Abstract
With the increase of the organ shortage, several authors assume that financial incentives would improve organ donation rates and fill the unbalance between the demand and the organs available for transplant medicine. This line of argument has been criticised with people arguing that an exchange of money for organs would violate the legal and the ethical principle of gratuity, decrease voluntarism and increase the body parts commodification phenomena. Switzerland is often highlighted as having under-average organ donation rates compared to other European countries. In this paper we investigate the opinions of the Vaud French-speaking population concerning direct, indirect and non financial incentives in order to assess their opinions and anticipate the further debate. As part of a broad survey about the organ donation decision-making process, questions about incentives for both living and deceased organ donation were addressed to Vaud inhabitants and physicians. The data collected showed that respondents were opposed to rewarding both living and deceased organ donation. The analysis of positive answers showed that indirect and non financial incentives were the most likely choice to acknowledge the donor's act. People in critical financial situations preferred direct financial incentives. These results showed that altruism and gratuity were key-values in the organ donation and transplantation social perceptions of the respondents. Thus, we assume that introducing financial incentives could tarnish the image of transplant medicine. Nevertheless, further studies are needed to evaluate if their introduction would improve the organ donation rates or decrease voluntarism.
Highlights
Contemporary organ donation and transplantation social representations are the result of a socio-historic evolution that emerged in the late 1960s and consolidated in the late 1980s, as the advent of immunosuppressant drugs transformed transplantation as the therapy of choice to treat terminal organ failures
People in critical financial situations preferred direct financial incentives. These results showed that altruism and gratuity were key-values in the organ donation and transplantation social perceptions of the respondents
For each incentive option displayed for living and deceased organ donation, the highest frequencies were observed on the answers “no”
Summary
Contemporary organ donation and transplantation social representations are the result of a socio-historic evolution that emerged in the late 1960s and consolidated in the late 1980s, as the advent of immunosuppressant drugs transformed transplantation as the therapy of choice to treat terminal organ failures. With the increasing occurrence of organ shortage in the late 1990s, several authors thought that financial incentives would improve organ donation rates and, fill the unbalance between the demand and the organs available for transplant medicine [2,3,4,5]. This line of argument was criticised arguing that an exchange of money for organs would violate the ethical rules of altruism and gratuity, decrease voluntary organ donation and increase the human body parts commodification phenomena [6,7,8]. Incentives would be used to acknowledge the act of the organ donor
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