Ethics on Organ Donor Compensation
Over the years, the number of patients waiting for organ donations has substantially
increased all over the world. Using the United States as an example, organ demands have
increased from 31,000 people in 1993 to more than 100,000 patients today. This is according to
the statistics from the United Network for Organ Sharing. It is quite obvious that these huge
demands have brought with it certain ethical implications on how the process should be done.
Some experts have argued that the organ donation problem could be fixed if donors could be
paid up to $10,000 dollars to donate a kidney. However, doing this will create a conundrum
according to the critics of this program arguing that doing that would mean the stakeholders are
ready for a society where the disadvantaged act as replacement parts for those means (Beard and
Kaserman 827) . The big issue is that organ shortage has remained a problem even after the
adoption of various policies to deal with this situation.
Ethics Surrounding Organ Donor Compensation
As much as many options have been tried, it is worth mentioning that financial incentives
in the form of donor payments have not been afforded the chance that it deserves. One could see
why this is a problem because in many countries, including the United States, selling organs is
against the law. In the United States, the National Organ Transplant Act 1984 states that human
organs should not be exchanged “for valuable consideration.” Despite this, there have been
numerous debates involving members of the transplant community on the idea of providing
incentives to organ donors using tax credits or even direct payments (Park np) . The problem with
agreeing to such kind of incentives is that an unregulated market for body organs could open and
this risk this could create can be enormous. Given the seriousness of the organ donation subject,
the transplant community has been at loggerheads with each other meaning that no consensus has
One organ that has brought issues on this subject is kidney donation. As much as human
beings have two kidneys, they only need one to function normally. It means that allowing organ
donation for sale could lead to serious implications on people, including the likelihood of
increased human trafficking. Paid kidney donation is only legal in Iran. The next closest country
is Australia which one could argue utilize this process well to offset wages lost during the
hospitalization process and recovery period (Skloot np) . The proponents of organ donation for
pay argue that if people in a position to donate their organs did so at a price, then the overall
healthcare system would improve and the donors would also benefit from the pay.
The critics of paying for these organs also have a point to make by suggesting that when
the process is made legal, some lawbreakers might take advantage of this. Human traffickers
might take advantage of this situation and use this deal to propagate this illegal business further.
However, there are other options that could work to help donors participate in this process in a
legally protected way. For instance, instead of providing actual money to these donors, they can
be compensated in other ways such as providing them with donor health insurance. According to
a study done nephrologists revealed that 75% of these specialists agree to the donor health
insurance plan. It has already been established that many of the people who are willing to donate
these kidneys are socially disadvantaged (Castro 143) . If the hospitals that use these donated
organs really want to help these people, the ethical way of doing this business should involve
providing the donors with health insurance that they need.
Even though people are divided on the issue of organ donation, it is worth mentioning
that the subject of health insurance could help in bringing people together. As already stated,
body organs should not be substantiated financially meaning that if laws allowed for organ sale,
people would charge differently for their organs. However, the health insurance issue could
smooth things over and lead to a common understanding. Moreover, the health insurance plan
would also remove the coercive problem brought about by organ sale (Petrini 89) . With health
insurance programs, people would not be coerced into donation because a health insurance plan
would have to be agreed upon first before any arrangements are made.
Apart from preventing coercion, health insurance for donors will ensure that these people
medical conditions are taken care of once they are done with the process. The issue surrounding
donor situations can help in explaining why health insurance is a better option than providing
direct payments. Many of the donors who agree to this donation process often do this because
they have huge family debts to pay. It means that coercion is the big reason that forces them to
take part in these activities. Moreover, some of the donors usually have medical conditions that
they have to contend with and since they are poor, some of them end up dying (Satz 103) . These
are the problems that donor health insurance is seeking to eliminate.
Risk of Harm to Donors
As much as organ donation is needed to ensure that the healthcare system remains
relevant, some critics are skeptical about the risk that this poses to the individual donors. The
broad ethical issue on organ donation is often tied to the idea that the human body is sacred and
inviolable, therefore, should not be seen as a private property that has any value (Petrini 92) .
However, this is not the risk that the critics are worried about because this is more of a morality
The more compelling issue is what would once people are allowed to sell their organs
legally. Many governments would not be able to control what happens in such markets. The risks
of exploitation could increase because it is very likely that intermediaries will exist during these
processes. Most of the dealings would happen in the black markets. After providing the organs,
very little attention would be given to the medical needs of these donors. The cause and effect
here would imply that the organ donations would mean nothing because without adequate
healthcare, these donors are as good as dead. However, it would be wrong to assume that
compensation for organs would directly lead to exploitation. Governments could take control of
this situation by offering reasonable compensation to the donors as a way of preventing such
exploitations (Asano, Fukushima and Kenmochi 133) . However, given the bureaucracy involved
in government activities, donors in quick need for money could explore other options.
From the analysis of the organ donation process, it is important to note that more scrutiny
is needed if the compensation system is to work. Even though active coercion cannot be
identified, passive ones that involve money can be identified. Compensation appears as the way
forward to increase organ supply but if it is not handled in a sane way, it could lead back to the
same problems. Governments could use the opt-out systems where people agree to donate their
organs after they die unless they declare otherwise. Evidence has shown that this system could
work despite the fact that many countries have shown their unwillingness to use this process.
Many people in developing countries would take such dals and in the process eliminate the organ
Asano, Takehide, et al. Marginal Donors: Current and Future Status. Berlin: Springer Science
& Business Media, 2014.
Beard, T. Randolph and David L. Kaserman. “On the Ethics of Paying Organ Donors:
AnEconomic Perspective.” DePaul Law Review, Volume 55, Issue 3 (2006): 827-852.
Castro, L. D. de. “Commodification and exploitation: arguments in favourof compensated organ
donation.” Journal of Medical Ethics, Volume 29 (2003): 142-146.
Park, Alice. “A Court Allows Payment for Bone Marrow. Should People Be Able to Sell Their
Parts?” 12 July 2012. Time. 10 April 2019. <http://healthland.time.com/2012/07/02/a-
Petrini, Carlo. “Ethical and legal considerations regarding the ownership and commercial use of
human biological materials and their derivatives.” Journal of Blood Medicine, Volume 2,
issue 3 (2012): 87-96.
Satz, Debra. Why Some Things Should Not Be for Sale: The Moral Limits of Markets. New York:
Oxford University Press, 2012.
Skloot, Rebecca. “Taking the Least of You.” The New York Times 16 April 2006: 6006038.