Controversy: Compensating Organ Donors — Should We?

The issue of compensating organ donors is important.  A decade ago it was rarely discussed, today the discussion is increasing in frequency and getting some very serious consideration by leading transplant physicians, medical ethicists, government regulators, insurance companies, politicians and many others. 

I have not ventured into controversial issues before but this one is too important to ignore.  Let’s begin a discussion here, to get your comments and ideas.  I’ll make sure they are passed on to legislators, regulators, the health care industry and other important audiences.   

The primary consideration is this; “How do we stop the dying by increasing the number of organ donations?”  We know that each year the number of people dying has increased.  Organ donation advocacy is wonderful and has met with some success but — it hasn’t been effective enough.  Can we devise some kind of compensation program that does not encourage the “sale” of organs? 

Below I have included excerpts on the issue from three sources along with the URL’s so you can read the entire story.  Please comment.  This is one of the most important issues we can discuss.

ABC News story on Donor Compensation

ABC News story excerpt:“Dr. Lewis Teperman, director of transplantation at New York University Medical Center, says there are about 7,000 liver transplants done in the United States a year. However, there are “about 20,000 people waiting, and most of those people die,” he says.”

That’s why Teperman advocates offering the relatives of a deceased donor a thank you in the form of a monetary gift — to cover funeral expenses.

Teperman says the small gift could offer a subtle, inoffensive incentive to would-be donors and their families.

“It is time to … give a small amount of money for a funeral expense,” Teperman says, “let’s say $500 that would be given directly to funeral home for everyone who donates.”

President’s Council on Bioethics and Transplantation

President’s council excerpt:  “These proposals take different forms: some offer full or partial reimbursement of funeral expenses; some offer tax credits or rebates; some offer direct cash payment. Defenders of such compensation proposals often seek to distinguish them from organ markets: the compensation would be public, not private, and thus would represent the appreciation of the entire community rather than a private contract between parties; a compensation system would set firm limits on what could be compensated – for example, allowing reimbursement for funerals of the deceased but not payment for living donors who wish to sell one of their organs; and a compensation system for procurement would be kept separate from the system of organ allocation so as not to endanger the equity of organ allocation, whereas the right to sell ones organs in the open market might also mean giving special advantages to wealthy prospective recipients”

News Report, Buffalo News

Excerpt from Buffalo News: “…. goodwill alone has never produced enough organs to meet demand. Although organ donation increased by 10 percent over the last decade, the number of individuals in need of a transplant increased by 30 percent.That the current policy has persisted for so long is a moral outrage. Even its defenders have difficulty claiming that the policy is successful. Instead, they argue that market-based alternatives, such as compensation for organs, are unethical and deter current “gift givers.” More outrageous is the fact that supporters of the current system advocate its continuation on humanitarian grounds. What is so humanitarian about letting people continue to die while awaiting transplants, just so we can feel good about “giving”? Clearly we’re not generous enough if approximately 6,000 people die annually, while another 79,000 or so are relegated to waiting lists.

Recently, the medical community has moved closer to recommending compensation for organ donation as a remedy for the shortage. The American Society of Transplant Surgeons has already endorsed payment for cadaveric organs. And the American Medical Association’s governing house of delegates will meet in June in Chicago to vote on a pilot program that would test the effects of different motivators, including payment, for cadaveric organ donations.”

I purposely have not taken a position on the issue because I’m still researching it and trying to make my own determination.  I do believe that a “Thank you” alone is not sufficient for the gift of life.  Your thoughts will help me and many others including those who make the policies that govern organ donation.  Please comment.

