Financial compensation for organ donors

Abstract

Purpose of reviewWith an increasing demand for donor organs, strategies to increase the number of available donor organs have become more focused. Compensating donors for donation is one strategy proposed to increase the availability of organs for transplant. This has been implemented in several systems internationally, but debate continues in the United States with respect to appropriate strategies. The National Organ Transplant Act (NOTA) currently prohibits the transfer of any human organ 'for valuable consideration' for transplantation, but allows for the removal of financial disincentives. Recent findingsSeveral proposals currently exist for compensating patients for living donation. Recent data have focused on studying and creating mechanisms for reimbursement of costs incurred as part of the donation process, which is related to the removal of disincentives to living donation. Others have advocated for the provision of actual incentives to patients for the act of donating, in an attempt to further expand living donation. The current debate focuses on what measures can reasonably be taken to increase donation, and whether additional incentives will encourage more donation or reduce the motivation for altruistic donation. SummaryCurrently, the transplant community broadly supports the removal of disincentives for living donors, including reimbursement of expenses for travel, housing and lost wages incurred during evaluation, surgery and after care. Others have advocated for financial incentives to further increase the number of donor organs available for transplant. Although the removal of disincentives is currently allowed under the existing legal structure of NOTA, providing financial incentives for living donation would require further evaluation of the economics, law, ethics and public readiness for a significant policy shift.

Cognitive mapping as an approach to facilitate organ donation among African Americans

“…There has been a long-time argument about payment or financial compensation for organ donors. 36,37 However, in our study, the strategy of ''Pay people or their families for organ donation'' received the lowest mean ratings from both disagreed and agreed groups. This suggests that financial incentive alone may not be an effective approach for facilitating organ donation among AAs.…”

Disparities in living donation

“…Along the same lines, socio-economic disparity among living donation rates is a true and persistent anchor to increasing living donation. The study of compensation for organ donation as well as other alternatives to aid donors in lower socio-economic tiers may have to be explored more broadly to possibly improve the income and gender gaps in organ donation [30,57].…”

Ethics of live uterus donor compensation

“…After all, in countries like the United States, it is recognized that other practices of exceptional self-sacrifice, which are partially altruistically motivated (e.g., voluntary military service), may at the same time be encouraged with promises of paid education and enlistment bonuses. 61 Furthermore, offering donors significant financial incentives is different from removing disincentives, 62 the latter of which might include reimbursement for travel costs, food, and accommodation, as well as replacing wages. As hinted at with our previous cases of gamete donation and surrogacy, there is less intolerance around forms of recompense that are considered fair and reasonable costs for partaking in these practices as a third party.…”