Articles: human.
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Biomarkers are becoming crucial in ever more medical tasks and are proposed to change medicine in profound ways. By biomarking ever more attributes of human life, they tend to blur the distinction between health and disease and come to characterize life as such. Not only do biomarkers strongly influence the professional conception of disease by pervading ever more diagnoses, but they also impact patients' experience of illness. To manage how biomarkers influence patients, professionals, and societies, we urgently need to move from identifying potentially relevant biomarkers to determine their meaning and value to individuals, professionals, and public health.
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The 1984 National Organ Transplant Act (NOTA) saw to the establishment of a national Organ Procurement and Transplantation Network (OPTN). As envisaged by the law's congressional sponsors, the Secretary of the US Department of Health and Human Services (HHS) was to institute a "central registry linking donors and potential recipients." In addition, the Secretary was to see to the institution of a "scientific registry of organ recipients" as well as "designate and maintain an identifiable unit in the Public Health Service to coordinate Federal organ transplant programs and policies." Forty years later, over 103,000 patients remain on the organ transplant waiting list for an average of 3-5 years during which time 17 die every day. ⋯ A Health Resources & Services Administration (HRSA) Modernization Initiative followed suit in March 2023. In this Perspective, we review the state of OPTN, discuss its recent oversight by the SCF, and describe its future reform as conceived and enunciated by HRSA.