The Ethics of Organ Transplants: The Current Debate

By Arthur L. Caplan; Daniel H. Coelho | Go to book overview

18. Life or Death:
The Issue of Payment in
Cadaveric Organ Donation

Thomas G. Peters

In 1989, 1,878 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 program could save thousands of lives.


BACKGROUND

During 1989, the United Network for Organ Sharing (UNOS) listed 18,946 new patients as candidates for vascularized organ transplants ( W. K. Vaughn, PhD, United Network for Organ Sharing, written communication, July 1990). By February 1990, at least 1,094 of these newly listed patients died waiting for a transplant. This 5.8 percent mortality figure included those

____________________
Originally published in JAMA 265, no. 10 ( March 13, 1991): 1302-1305.

-196-

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