AST and ASTS On Incentives and Disincentives For Organ Donation

Last June, I spent two days at a joint workshop of the American Society of Transplant Surgeons and the American Society of Transplantation, discussing the ethics, legality, and feasibility of providing incentives for organ donation. I blogged about the experience here.

A paper stemming from the workshop and approved by the Boards of both the American Society of Transplantation and the American Society of Transplant Surgeons has now been published in the American Journal of Transplantation and is available online.  From the paper:

The potential for financial incentives to increase organ donation, and ethical considerations that might accompany their implementation remains a controversial topic, fraught with confusion and misunderstanding, and with global implications. Given the growing organ shortage and the evolving discussion of these issues, leadership of both the American Society of Transplantation (AST) and American Society of Transplant Surgeons (ASTS) agreed to convene a workshop to develop a policy statement, acceptable to both societies, on the potential of creating incentives for organ donation in the United States On June 2–3, 2014, 38 representatives of the two societies (including experts in medical ethics, economics, and health care law and policy) assembled in Chicago to explore the potential of incentives to increase both living and deceased organ donation. . . .

By the end of the meeting, it was agreed that though donors assume medical risk and, in most cases, the financial costs associated with donation, everyone else involved in the organ transplant process (recipients, physicians, hospitals, and associated professionals) benefits, most often financially. Might changing this dynamic encourage more potential donors to become actual donors? . . .

We believe it important not to conflate the illegal market for organs, which we reject in the strongest possible terms, with the potential in the United States for concerted action to remove all remaining financial disincentives for donors and critically consider testing the impact and acceptability of incentives to increase organ availability in the United States. However, we do not support any trials of direct payments or valuable considerations to donors or families based on a process of market-assigned values of organs.

Read the whole thing here. 

My sense is that this is a small, but important, step forward in the debate over incentives and disincentives to donate. The authors are leaders in the major transplantation societies, and their views carry a lot of weight.

HT: Al Roth, via Frank McCormick

Comments

[Jimbino]

So what is the argument against letting a person at age 18 offer his organs for sale, contingent upon his death, in a free market?

[Kim Krawiec]

Jimbino -- they're too lengthy to fully detail here, but in brief, break down into the usual categories of coercion, exploitation, commodification, corruption, and equality of access. I discuss many of these in more detail here:http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2394242
and here:
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2176410