About Bob Aronson

Bob Aronson is a former journalist, a Minnesota Governor's Press Secretary and talk show host. For nearly a quarter of a century, he led the Aronson Partnership, a Minnesota-based communications consultancy that prepared corporate and government executives for crisis situations, regulatory testimony, media interviews and Presentations. Among his clients were all three U.S. Mayo Clinic locations, 3M, general Mills, CH2M Hill, the U.S. Department of Energy and scores more. In 2007 bob had a heart transplant after suffering from idiopathic dilated cardiomyopathy for 12 years. Shortly after he got his new heart he founded the now 4,300 member Facebook support group, Organ Transplant Initiative. At the same time, he established the Bob's Newheart blog where he has posted nearly 300 columns on organ donation, transplantation and other health related issues. The Viewpoint blog was started in late 2016 and bears the name of the Radio Talk show Bob did from 1966 until 1974, when he resigned to become Minnesota Governor Rudy Perpich first Press secretary. Bob and his artist wife Robin, live in Jacksonville, Florida with their two dogs, Reilly and Ziggy. Bob is also a woodworker and makes all of the furnishings for Robin's art festival booth. He also makes one of a kind jewelry or "memories" boxes that he donates to select transplant patients, caregivers, donor families and others who have somehow contributed to making life easier for the ill, the elderly and the less fortunate. Bob is in the final stages of editing two full-length novels that will be available on Kindle when ready for release sometime in early 2017. One is a sci fi novel about an amazing discovery near Roswell, New Mexico and you will be surprised to find it has nothing to do with the Roswell story everyone knows. It features a woman scientist who investigates impact craters for the U.S. Department of the Interior, Dr. Rita Sylvester and her female student intern. The other book is a political thriller that introduces a new hero to the genre, Fargo Dennison.

Posted on January 20, 2008, in Donor Compensation. Bookmark the permalink. 5 Comments.

  1. I gone through the article published on the internet i fully support for comppensation for kidney donors and legalise the system for kidney donation in every country for example in IRAN if a person donate a kidney in a meager compensation he will not satisfy because after surgery nor patient nor government look over the health of the donor may he face any health risk and he is not in position to treat himself due to financial burden on him everybody is not a millioner or billioner so in conculision i support for compensation must be good for kidney donor he is giving a life to other person also think it know a days in this world only 1% close relative give kidney to there relatives only.


  2. I am on the fence about this issue. I do think that there should be some type of compensation for the donor. Such as paid medical bills and expenses. But where would the money come from? The organ receivers family? Organ transplants are so expensive that the donors family would not be able to pay. As a nation we are already have economical and monetary problems that i am not sure how compensation would work out. Unless the hospitals and pharmasutical companies would take it as a write off on their taxes but then you would need the ok from the IRS to do that. It seems like a complication issue. I would gladly support compensation of donors if a good idea came up. The other problem would be how would you put a price on an organ? When it comes to someone’s life a kidney is just as important as a heart. Also how would you decide how to compensate a family who donated their family members organs after they were deceased? It seems like a bunch of ideas and issues would have to be discussed, thought out, and mapped down to a science to determine how compensation should work. I do think it is a great idea though.


  3. Bob, thank you for your post on this timely topic. I am personally still not convinced that compensating donors would increase the number of available organs, but I think it’s good to get the idea out there to talk about it. I can, however, see the idea having more of a chance in the US than presumed consent, which I am sure you know is being debated in the UK as a viable way to increase donation.

    There is a new article in AM News (one of the AMA’s publications) that discusses incentives to donation – worth the read. Here’s the link.

    My own personal bias (and I am biased, since I work with the Alliance for Paired Donation, one of the largest networks to facilitate kidney paired donation) is that we should remove financial barriers to living donors before compensating family members of deceased donors.

    If your readers would like to learn more about kidney paired donation, please visit our Web site at


  4. At an absolute minimum, donors should be compensated for their expenses. Those could include funeral costs for deceased donors, and other costs (surgery, time off work, etc.)


  5. My brother is sitting on the kidney transplant list right now. He just turnded 12 this past december. If someone would step up to donate one of their kidneys to save his life I think they deserve more than just a thank you. Compensation is a viable option to help save many lives young and old. With out the insentive of compensation not many people would just decide to donate one of their organs. Give the people some insentive, give them compensation.


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