Abstract
The likelihood of being a potential deceased organ donor is higher for individuals who have been exposed to situations typically characterized by a severe head trauma or stroke that result in brain death. Employing count data models that account for overdispersion and/or excessive counts of zeros, this paper assesses the unintended consequences of enforcing stricter gun control laws and the effects of gun ownership on homicide organ donor supply in the United States using county data for the period 2009–2015. The findings confirm the transplantation paradox hypothesis that stricter gun control laws reduce the expected cases of gun homicides and thereby reduce deceased organ donor supply and exacerbate the organ shortage. The findings are robust to several measures of the strength of gun control laws, restricted samples and spurious outcome variables. However, the direction of the impact of gun ownership levels on homicide organ donor supply proved to be inconclusive.
Highlights
The likelihood of dying under circumstances that would render an individual’s organs suitable for transplantation is very low
Since gun homicide and homicide organ donor supply rates are defined as count/population, the model is adjusted by defining county population as the exposure variable from which cases of homicide occur
This study used county-level cross-sectional data to evaluate the effects of gun ownership and the unintended consequences of enforcing stricter state gun control laws on gun homicide rates and homicide organ donor supply
Summary
The likelihood of dying under circumstances that would render an individual’s organs suitable for transplantation is very low. Examples include mental health parity laws that provide insurance coverage for mental health treatment (Lang, 2013), state motorcycle helmet laws that aim to reduce crash fatalities due to helmetless riding (Peng et al, 2017) and gun control laws that aim to reduce gun-related fatalities (Lee et al, 2017) None of these interventions intend to affect organ donor supply. The requirement of the death of an individual in such a way that would render her organs suitable for donation to save someone else’s life represents a public health paradox and these large-scale policy interventions might have the unintended consequence of reducing an already low organ donor supply (Annas, 1988).
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