HU 280 – Bioethics
February, 19, 2012
Compensation for Live Organ Donors
Currently, there are over 100,000 people on the United Network for Organ Sharing (UNOS) waiting list for organ transplantation (2012, Transplant Trends). Only 26, 246 transplantations occurred between January and November of 2011, (UNOS, 2012, Transplant Trends). There is a huge contrast in the number of people needing organs and the number of organs actually available for transplantation. This lack of organs creates a serious dilemma regarding how to increase the supply of organs for transplantation. So far, many of the efforts to increase organ donation have focused on the procurement from deceased donors; unfortunately, those efforts have failed to yield any significant increase to organ donation. Perhaps, it is now time to focus on increasing donation from live donors. Rather than the current method for organ procurement from live donors, which relies on altruism, there needs to be a shift toward providing incentives or compensation to live donors in the form of payment. A Market for Organs
This system of payment cannot be a free-market where organ donors and recipients work out a deal; instead, this system needs to be a “regulated market in which the government would act as the purchaser of organs – setting a fixed price and enforcing conditions of sale” (Caplan, 2008). Parks & Wike provide an abridged version of the financial incentive plan for organ donation which was developed by Gaston, Danovitch, Epstein, Kahn, Matas, & Schnitzler (2010, p. 244-251). Their plan is well thought out and provides reasonable compensation to organ donors. Not only would their proposal provide compensation of wages and travel reimbursement during the evaluation and perioperative time frame; it would also include a $1,000,000 life insurance policy for 1 year following surgery, supplemental health insurance coverage until the donor reached eligibility requirements for Medicare, and the donor’s choice of either a $10,000 tax deduction or a $5000 non-taxable lump sum (Parks & Wike, 2010, p. 246-247). Risk of Donation
Compensation is necessary to cover the risks that organ donation incurs. Organ donation requires major surgery, which does come with certain risks including “pain, infection, blood loss (requiring transfusions), blood clots, allergic reactions to anesthesia, pneumonia, injury to surrounding tissue or other organs, and even death” (UNOS, 2012, Living Donation Information You Need to Know). Health risks could also arise years after the donation of an organ. Following kidney donation, people are at risk for hypertension, hernia, organ damage or failure that could actually lead to them requiring dialysis or transplantation (UNOS, 2012, Living Donation Information You Need to Know). The risks of liver donation include “wound infections; hernia; abdominal bleeding; bile leakage; narrowing of bile duct; intestinal problems including blockages and tears; organ impairment or failure that leads to the need for transplantation” (UNOS, 2012, Living Donation Information You Need to Know). Persons are also at risk for developing psychological impairment that could potentially affect them for many years following donation. All of these risks could end up being very costly for the donor. Even though the transplant recipient’s insurance will cover the expenses of the donor’s evaluation, surgery, and some follow-up tests, there is no form of compensation currently offered for the time missed from work, travel expenses, and extended health care expenses that may arise. The recovery process following organ donation can last anywhere between 4 weeks and 2 months before the donor is able to return to work and normal activities (UNOS, 2012, Living Donation Information You Need to Know). That is a long time for a person to be without work. UNOS also stated: “Some donors have reported difficulty...