Should We Pay Organ Donors?

October 16th, 2008 | Sources: Economist

Last year 7,000 Americans died while waiting for an organ transplant. That’s nearly twice as many deaths as we have sustained in Iraq since the war began. A record 100,000 Americans are waiting to receive a transplant, more than 25% of which have been on lists for 3 years or more.

The mismatch between organ supply and demand is to blame, and this has widened lately due to factors ranging from an aging population to reductions in fatal traffic accidents.

The US has made one significant attempt to increase donor organ supply: an “opt-in” system in which willing donors indicate their preference on drivers’ licenses.  Few providers honor these wishes if surviving family members object.

Back in 1991, the World Health Organization recommended banning trade in organs, because it would exploit the world’s poorest and least educated people. Subsequently India, South Africa and other countries banned the sale of organs, but that had the effect of creating a black market. Horrific organ harvesting scandals have surfaced in these countries, Israel, Kosovo and elsewhere.

Budget-strapped national health systems worldwide have become aware that transplantation is cheaper than the alternative and associated with improved quality of life and productivity. So some of them now do pay living kidney and partial liver donors.

In Israel for example, donors receive $5,100 to replace lost earnings during organ harvesting. And Iran of all places enacted a similar system in 1988. It now has the highest living-donor rate in the world. The Netherlands will likely soon pass similar legislation and proposals along the same lines have gained traction in Australia, the UK and the US.

Organ transplantation is a proven technology that saves money and improves outcomes. It’s time to act.



  1. Dave Undis | 17/10/08

    Paying organ donors would save thousands of lives every year. As the organ shortage continues to grow, public opinion will eventually support a legal organ market and changes in public policy will follow.

    In the mean time, there is an already-legal way to put a big dent in the organ shortage — allocate donated organs first to people who have agreed to donate their own organs when they die. The United Network for Organ Sharing, which manages the national organ allocation system, has the power to make this simple policy change. No legislative approval is required.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.

    Americans who want to donate their organs to other registered organ donors don’t have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

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