Category Archives: Donor Compensation

Altruism Isn’t Working — Should We Be Able to Buy Organs?


Everyone makes money on organ transplants except the donor.  That’s right physicians, hospitals, clinics, Organ Procurement Organizations  (OPOs) and funeral homes all make money on organ donation.  The 258 solid organ transplant centers in the U.S. share the wealth of this multi-billion dollar industry but the organ donor gets nothing more than the satisfaction of having done a good thing.

There are 117,000 people waiting for transplants in the United States.  Only about 28,000 of the procedures are done here yearly and that fact has remained static for several years while the number of people on the list keeps increasing.  Last year there were about 6,000 living donations and over 7,000 patients died while waiting for their names to come up on the transplant list.  Those are very disturbing numbers.

What is more disturbing, even infuriating is the fact that while survey’s show overwhelming  American support for organ donation (over 90% of us think it’s a great idea) only about 40% of us ever get around to becoming donors.  That’s why people are dying.  It’s not that Americans don’t want to donate…it’s just that they don’t get around to it…there is no sense of urgency for them as there is for the patient who quietly waits for his or her call to come.

With only 40% donating organs it is obvious we should be trying something else,  Perhaps it is time to find a new way to encourage people to become donors now rather than continuing to kick the can down the road and allowing more people to die .  Guilt trips haven’t worked well and neither have appeals to the human sense of sacrifice and doing the right thing so that means we absolutely must try something else and that something is money.  Money talks, money works and money motivates.

Before I get into any suggestions on how to use money or where to get it let’s go back to my opening comments.  Everyone is making money on organ transplants except the patient.  Let’s look at just how much money is involved.

According to Transplant Living http://www.transplantliving.org/before-the-transplant/financing-a-transplant/the-costs/  These are the estimated  U.S. Average 2011 Billed Charges Per Transplant

Transplant

30 Days
Pre-
transplant

Organ

Procurement

Hospital
Transplant Admission

Physician
During Transplant

180 Days
Post-transplant
Admission

Immuno-
suppressants

 Total
Heart Only $47,200 $80,400 $634,300  $67,700 $137,800 $30,300 $997,700
Single Lung $10,300 $73,100 $302,900 $33,500 $117,700 $23,700 $561,200
Double Lung $21,400 $90,300 $458,500 $56,300 $142,600 $28,200 $797,300
Heart-Lung $56,800 $130,500 $777,700 $81,000 $169,100 $33,300 $1,148,400
Liver $25,400 $71,000 $316,900 $46,600 $93,900 $23,300 $577,100
Kidney $17,000 $67,200 $91,200 $18,500 $50,800 $18,200 $262,900
Pancreas $17,000 $65,000 $108,900 $17,800 $61,400 $19,300 $289,400
Intestine $55,100 $78,500 $787,900 $104,100 $146,600 $34,600 $1,206,800

*Most transplant programs have social workers and financial coordinators who can help you with the financial details of your transplant. Depending on the structure at your center, one or both will help you develop a strategy.  For a finely detailed analysis of the cost of transplants you’ll want to study this report from 2008 http://publications.milliman.com/research/health-rr/pdfs/2008-us-organ-tisse-RR4-1-08.pdf

Medical costs include:

  • insurance deductibles
  • insurance co-pays
  • pre-transplant evaluation and testing
  • surgery
  • fees for the recovery of the organ from the donor
  • follow-up care and testing
  • additional hospital stays for complications
  • fees for surgeons, physicians, radiologist, anesthesiologist and recurrent lab testing
  • anti-rejection and other drugs, which can easily exceed $2,500 per month
  • rehabilitation

Non-Medical Costs

Non-medical costs include:

  • food, lodging and long distance phone calls for you and your family
  • transportation, to and from your transplant center, before and after your transplant
  • plane travel to get to your transplant hospital quickly
  • child care
  • lost wages if your employer does not pay for the time you or a family member spends away from work
  • If your transplant center is not close to your home, lodging close to the center before and after your surgery. Some centers offer free or low-cost hospitality houses for you and your family.

The above data clearly establish that transplants are expensive and that a good many people and organizations are profiting from it and I have no objection to that.  People ought to be paid for their work.  At the same time, though, is it fair that donor’s and their families get nothing?  Is it fair that in many cases donors, especially living donors may have substantial out of pocket expenses that are not reimbursed?

Living donors actually face a disincentive because they may have to pay the bills for travel, meals, accommodations, lost income and other expenses, including medical costs if their own health is compromised because of the operations. They also take on at least some risk of future discrimination from employers or insurers.

