NCPA - National Center for Policy Analysis

Living and Deceased Organ Donation Should Be Financially Neutral Acts

July 15, 2015

The supply of organs -- particularly kidneys -- donated by living and deceased donors falls short of the number of patients added annually to transplant waiting lists in the United States. To remedy this problem, a number of prominent physicians, ethicists, economists and others have mounted a campaign to suspend the prohibitions in the National Organ Transplant Act of 1984 (NOTA) on the buying and selling of organs.

A team of researchers with the American Journal of Transplantation marshal arguments against the claim that the shortage of donor organs would best be overcome by providing financial incentives for donation. The United States can increase the number of organs available for transplantation by removing all financial disincentives that deter unpaid donors. These disincentives include:

  • Cost of travel and lodging for medical evaluation and surgery.
  • The opportunity cost of lost wages during surgery and recovery.
  • The cost of dependent care during recuperation.

Payments for living donor's organs should remain prohibited because:

  • A system that uses financial rewards to motivate living donors creates risks for recipients because organ vendors would have a motive not to disclose information that could result in their not being accepted as a vendor.
  • Most payment structures would rely heavily on the economically distressed.
  • The Iranian example suggests that payments discourage altruistic donation.

Eliminating financial disincentives should produce a substantial and sustainable increase in the rate of kidney donation as experienced in Israel, but is also being implemented in Australia, Canada, and the Netherlands.

Source:  F.L. Delmonico, et al., "Living and Deceased Organ Donation Should be Financially Neutral Acts," American Journal of Transplantation, March 31, 2015.


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