Shifting ethics: debating the incentive question in organ transplantation

Joralemon, Donald

doi:10.1136/jme.27.1.30

Cited by 56 publications

(18 citation statements)

References 24 publications

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“…Lower rates of deceased organ donation among certain ethnic/racial minority groups in the setting of greater need for some organs (particularly kidneys, for which immunologic factors affect compatibility of transplanted kidneys and transplant outcomes) have also heightened awareness of the need for efforts to understand mechanisms through which donation among different ethnic/racial groups can be improved (3)(4)(5). Public incentives (such as financial reimbursement, health care-related reimbursement or other recognition for living donors or deceased donors' families) to enhance persons' decisions to donate have been widely debated (6)(7)(8)(9)(10)(11). Concerns regarding the exploitation of persons with low income and regarding the appropriateness of applying a monetary value to human organs have spurred many groups to denounce monetary incentives for donation (9,12,13).…”

Section: Introductionmentioning

confidence: 99%

Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Boulware

Troll

Wang

et al. 2006

American Journal of Transplantation

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Attitudes toward monetary and nonmonetary incentives for living (LD) and deceased donation (DD) among the U.S. general public and different racial/ethnic and income groups have not been systematically studied.We studied attitudes via a telephone questionnaire administered to persons aged 18-75 in the continental United States. Among 845 participants (85% of randomized households), less than one-fifth participants were in favor of incentives for DD (range 7-17%). Most persons were in favor of reimbursement of medical costs (91%), paid leave (84%) and priority on the waiting list (59%) for LD. African Americans and Hispanics were more likely than Whites to be in favor of some incentives for DD. African Americans were more likely than Whites to be in favor of monetary incentives for LD. Whites with incomes less than $20 000 were more likely than Whites with greater incomes to be in favor of reimbursement for deceased donors' funeral expenses or medical expenses. The U.S. public is not generally supportive of incentives for DD, but is supportive of limited incentives for LD. Racial/ethnic minorities are more supportive than Whites of some incentives. Persons with low income may be more accepting of certain monetary incentives.

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Section: Introductionmentioning

confidence: 99%

Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Boulware

Troll

Wang

et al. 2006

American Journal of Transplantation

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“…Landolt et al are right in their conclusion that there can be good reasons to educate the public and actively change attitudes. We should, however, be aware of the fact that surveys of public attitudes can easily be used politically to support the ethical preferences of the transplantation profession and "not just to assess, but to sway, public opinion" (17).…”

Section: Discussionmentioning

confidence: 99%

Altruistic Living Kidney Donation Challenges Psychosocial Research and Policy: A Response to Previous Articles

Hilhorst

Kranenburg²,

Zuidema³

et al. 2005

Transplantation

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The authors advocate an interaction between research and policy making. Social research can best influence transplantation policies in altruistic living donation by in-depth interviews into the complicated background beliefs underlying personal preferences. In addition, the public should be encouraged to judge the immanent issues in a morally responsible way. In the end, a fair balance should be established between the impartial requirements of social justice and the partial motivations of individuals involved in altruistic living donation. Although discriminatory acts should be rejected categorically, donation policies should be willing to consider, support, and accept motivations based on personal loyalties.

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“…When Web site administrators halted the process, the bidding had topped $5.7 million. The public reacted to the offer with condemnation and outrage (Harris and Alcorn 2001;Joralemon 2001). Recently, the clinical ethics committee of a Denver hospital recommended a "compassionate exception" to allow surgery to proceed when one of its transplant surgeons refused to perform a transplant procedure for a candidate whose donor had been solicited through a Web site matching donors and candidates.…”

Section: Compensatory Systems For Increasing Procurement Ratesmentioning

confidence: 97%

Alternatives to Encouraged Donation for Organ Procurement: Moral Principles and Ethical Practices

Lally

Schultz

2006

Public Integrity

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Voluntary donation of body organs for transplantation has failed to meet demand. This article reviews organ procurement and allocation in the United States, critically examining the current system and discussing alternatives. It proposes that a procurement system that pays for the costs of donation, as in the 2004 Wisconsin law, would be a way to employ financial incentives to increase organ donations without incurring many of the moral problems raised by critics.

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Shifting ethics: debating the incentive question in organ transplantation

Abstract: The paper reviews the discussion within transplantation medicine about the organ supply and demand problem.

Cited by 56 publications

References 24 publications

Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Altruistic Living Kidney Donation Challenges Psychosocial Research and Policy: A Response to Previous Articles

Alternatives to Encouraged Donation for Organ Procurement: Moral Principles and Ethical Practices

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