The American Medical Association says that at the low end, the added expense of donating may be a few hundred dollars, but the range can rise to about $20,000.   The AMA points out that while Federal law strictly prohibits the selling of any organs, donors may be reimbursed legally for their expenses. Still, that hardly is a guarantee.

Not well known is the fact that low-income donors and recipients can get financial aid through the National Living Donor Assistance Center, which is federally funded. More affluent recipients also can choose to pay donors’ expenses directly. But most donors come from that great middle ground where they may have to experience a financial loss in order to donate an organ.  That is an extraordinary and unreasonable expectations and should be addressed.  Why should a donor have to pay a financial price for doing the right thing?

According to the American Medical Association (AMA) the ir House of Delegates voiced its support in June of 2012  for an important proposition: http://www.ama-assn.org/amednews/2012/08/13/edsa0813.htm

“Living donors should not have to fear negative financial consequences for giving the gift of life. The recommendations call on governments, state and federal, to help remove financial barriers to living donation. That includes provisions for mitigating out-of-pocket expenses, ensuring access to health insurance, and guaranteeing freedom from discrimination in employment and in obtaining life insurance.

One example noted in a report to delegates is the proposed federal “Share Your Spare Act,” which would provide a tax credit of up to $10,000 to cover donor expenses or lost wages. A number of states and the federal government already have enacted a patchwork of donor work leave provisions, mostly for government employees. There also are a number of state tax credit provisions for donors.

The Affordable Care Act and its prohibition against preexisting condition denials, upheld by the U.S. Supreme Court after the delegates’ vote, is expected largely to take care of concerns about donors’ future access to health insurance coverage starting in 2014. Necessary legal protections against discrimination in employment and in purchasing life insurance are still lacking.”

Deceased donors pay nothing for the organ recovery and transplant process but their families still have to foot the bill for the illness that caused them to die and for all expenses following the death including funerals.  Somehow it seems as though there should be some accommodation for donors.  More for Living donors who can actually experience considerable cost to both their financial and physical health but why not at least pay funeral expenses for the gift of life from deceased donors?

When the National Organ Transplant Act (NOTA) passed and was signed into law in 1984 it prohibited payments for organs but did not prohibit reimbursement of expenses.  It didn’t address that subject at all.  That would be a perfectly legal step to take and maybe, given the right explanation, the public would approve of a financial incentive to donate that would at least cover expenses including funerals.  Other incentives could  be contributions to retirement plans, college scholarships or paying some or all of the cost of health care for the surviving spouse or partner.

We should point out here that the organ in greatest demand is, of course, the kidney.  In the U.S. of the 117,000 people on the transplant list, about 90,000 of them are waiting for kidneys.   How do we get more kidneys?  One way is to pay for them which is strictly prohibited by the 1984 law that established the organ transplant industry.   Laws, though, can be changed and if the proper safeguards are in place paying for organs could work.   An example of a country where organs are legally bought and sold is Iran.   Yes, Iran.  Not often an example of anything good this system seems to be working for Iran as they have virtually eliminated their kidney shortage.

Iran is the only country where the selling and buying of kidneys is legal. As a result, there is no shortage of the organs.  Here’s how it works there. The system allows people to sell and buy kidneys under state-regulated surveillance.  Two charities facilitate the process by finding potential vendors and introducing them to the recipients, and are charged with checking the compatibility of a possible donation and ensuring a fair trade.  After the transplant, the vendor is compensated by both the government and the recipient.  Iranians are not allowed to donate kidneys to non-citizens.

Would that work here…there are pros and cons but there’s also a little bit of research on the subject.  In 2010 a survey of 409 Philadelphia, Pennsylvania commuters was published by the American Medical Association on how willing people would be to donate under 12 different scenarios.  The study found that many concerns about paying kidney donors may be overblown. Among other things, participants were asked how willing they would be to donate a kidney to family members or strangers for no pay, for $10,000, or $100,000.

“The study provides no evidence whatsoever that the poor would be exploited or wouldn’t make informed choices,” said Scott D. Halpern, MD, PhD, the study’s lead author and assistant professor of medicine and epidemiology in the division of pulmonary and critical care medicine at the University of Pennsylvania School of Medicine. “The central finding is that payments do not seem to influence the poor more than the rich. The influence of a $10,000 payment on people earning more than $100,000 a year is the same as a $10,000 payment is for people earning less than $20,000 a year.”

