Financial Incentives: Alternatives to the Altruistic Model of Organ Donation

Journal of Transplant Coordination, Vol. 9, Number 4, December 1999 5500 donors per year,2 the number of deaths due to lack of organs5 is anticipated to outstrip the number of organ donors annually very soon. Present methods for securing organ donations rely on voluntary donations by the general public. The primary motivation for the donation of organs is presumed to be altruism. However, the notion that organs are a gift has become increasingly problematic as the public becomes aware that organ transplantation does indeed financially benefit some sectors of society. The continued struggle over the equity and rationality of the organ distribution system further degrades the notion of the “gift.” Moreover, donated organs are hardly gifts in the traditional sense: nonliving donors cannot actively exchange their “gift” with an intended recipient, who in turn cannot reciprocate. In purely fiscal terms, transactional costs of procurement, distribution, and transplantation likewise prevent pro gratis dispensation of organs from donors to intended recipients. Finally, policy efforts such as “required request” (procedures to ensure that families of potential donors be asked to donate organs and tissues), which were designed to better direct altruistic appeals along “gift-of-life” Financial incentives: alternatives to the altruistic model of organ donation