Compensate to Alleviate: Non-Cash Incentives Drive Up U.S. Organ Donations

Jessica Ayoub

Mr. Jones

English 1B, Section 87

April 14, 2016

Paper #1—Final Draft

Compensate to Alleviate

The shortage on donations of irreplaceable organs is highly concerning. In America there are 114,000 patients in need of organ transplants and only 3,300 donors (Park). Providing non-cash compensation may incentivize more living people to donate major organs, such as kidneys or livers, and will foster ethical principles. Through the drastically unequal number of donors to recipients it is evident that the donation system, with no form of compensation, is not effective enough. Satel, through her own experience of receiving a kidney from a friend, is a firm believer that altruism alone does not provide enough organs for those in need (235). Any form of non-cash compensation may alleviate from the drought of organ donations we are facing because altruism, clearly, is not enough.

Giving non-cash compensation is a mere act of encouragement; it is not a price tag. The incentive given is worth less than the priceless donation given to save someone else’s life. As de Castro remarks, “The point is that we cannot reduce the value of a person’s life to the amount of money that he–or his body–could have generated” (de Castro 145). Lack of donors is an issue acknowledged by many and people recognize that non-cash compensation is ethical; thus, several people are advocating non-cash compensations. As demonstrated in the online article – “A Court Allows Payment for Bone Marrow. Should People Be Able to Sell Their Parts?” – by Alice Park, published in 2012, “in a concession to the spirit of NOTA”, only, non-cash compensations are allowed to be given to bone marrow donors (Park). Moreover, China is debating the possibility of giving incentives in the form of “…tax rebates, deduction of transplant-related hospital fees, medical insurance, tuition waivers for donors’ family members…” (Satel 235). This form of non-cash compensation that China is contemplating to offer donors “encourages, its citizens to become altruistic” organ donors and preserves the value of human worth by not setting a price on organs (de Castro 145).

Recognized as a progressive country, it is regressive of America to turn a blind eye to the undeniably unethical effects that the black market has on organ donations. “Being underground,” according to de Castro, “the market is not subjected to institutional regulation that could ensure proper pretransplant and post-transplant care for the donors” (145). The unfathomable need for organ donations is what causes black market sales to occur (Beard and Klitzman 834). The need for organs outweighs the donors and that is the reality that causes recipients to resort to the black market. To maintain principles of organ donations a system of non-cash compensation must be enforced, in order to entice more donors and be able to compete with the black market. Legalizing non-cash compensation will increase donors and lead to the decrease of black market sales, thus ensuring ethical transplant guidelines for donors and recipients. Non-cash compensation will cause a domino effect that eliminates several unethical issues that have to do with organ transplants. With the increase of donors that non-cash compensation will entice, less organ recipients will have to opt to the black market; hence, reducing the amount of people who sell their organs through the black market for quick cash. Non-cash compensation is an ethical way to boost organ donations and to shrink black market sales.

This form of compensation would eliminate concerns that donors or recipients would be unduly endangered. Due to the method of non-cash compensation, “economically disadvantaged Americans” will not feel financially influenced to donate organs for quick cash (National Kidney Foundation). Satel acknowledges the ethics behind non-cash compensation, by adding to the notion of it being “unattractive to desperate people,” since donors will not be receiving direct cash (Satel 235). Giving compensations for donations should not break current organ donation rules; thus, any vulnerability “should be taken into account by any system of procuring human organs, whether compensated or otherwise” (de Castro 145). As a matter of fact, compensation will require more guidelines to be set, which ensures the upholding of ethical standards (Petrini 92). All in all, “…humanity is more likely to be better off because” non-cash compensation will remove worries about dangers that usually come with black market sales (de Castro 145).

People against compensating donors argue that compensation – even if it’s not cash – for an organ is an unethical act that commercializes the human body. The director of the bioethics program at Columbia University, Robert Klitzman, states, “We don’t allow people to buy and sell human beings, that’s slavery… Should we allow people to buy and sell human body parts?” (qtd. in Park). Klitzman raises the question of morality by forcing people to compare the buying and selling of human organs to the buying and selling of human beings. Although I understand why some believe that giving compensation may “…cheapen human dignity and the concept of self” I still feel that this belief is assumed too quickly, leading people to neglect the option of non-cash compensation, which does not set a price on the human body (Beard and Kaserman 839). Therefore, the term “buy and sell” should not be applicable to all forms of donor compensation (Park). In support to the idea that not all forms of compensation should be considered selling, de Castro says, “We get into many different transactions and it is not fair to lump everything under the category of selling” (144). Also, Klitzman’s “negative attitude toward donor payment” is made clear through his “greatly exaggerated” comparison to slavery (Bear and Klitzman 839). Therefore, Klitzman’s reasoning may be questionable because unlike slavery, which diminishes people and takes away their autonomy to live freely, the giving and receiving of human organs save lives. Giving non-cash compensation is just an ethical act of encouragement that can never place a price on the “infinite value of human life” (de Castro 145).

It is evident that there needs to be an incentive for more people to donate. Several countries are taking the step of providing non-cash compensation as a motive for donors. While, America is aware of the organ shortage people are stuck debating ethics. Other countries have well thought out the pros and cons of compensation and that is why many have resorted to the ethical form of non-cash compensation. This form of compensation is an ethical step to the solution of organ shortages. America needs to take that step and legalize non-cash compensation for living donors.

Works Cited

Beard, T. Randolph, and David L. Kaserman. "On the Ethics of Paying Organ Donors:

An Economic Perspective." DePaul Law Review 55.3 (2006): 827-50. PDF file.

de Castro, L. D. "Commodification and Exploitation: Arguments in Favour of

Compensated Organ Donation." Journal of Medical Ethics 29.3 (2003): 142-

46. PDF file.

Park, Alice. "A Court Allows Payment for Bone Marrow. Should People Be Able to Sell

Their Parts?" New York Times. The New York Times Company, 2 July 2012.

Web. 02 Apr. 2016.

Petrini, Carlo. "Ethical and Legal Considerations Regarding the Ownership and

Commercial Use of Human Biological Materials and Their Derivatives."

Journal of Blood Medicine 2012:3 (2012): 87-96. Web. 10 Apr. 2016.

Satel, Sally. "Yuan a Kidney?." The St. Martin's Guide to Writing. 10th ed. Ed. Rise B.

Axelrod and Charles R. Cooper. Boston: Bedford/St. Martin's, 2013. 234-36.

Kindle.

The National Kidney Foundation. "Financial Incentives for Organ Donation." The St.

Martin's Guide to Writing. 10th ed. Ed. Rise B. Axelrod and Charles R. Cooper.

Boston: Bedford/St. Martin's, 2013. 236-37. Kindle.