Patients who die waiting for a transplant do so not because of a shortage produced by natural limits or human indifference, but rather due to an inefficiency of existing organ procurement policies. In Part Two, we examined many different proposals to maximize the efficiency of procurement policies. While some of the practices have proved moderately successful in the United States and abroad, the considerable scarcity of transplantable organs remains. As a result, many in the transplant community have began to re-examine the 1984 National Organ Transplant Act, which forbids "any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation, if the transfer affects interstate commerce." Since the mid-1980s, more and more members of the transplant community have supported financial incentive programs, asserting that money and morals can mix in human transplantation.
There are two main arguments that support this belief. One, a libertarian argument, holds that individual autonomy protects that right to dispose of body parts in any fashion. The second, a more consequentialist position, holds that sale of cadaveric body parts is an acceptable method if it secures more organs to save human lives. Some people believe in the validity of both philosophies while others cannot justify the mixing of money and morals for any reason. Clearly, organ commodification remains a very controversial subject and changing attitudes may very well reflect a societal uncertainty about values.
Among the first proposals to alleviate organ shortages by means other than altruism was a program of "reward gifting," a plan to increase cadaveric donations by offering a $1000 "death benefit" incentive to the families. Thomas Peters submits that such a tangible incentive would increase dona