Life or death. The issue of payment in cadaveric organ donation

Abstract

IN 1989, 1878 people died while awaiting organ transplantation. Public awareness programs, professional education, and legislation have not increased organ donation; the motive for consent in organ donation remains altruism. I shall argue that because of an ever larger number of patients listed as candidates for lifesaving organs, the policy of a death benefit payment to motivate families of potential organ donors should be studied. A death benefit of $1000 paid through organ procurement organizations would not necessarily be coercive. Laws now prohibiting organ brokerage and assuring fair organ allocation would continue unchanged. A death benefit payment may most favorably affect the socially disenfranchised through increased organ transplantation in minority populations. Because so many salvageable lives are now lost, only because organs cannot be obtained, pilot programs to determine the impact of death benefit payment to the enabling (consenting) next-of-kin should be initiated. If organ recovery increases sufficiently, a nationwide