The case for financial incentives to encourage organ donation

The existing system of organ procurement has failed in its mission of providing an adequate number of organs for transplantation. The organ shortfall results in diminished life expectancy and quality of life for dialysis patients and in increased mortality for patients with end-stage cardiac disease and liver failure who are unable to obtain transplants. Oft-repeated arguments against sale of human organs do not stand up to careful examination, and seem anachronistic in the context of widespread current acceptance of financial incentives for tissue donation in analogous fields, such as reproductive medicine. This essay advocates the staged introduction of a reward-based system of organ donation, initially for cadaveric harvesting and, possibly, later for living donation. Although imperfect, the proposed approach would represent a significant improvement over the status quo.