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Are Financial Incentives the Best Solution to the Crisis in Organ and Tissue Donation?
One of the most important issues of the modern medical world is the global crisis in organ and tissue donation. This crisis is severe and is only becoming worse – mainly, that there are not enough donors, both living and post-mortem. A third of those already on the waiting list will die waiting for a donor. This huge shortage has led, also, to a growth in an unregulated and highly illegal black market in organs, often involving organ tourism. This black market not only puts donors lives at risk but it exploits the poor and vulnerable, allowing the rich to purchase organs from often coerced, by actual force or situation, donors in abject poverty. Financial incentives potentially provide a solution to this immediate, life-threatening crisis.
The first and most practical aspect of this issue is whether or not financial incentives are economically viable. The introduction of such incentives would cause the redistribution of a significant monetary sum, and many would argue that it is not financially feasible in the current economic climate. At a time where public spending cuts are taking place worldwide, financial incentives may seem fiscally irresponsible and actually a damaging change in the allocation of funding, especially in regard to research and development of alternatives to living and post-mortem organ donation, such as stem cell research or xenotransplantation. However, embryonic stem cell research in particular is an incredibly costly area of research and development, with funding for stem cell research in the United States for 2008 estimated at $938,000,000, despite little progress or development actually being made. These figures were published by the National Institute of Health at the request of Congress in order to clarify funding for research, conditions and diseases. The credibility of the N.I.H. and the purpose of the report suggest this source is both credible and accurate. Much of the funding for research is provided by private sponsors and companies – state provided financial incentives would not prevent these. Moreover, the suggestion that financial incentives would be an irresponsible expense is not accurate due to the savings made by an increase in donations – every year of aftercare for kidney transplant patients in the Netherlands costs €12,000 compared to €60,000 annually to maintain a patient on dialysis. The accumulated savings would outweigh any expense incurred by providing financial incentives and therefore is a cost-effective system.
 “Waiting for a Transplant” www.nhs.uk 15/01/2009
 National Institute of Health Research Portfolio – published February 1st 2010
 2007 Dutch report on financial incentives for organ donation by Mr. G. Van Dijk and Dr. M.T.Hilhorst
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