Paying For The Gift Of Life

The notion of paying families for organ donations is, at best, unsettling. However, given the small percentage of people voluntarily agreeing to donate their organs, a study to examine the advantages and disadvantages of a paid donor program should be explored.

Such a program would break new ground, since financial incentives were banned by Congress in 1984. However, only 25 percent of 78,000 organ transplants currently needed will occur in time to save a life, according to the United Network for Organ Sharing, the nonprofit agency that the government pays to oversee the nation's organ donor network.

Fifteen people die each day waiting for an organ transplant. That figure alone argues for at least an exploration of some way to increase the number of organs available for donation.

"We have a nationwide crisis, and altruism doesn't seem to be hacking it right now," said Dr. Frank Riddick Jr., chairman of the American Medical Association's Council on Ethical and Judicial Affairs.

If the AMA agrees to test financial incentives, Congress would have to change the law to permit such a study. Already, a congressional bill introduced in May, the Gift of Life Tax Credit Act, would allow a donor family a $10,000 tax credit in exchange for donated organs.

It's easy to understand why there is plenty of dissent on this issue. The moral and ethical questions it raises are enormous.

Agreeing to have a loved one's organs harvested in terminal cases - even to save another person's life - can be a gut-wrenching decision. It may be that a financial inducement, with appropriate safeguards, may persuade family members to at least consider organ donations.

One of the problems those in organ procurement face is that families don't discuss such an important matter before it's too late. Often, family members might say they don't know what their loved one would want, so they turn down any request for organ donations. Financial considerations may prompt more Americans to at least leave instructions about whether to donate organs.

For most people, if they do consent, they're doing it out of altruism. That is the prime motivator. Money is not really an incentive; in fact, it runs a risk of turning off more family members than enticing them.

Until our entire culture gives more consideration to death and dying, even tax credits and money for funerals may not change anyone's mind about organ donations. But a well-designed study would be useful to determine how people would feel about monetary incentives. Short of that, a nationwide educational campaign about the need for organs is called for.

This is an ethical minefield. But as long as people who could be given the gift of life are dying for lack of an organ, there is a compelling reason to at least explore whether financial incentives might reduce the number of needless deaths.

Copyright © 1999 - 2002 The Buffalo News.

This article posted January 16, 2002.