On the flip side of the “pay for organs” issue there are some very serious concerns.  Pakistan, for example, is rife with kidney for sale nightmares. According to a 2007 story in the Washington Post  http://www.washingtonpost.com/wp-dyn/content/article/2007/04/13/AR2007041302066.html  “About 40 percent of the people in some Pakistani villages are turning up with only one kidney. Charts presented at the meetings show that the number of “donations” from unrelated Pakistanis is skyrocketing. Two-thirds of the people receiving these organs are foreigners. Data from the Philippines show the same thing.”  And it is even worse today in 2013.

A number of arguments against selling organs get bandied about, but there are two which lie behind most of the others. The first involves the concern with how selling organs leads to the commodification of human bodies, and the second is the concern with the exploitation of the poor for the benefit of the rich. These are difficult arguments to explain and are not convincing to everyone, but they cut to the heart of what we want our society ultimately to be like.

The bottom line is that something must be done to meet the demand for organs. It is at least as unethical to let people die because of being afraid to change the system as it is to pay for organs from poor people.  You can learn more on this subject by checking out these links:

http://www.cnn.com/2012/07/03/health/allowed-sell-organs-time/index.html

http://www.npr.org/2008/05/21/90632108/should-we-legalize-the-market-for-human-organs

http://www.newint.org/argument/2010/10/01/human-organ-trade-debate/

http://plato.stanford.edu/entries/organs-sale/

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

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Kidney For Sale; The Case for Compensating Donors


THIS IS NOT AN OFFER TO BUY ORGANS.  ATTEMPTS TO SELL ORGANS HERE WILL NOT BE PUBLISHED.

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Let me begin by quoting Sally Satel M.D., Kidney transplant recipient and Resident Scholar American Enterprise Institute: (Kidney for Sale, Lets Legally Reward the Donor  http://www.aei.org/publications/filter.all,pubID.29515/pub_detail.asp)

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“America faces a desperate organ shortage. Today, more than 78,000 people are waiting for a kidney transplant; only one in four will receive one this year, while twelve die each day waiting for help. Not surprisingly, many patients are driven to desperate measures to circumvent the eight-year waiting list—renting billboards, advertising in newsletters, or even purchasing organs on the global black market. Altruism (the current system where one donates an organ through the goodness of their heart) is an admirable but clearly insufficient motivation for would-be donors.

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According to the International Society of Nephrology, kidney disease affects more than 500 million people worldwide, or 10 per cent of the adult population. With more people developing high blood pressure and diabetes (key risks for kidney disease), the picture will only worsen.

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There are nearly two million new cases of the most serious form of kidney disease–renal failure–each year. Unless patients with renal failure receive a kidney transplant or undergo dialysis–an expensive, lifelong procedure that cleanses the blood of toxins–death is guaranteed within a few weeks”

 

The argument against paying people for their organs (living donors of kidneys and livers) is that the practice would prey on the poor.  Supposedly only people who are in desperate need of money would sell their organs.  “The rich or reasonably well off,” the argument goes, “Don’t need the money so few of them would become donors under such a system.”  Additionally, wealthy people could buy organs from the poor but the poor could not afford to buy organs if they needed them.  So the question;  “Is it ethical to compensate people for their organs?”  My answer is, probably not — if the exchange is simply cash from the recipient to the donor for a kidney.  But what if there are other considerations?  Dr. Satel offers some interesting options:

“My colleagues and I suggest a system in which compensation is provided by a third party (government, a charity or insurance) with public oversight. Because bidding and private buying would not be permitted, available organs would be distributed to the next in line–not just to the wealthy. Donors would be carefully screened for physical and psychological problems, as is currently done for all volunteer living kidney donors. Moreover, they would be guaranteed follow-up care for any complications.

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Many people are uneasy about offering lump-sum cash payments. A solution is to provide in-kind rewards–such as a down payment on a house, a contribution to a retirement fund, or lifetime health insurance–so the program would not be attractive to people who might otherwise rush to donate on the promise of a large sum of instant cash.   The only way to stop illicit markets is to create legal ones. Indeed, there is no better justification for testing legal modes of exchange than the very depredations of the underground market.”

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Dr. Satel goes on to say that, “Momentum is growing. In the British Medical Journal, a leading British transplant surgeon called for a controlled donor compensation program for unrelated live donors. Within the past year, the Israeli, Saudi and Indian governments have decided to offer incentives ranging from lifelong health insurance for the donor to a cash benefit. In the United States, the American Medical Association has endorsed a draft bill that would make it easier for states to offer non-cash incentives for donation.”

  • Dr. Satel and her colleagues call on Congress to reform the 1984 National Organ Transplant Act (NOTA), which makes it a felony to provide material reward for an organ. The authors suggest that:

 • Congress should amend NOTA so that existing criminal penalties for selling and brokering organ sales between individuals do not apply to any economic incentives offered by federal, state, or local governments. Such a revision would not require any such incentives; it would simply allow states and federal agencies to undertake experimental incentive programs.

