Mixed Incentives, Different Voices: A Qualitative Study of Organ Donation Incentive Policies in Two Big Chinese Cities

Abstract

China is facing a shortage of human organs for transplantations and is also in the process of reforming its system of incentives for human organ donation. We conducted a two-year research project in two big Chinese cities (Beijing and Tianjin) with three primary objectives: (1) to review the institutional progress of policy reform for organ donation in mainland China; (2) to understand how China’s current three prevailing organ donation incentive methods (namely honorary, compensationalist, and familist) have been run in practice; and (3) to clarify what particular incentives should be adopted in mainland China as part of our policy recommendations for improving organ donation rates. In-depth interviews with eighteen persons familiar with organ donation were conducted. Our main findings were that, according to our interviewees, while honorary, compensationalist, and familist incentives have coexisted in the current Chinese practice of organ donation, no one type of incentive has shown significant advantages over others. The effectiveness and suitability of these different types of incentives for organ donation should therefore be subject to long-term observation and ethical evaluation.