Financial Incentives for Living Kidney Donors: Are They Necessary?

Prevention of Transnational Transplant-Related Crimes—What More Can be Done?

“…15 Opponents further argue that ethically unproblematic methods of increasing organ supply (such as removing financial burdens borne by many donors) should be adopted, rather than incentive programs which have been found, over many decades, to produce lower rates of transplantation than voluntary, unpaid donation. 9,16 In countries where organ trading occurs, recipients are overwhelmingly national elites and "transplant tourists." 5 Fully eliminating the global black market in organs is a persistent challenge so long as residents of countries where legal prohibitions are enforced can travel to other countries where such laws are loophole-riddled or poorly enforced.…”

Trade in kidneys is ethically intolerable

“…It specifically prohibited payment for organs, and required review by an authorisation committee of all prospective living donors who are unrelated to the intended recipient, defined as all those not spouses, children, parents or siblings, but who wish to donate "by reason of affection or attachment towards the recipient or for any other special reasons"(4). 1 This Act was notably amended in 2008 and 2011 (7), partially to address concerns that the process of the review of prospective unrelated donors was not effective in identifying and addressing cases in which paid "donors" were presented as altruistic unrelated donors. The amended Act now requires verification and countersigning of documents attesting to the identities of and relationships between prospective donors and recipients, and additional approvals for foreign nationals (7).…”

“…Funding support: None Note 1 The definition of "unrelated donor" differs according to the laws governing organ procurement in each country. The term should not be considered synonymous with paid donors.…”

“…The use of financial incentives to increase living kidney "donation" has been the subject of debate among ethicists and transplant professionals since the 1980s. The persisting problem of insufficient supply of human kidneys for transplantation in many countries is repeatedly cited as a rationale for the introduction of legal markets in kidneys (1). Illicit trade in kidneys also remains a widespread problem, and some commentators have argued that the introduction of regulated markets -sometimes described as "incentive programmes" -would reduce such trafficking and prevent the harms associated with the black market (eg.…”

Debating Organ Procurement Policy Without Illusions

“…From these data, they conclude that the waiting list "may therefore result in overstatement of the gap between supply and effective demand for kidneys...." 1 A closer examination of the data indicates otherwise. Approximately 10,500 candidates were listed as status 7 in 2012, of whom 5,250 became active within 12 months of listing and one-third (w3,100) remained inactive.…”