In some countries, there may also be financial disincentives to deceased donation e. Competent adults should be free to make their own decisions about the medical procedures that they will undergo and the risks that they will take.
Among respondents who had previously declined to grant consent, 19 percent stated that incentives would make them more likely to grant consent, 13 percent stated that incentives would make them less likely to grant consent, and 68 percent said that incentives would have no effect.
The good is highly perishable, and recovery and transfer to the final user must be accomplished under extreme time pressure. Exploitation involves harm — but offering people something in return for organs which can no longer benefit them after their deathdoes them no harm.
The process of making an organ available requires skilled labor and technology. Concerns about inadequate information arise, however, even under the gift model now in place and are discussed in Chapter 9 of this report.
Comparisons of surveys that ask about the willingness to donate and actual registration rates often detect a disconnect between the responses and the actual behavior. Nevertheless, consideration of the case for such a market is a useful exercise.
A perfectly functioning market and a fair distribution of income and assets would not likely produce equity in the current healthcare system. A futures market is a market in which the commodity bought and sold is the right to sell organs at a future time in the event that a person dies in circumstances that permit organs to be recovered and transplanted.
Few people pay directly for organ transplantation, which is expensive even without payment for the organs. Table 3 Additional guidelines for development of a regulated system of incentives for living donation There should be a clear and transparent process for providing information about risks to the donor, ensuring that the donor understands the operation and its risks and obtaining donor consent.
There is preliminary evidence to suggest the change has increased donation rates there and the number of willing donors. This price structure would result from the interaction of the array of kidneys available with the variety of patients in need of a kidney at any point in time and the trade-offs among kidney characteristics that are medically possible for transplantation into various patients.
In living donation, a mentally competent adult has an organ or organ part that can be supplied to the market at some risk and financial cost. Although some advocates for payments acknowledge that the adoption of a sale model raises legitimate ethical concerns, they believe that the lives saved by increased rates of organ donation outweigh all opposing concerns Barnett et al.
They would compete with one another for the available organs, the price would settle down at the market-clearing price, and the cost of organs would become part of the total charge to a third-party payer for an organ transplant. Kidneys would be allocated to the number 1 person on the list as determined by defined and transparent criteria.
They focus on obtaining organs while leaving organ distribution and allocation to other mechanisms, either current or newly devised. When organs are recovered after death, one might argue that the exercise of this liberty harms neither the donor nor society in any direct fashion and that this use of organs is thus overwhelmingly beneficial to the individuals who need organs and to society at large.
A higher price coaxes out more supply by making it worthwhile for producers to produce more of the good or, if the total amount of the good is fixed, by encouraging the current owners to put more of the good up for sale.
As explained in Chapter 3bodies are supposed to be treated with respect—with funeral rites and burial or cremation—and not simply discarded like worn out household furniture and certainly not sold by the relatives or anyone else to the highest bidder.
People in need of organs rely on public or private insurance to pay the cost of acquiring the organs and transplanting them, and a transplant is not received unless insurance coverage or access to charity care is available the so-called green screen.
As indicated in the previous section, the existing approach—in which organs are gifts rather than items for sale—rests in part on a widely shared supposition that solid organs of deceased individuals should not be bought and sold. Again, implementation would be complex.
Proposed Solution Regulated systems that remove disincentives to donation and reward donors have the potential to increase donation, save lives and reduce or eliminate the unregulated markets and the harm they cause.
We must also recognize that many highly motivated potential donors do not come forward or do not progress through the evaluation and donation process because of the substantial financial and logistical obstacles Table 1.
The most radical of these proposals involved legalizing the purchase and sale of organs in a free market. As explained in Chapter 3bodies are supposed to be treated with respect—with funeral rites and burial or cremation—and not simply discarded like worn out household furniture and certainly not sold by the relatives or anyone else to the highest bidder.
Public Comment Proposal. A White Paper Addressing Financial Incentives for Organ Donation. OPTN/UNOS Ethics Committee. Prepared by:. An ethical appraisal of financial incentives for organ donation.
The ethical landscape regarding financial incentives for organ donation is complex, A second argument against financial incentives is that donation rates may actually decrease because of backlash from current donors who may feel that financial compensation undermines.
One of the biggest fears with introducing financial incentives is that it might lead to an organ market and create a situation in which the rich could exploit the poor for organs.
The proposals that warrant more serious consideration involve cash payments for organs—or other financial incentives for organ donation—determined within a regulatory framework.
They focus on obtaining organs while leaving organ distribution and allocation to other mechanisms, either current or newly devised. Help others become living donors by supporting the American Transplant Foundation’s lifesaving initiatives. Your financial donation can be as valuable as a living donation.
Learn more about living donation and our Patient Assistance Program.
The financial incentive could go to the donor before death or to the donor’s estate after death in exchange for the donor’s agreement to allow his or her organs to be recovered after death. In situations in which the donor’s family makes the decision to donate, the incentive could go to the family.Financial incentives on organ donation