Compensation versus Markets
Andrew H. Barnett, Roger D. Blair;
and David L. Kaserman
A number of proposals have recently emerged suggesting monetary compensation for cadaveric organ donors or their surviving family members as a method of encouraging greater donation rates. 1 If successful, such compensation schemes would save thousands of lives annually by expanding the currently inadequate supply of transplantable organs. 2
Several necessary conditions must exist for cadaveric organ donation to occur. Potential donors are generally brain-dead, heart-beating cadavers less than fifty-five years old and free of infection. All major organs other than the brain must be functioning while they are temporarily sustained on the heart‐ lung machine. As a result, most organ donors are relatively young persons who have been involved in an accident in which severe head injury occurred. Despite these rather demanding requirements, there appear to be a sufficient number of deaths under these circumstances to satisfy the annual demand for transplantable organs if collection rates could be improved.
The recent compensation proposals represent a drastic departure from the medical profession's long-standing policy advocating continued reliance on altruism for organ supply and opposing payment of any kind to organ donors. Such proposals stem from a recognition that, from a truly ethical point of view, the primary objective of saving patients' lives should dominate our natural desire to impose our own moral or philosophical attitudes on others. In the case at hand, this means that, on ethical grounds, physicians (and others) should abandon their traditional support for the current altruistic organ procurement policy if some alternate policy can reasonably be____________________