The latest iteration of an ongoing debate over the propriety of compensating live organ donors is now transpiring in the pages of the AJT (12:306-12, 2012 with letters to follow). Current law in the US, the National Organ Transplant Act of 1984, outlaws “valuable consideration” in organ donation. Some defend the present scheme by decrying the impurity of introducing financial considerations into the process and noting the abuses associated with unregulated systems elsewhere. Others note that financial considerations already exist with recipients and providers all profiting from donor altruism, and recurring questions regarding donor protection in the current process. I must confess that my own thinking in this regard has changed dramatically in recent years.
Is compensating donors a reasonable approach in the developed world, assuming adequate oversight and protection is provided? Can it be done ethically? Is it desirable? How else might we deal with the crushing burden of years on the waiting list for our patients?
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