 

• Compensation to prospective donors could take the form of health insurance, tax credits,

tuition vouchers, or contributions to tax-free retirement accounts.

 

• Rigorous protections for the safety of donors would be created.

 

• Because the compensation would be provided by the government, every patient in need

would benefit, regardless of income.”

 

The issue of paying for human organs is controversial to say the least but that does not mean it can’t or won’t work.  Iran, which is usually not a good example for much of anything, allows for such a program and the result reportedly is that their waiting list has sharply declined and in some cases it has diminished entirely. 

http://freakonomics.blogs.nytimes.com/2008/04/29/human-organs-for-sale-legally-in-which-country/ 

 

 

What we need in the United States is an open dialogue free of emotional outbursts that would allow for a small pilot program to test the concept.  We need universal agreement on the need to elminate organ transplant waiting lists, much like the commitment the National Kidney Foundation made to eliminating the kidney waiting list within ten years.   We must also agree, though, that the altruistic approach that we’ve tried for the last quarter of a century does not work.  Every year the number of people who die while waiting for a transplant grows, yet we continue to cling to the notion that if we work a little harder more people will become donors.  Well, everyone has worked very hard and we are still losing the battle.  As I have written before about the United Network for Organ Sharing (UNOS) which regulates the entire process, “It’s not working and it is time we tried something that will work, we must stop the dying.”  We’ve got to do something new and a pilot program somewhere in the United States would be a great way to start.  What have we got to lose?

 

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the need for more organ donors.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may have saved or affected 50 or more lives.

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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com.   Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php 

Would You Give Up a Kidney for $47,000 U.S.?


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THIS IS NOT AN OFFER TO BUY ORGANS – EFFORTS TO SELL ORGANS HERE WILL NOT BE PUBLISHED. 

 

While the organ shortage is bad here in the U.S. it is much worse in Australia where only 10 percent of its citizens become organ donors as compared to the U.S. where it is 27 percent.  In both cases, though, the gap between those who need organs and available organs grows wider each year causing the needless deaths of thousands of people worldwide, 7,000 in the U.S. alone.

 

Australian kidney specialist Gavin Carney proposes paying kidiney donors $47,000 U.S. for one of their two kidneys.  You can read the full Associated Press story at the following URL   

http://www.wtop.com/?nid=106&sid=1398289

He says, “Allowing the sale of organs would save thousands of lives and billions of dollars in care for patients on transplant waiting lists. He also said it would stop people from buying organs on the black market in developing countries, where they pursue risky, unregulated surgeries.”   
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“I don’t support (illegal trade),” Carney said. “But I also do not agree with the fact that we should let people just rot on dialysis until they have been on dialysis so long they are untransplantable.”

Predictable, of course, was an outpouring of objections from the medical community and the ubiquitous ethicists.  None of them offered anything but criticism.  God forbid they should offer a solution; these people exist to object not to solve problems.

Fortunately, Thomas Mone who is certainly qualified to comment could at least see some merit to the idea.  (Mone is chief executive of OneLegacy, a non-profit organ procurement organization serving L.A. and six neighboring counties. He is also president of the Association of Organ Procurement Organizations, and is a director of the United Network for Organ Sharing.  He had many comments that you can read for yourself in his March 31, 2008 commentary in the Los Angeles Business Journal.  (http://www.entrepreneur.com/tradejournals/article/178189602.html)

Among other things he says, “It isn’t difficult to identify a stronger incentive. If potential donors were offered cold, hard cash and made aware that they can lead a normal life with a single kidney, there’s little doubt that the donation rate would be much higher.”

But to do so in this country would raise a number of concerns.

How much should be paid for a kidney -and who should pay it? The recipient, or the government, via Medicare? A payment of $5,000 would probably be sufficient to attract more than enough donors to erase the current shortage of 45,000 kidneys a year.

“Or,” he notes, “Instead of a fixed amount for the kidney itself, should the payment also cover expenses for hospitalization and recovery? And what about wages lost by the donor during the donation and recovery period? Should donors get guaranteed insurance coverage rather than cash?”

Mr. Mone points out the downside, too,  “…. there is little doubt that if payment for donation were permitted in this country, a huge percentage of the donors would be poor people. And if the recipients of kidneys, and not the government, were paying for them, the practice would be viewed by many Americans as allowing the rich to take advantage of the poor.”.  To avoid the risk of readers saying I took Mr. Mone out of context, I urge you to read the full commentary by clicking the URL link above.

