roads, they may cost lives elsewhere. It's time to start planning ahead.

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