The "From Innovation to Crisis" section of the introduction provides a historical account of U.S. kidney transplants (no kidney transplants to identical twin living donor kidney transplants to cadaver/unrelated living donor kidney transplants). Dr. Barry Jacobs's State-funded compensated kidney donation scheme is then described and, appropriately, skewered. The author also reports the sobering fact, unknown to most laypersons and ignored by most physicians, that "the average lifespan on dialysis in the United States is only four years."
The "Congress Demands, "Just Try Harder"" section of the introduction explains the origin of the 1984 National Organ Transplant Act (NOTA), which banned compensated organ donation in the United States. The author then details the extent of the current, and inevitable, black market in kidney sales that was a direct consequence of NOTA and multiple additional States banning compensated organ donation. The author's diplomatic treatment of NOTA, stating "what Congress did seemed reasonable," annoyed the radical sensibilities of the LIBERTARIAN BIOETHICS BLOGger but, given the book's target audience, is understandable.
The "What Next?" section of the introduction notes that, since cadaver kidney organ donation cannot possibly meet U.S. demand, compensated kidney donation "has recently reemerged as a possible solution." A historical account of the successful compensated kidney organ donation system in Iran is then given. Readers are then provided additional horrific statistical data proving the failure of the current U.S. non-compensated system.
The "Americans Suffer" section of the introduction interjects a human-interest story into the narrative, depicting the disturbing life of a dialysis patient (a friend of one of the author's friends).
Dr. Fry-Revere closes the introduction by asserting that she considered donating a kidney to the friend of the friend mentioned in the "Americans Suffer" section. Compassion for the plight of the unfortunate is the fundamental emotional trait of the libertarian. The author, clearly a libertarian, has earned my respect; I shall read on.