He sums up his article by saying, “I believe the best way to proceed would be with small-scale pilot programs that offer donors lifetime insurance coverage and see what the effect would be.

If such programs do not indicate that there would be any negative effect on the national organ donation process, then the practice of paying for kidneys through insurance coverage and similar non-cash incentives should be allowed”.

Here is what I believe.  I think we have to change the current system to one of presumed consent tied to some form of compensation.  I like the idea of providing donors with free lifetime healthcare.  But even that may not be enough.

Thank you Mr. Mone.  Finally, a voice of reason from those in the health care industry

Visit BlogsByBob at http://blogsbybob.wordpress.com   Also visit and join, Organ Transplant Patients, Friends and You  http://tinyurl.com/225cfh

More On Compensation for Organ Donors


Just yesterday I wrote a blog on compensating organ donors.  The response has been excrellent.  Obviously there are many people with very strong opinions on the subject most of which support some kind of compensation, like paying for funeral expenses.  Doing so would not only help donor families but might also serve as an incentive for future organ donors.  The “devil” though, is always in the details.  We would have to find a compensation method that is fair perhaps one similar to the current system where the recipients insurance pays for donor related medical expenses.  Funeral’s probably are far less expensive that the cost of the medical team that removes and transports the organ.  The information on the “Motley Fool” site may be helpful to you as you consider the issue.   http://www.fool.com/foolu/askfoolu/2002/askfoolu020305.htm

Excerpt from “The Motley Fool”  Here’s a breakdown of average costs, nationwide, according to a 1999 National Association of Funeral Directors (www.nafd.org) survey. Some parts of the country will be more expensive, though, and others will be less expensive. In addition, you can spend a lot more or a lot less, depending on some decisions you make.    Of course, this isn’t all that’s involved. It’s just what a funeral director would typically be involved in. Here are some additional expenses:

  • Cemetery plot: $500 to several thousand
  • Opening and closing the grave: $350 to $1,500, depending on the time and day of the week
  • Headstones, statues, or markers: $500 to several thousand
  • By contrast, a cremation can cost just $1,500 or less.

So far the discussion has concentrated on donors who die, but what about living donors, the people who give a kidney or a portion of their liver, how do we compensate them?  Transplant Living URL  http://www.transplantliving.org/livingdonation/financialaspects/costs.aspx

Excerpt from Transplant Living:  Medical expenses associated with living donor evaluation are covered by either the recipient’s insurance or in certain circumstances, by the Transplant Centers Organ Acquisition Fund (OAF). In either instance, the living donor should not incur any expenses for the evaluation. However, expenses related to another health concern that may identified during the evaluation process will not be covered by the recipient’s insurace or the OAF.

The actual donation surgery expense is covered by the recipient’s insurance. The transplant center will charge a recipient’s insurance an “acquisition fee” when he or she receives a transplant. The medical costs related to the donation procedure and required postoperative care are also covered by this fee. In some instances, the actual itemized bill for the donor procedure is submitted to the recipient’s insurance.

Anything that falls outside of the transplant center’s donor evaluation is not covered. These costs could include annual physicals, travel, lodging, lost wages and other non-medical expenses. Although it is against the law to pay a living donor for the organ, these costs may be covered by the recipient. Be sure to check your specific insurance policy or ask a transplant financial coordinator about concerns related to your specific circumstances.

Here’s another great source: Washington University Medical School in St. Louis.  http://mednews.wustl.edu/tips/page/normal/8102.html

Excerpt from Washington University Medical School in St. Louis: “Last year nearly 7,000 people donated a kidney, segment of the liver or lobe of a lung to help someone in need of a transplant. In fact at some major transplant centers — like Barnes-Jewish Hospital and St. Louis Children’s Hospital at Washington University Medical Center — the number of transplants involving living organ donors now exceeds the number of transplants using organs from deceased donors.

In an effort to close the gap between organ supply and demand, researchers at Washington University School of Medicine, the University of Michigan and the American Society of Transplant Surgeons are studying ways to reimburse living donors for some of their out-of-pocket expenses when they choose to donate an organ.”

Obviously the issues are numerous but we can only change things if we speak out and let the world know what we think about them.  As I said in yesterday’s blog, I will forward all comments to policy makers and thought leaders around the country.  Please, Please comment. 

PS After writing this blog I noticed a comment that directly address the issue of living donors.  Please read the comment but here is a very helpful URL  http://www.ama-assn.org/amednews/2008/01/28/prsb0128.htm

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  http://abcnews.go.com/US/Story?id=91551&page=1

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 http://www.bioethics.gov/background/org_transplant.html

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 http://www.independent.org/newsroom/article.asp?id=285

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.

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