Cash compensation to organ donors: a sensitive issue

In the more than 50 years since the first successful organ transplant, hundreds of thousands of patients have had their lives extended because of organ donations. Yet despite decades of campaigns to persuade Americans to donate organs after they die, the demand increasingly exceeds the supply, says USA Today.

It is a quiet crisis that argues for new approaches. Several ideas, although controversial, are under consideration or already underway. Among them:

· Under a "futures" contract, the estate or family of an adult who agrees to donate organs might receive some financial remuneration, typically less than $10,000, for funeral and other expenses. Organs would go into the donor system, not be sold to individuals.
· LifeSharers is an existing network of 4,500 donors. Members agree to specify that when they die, priority in getting their organs should go to other members, also registered as donors.
· More controversially, Arkansas, Georgia, Iowa, Minnesota, New Mexico, North Dakota, Utah and Wisconsin allow tax deductions of up to $10,000 to compensate living donors for travel, expenses or lost income. This is legal because the money comes from the state. It also requires screening for psychological fitness.

Providing financial incentives for donor participation is an ethical minefield, but in a measure of how severe the shortage has become, the American Medical Association, which had long opposed payments to donors, now favours limited experimentation.

With more than 6,000 patients dying each year while on organ waiting lists, limited financial incentives are worth trying. They should be confined for now to post-mortem donations, and organs should be distributed as they are, based on medical need and time on the waiting list – not on ability to pay, says USA Today.

Source: Editorial, Organ donations fall short; financial incentives can help, USA Today, June 25, 2006

For text (subscription required): http://www.usatoday.com/printedition/news/20060626/edit26.art.htm

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Eustace Davie, Director of the Health Policy Unit
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