Financial Compensation For Organ Donors

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The National Organ Transplant Act of 1984 states that ‘it shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.’ 

The penalty for breaking this law is a fine of $50,000 or up to five years in prison or both. The doctrine asserts that there should be no financial consideration involved in donation or organs because it’s a voluntary act, and such actions should not include commercial substance. Here to understand the issue of paid donation, it is necessary to understand the drivers for it. There is a global shortage of organs available for transplantation. This gap between demand and supply has prompted many people in the wealthier nations with organ failure, to seek transplants overseas often in developing countries. Frequently these individuals do not ask questions about how these organs obtained from donors. The process is further fueled by dishonest health professionals and brokers seeing the potential for financial gain and taking advantage of both the desperate recipient and the vulnerable seller. 

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Putting a price tag in such events will eventually mean that healthy individual will enlist as donors and receive money for organs that might save some others life but will also give money to these individuals who will try to make their ends meet and this means that the noble cause or the altruism from the donation shall fade away. There is a very significant chance that wealthy individuals in need of an organ shall bypass the legal boundaries, and this will give place and ignite illegal trade of human organs, and there can be exploitation of the poor individuals of the society. Sadly for the majority of donors, selling an organ such as kidney does not result in the significant economic benefit of which they dream about Many fall back into debt, often compounded by the inability to work following donation due to ill health. Supporters of paid donation argue that a person should have the fundamental right to choose the fate of his or her organs. In the setting of paid donation, informed consent is often of dubious and with the risks of surgery often not being adequately explained or understood as the donors is illiterate, and many individuals are pressured to donate by family members.

Research also shows that families have refused to donate organs of their loved ones who passed away and that 92% said that payment would not have persuaded them to give. Studies also show that US people have a huge trust deficit, and they are afraid that the health care of the potential organ donor might be compromised if their status is known, and that is why putting a price tag does not even help much. 

A tailored program of financial incentives for organ donation is not likely to change these perceptions and may aggravate mistrust. This is true even with the suggested manoeuvre of paying the money to funeral homes; this strategy will raise the price of a funeral without benefiting the donor’s family. Making financial incentives available at the time of death opens the possibility of creating new sources of tension and dissension between family members who are faced with the option of organ donation. Finally, a program of financial incentives for organ donation could expose transplant recipients to unnecessary risks because living donors and donor families would have an incentive to withhold information concerning the donor’s health status so that they can be assured a financial 

The donation of organs might see as no-cost activity towards the donors, but this is not the actual case. There is an expected expense of about USD 3,000 to experience all the techniques of Kidney donations. This may include time off from work, accommodation costs, travel costs, and child care expenses. Such factors aggravate the mistrust of the public in such programs, and it causes more damage to the noble cause of donation as well. 

Universal strong condemnations of selling organs have issued by voluntary health agencies and religious authorities, including Pope John Paul II, who wrote that buying and selling organs violates the dignity of the human person. American transplantation associations repeatedly endorsed the stance that paying donors for their organs was not only illegal but unethical.

There is a monstrous interest for such organs, and the tight sitting rundown for such transplants is additionally expanding day by day. Human beings should make endeavours to get assistance from technological advancement. In the coming years, due to the ageing of the population and the low availability of donor organs, there will be an urgent need for bioengineering solutions to assist, mimic, or replace failing patient organs. These solutions can be offered by developing artificial or bioartificial organs as well as tissue-engineered organs. Artificial organs are based on biomaterials and novel designs. Typical examples of these are artificial kidney devices for better and more continuous patient treatment or artificial liver devices for blood detoxification. Bioartificial organs combine biomaterials and biological cells. Granted applications for stem cells are somewhat limited though that is down more to ethical considerations more than scientific limitations. Still, the studies that have been done with stem cells have proven that it is possible to grow organs in a lab, which could then be implanted.

Significant efforts have also been focused on constructing tissue-engineered organs as alternatives to direct transplantation of donor organs. An essential component of these is the scaffold, dimensional (3D) construct that serves as temporary support for isolated cells to grow into new tissue before they are transplanted back to the host tissue. Therefore scientific possibilities are enabling the human race to have some control over the current medical needs. When applied to medicine, the techniques are referred to as 3D bioprinting, and the achievements in the emerging technologies have already been quite remarkable. Scientists have successfully 3D-bioprinted several organs, including a thyroid gland, a tibia replacement that’s previously been implanted into a patient, as well as a patch of heart cells that actually beat. All of these organs were made possible by refinements to the type of Bionic, one of many improvements to the process we can expect to see in the years to come, as there is now an institution dedicated to advancing 3D bioprinting techniques.

There are still enormous challenges as of now being faced by scientists, and there is a need for new biomaterials, for better understanding and tailoring of the biomaterial cell and tissue interaction, for better immune protection and mass transfer, as well as for the development of new concepts and designs. 

In China, attempts have been made to implement some form of government control over the selling of organs. Permission is given to individual hospitals by the provincial health authorities, allowing them to offer organ transplants to foreign visitors, with punishment to those institutions that provide the service illegally. 

Such systems are proposed to remove the need for an underground and illegal black market. The buying and selling of human organs and tissues can never be made ethical because it will always penalize the weakest. Financial gradients are inherently exploitative, with the poorest in society being the ones who come forward as sellers every time. Further, such a system can never be adequately regulated to prevent the exploitation of the poor and where financial motivation drives the decisions of the health professionals. This will also undermine the care of the recipient, with financial gain taking precedence over patient care.

We can make use of research work that has already been done some time back such as by Nobel Laureate (Economics), Gary S Becker and his co-worker Julio J Elias established a Market price for a live donor kidney as a commodity. 

I am assuming that an American individual is earning a mean of USD 40,000 annually and has a life valued at USD 3 Million. The individual faces a risk of death from a nephrectomy of 1%, a decrease of 5% in quality of life, and will lose USD 7,000 of income due to recovery from surgery; they calculated a kidney purchase price of USD 45,000. According to them, the current non-system promotes a black kidney market available only to the wealthy who bear the total expense for what may be inadequately screened, sub-optimally matched organs inserted by unregulated surgeons. So, Becker and Elias’s proposal would end the advantages of wealth in organ acquisition since more indigent individuals would obtain their kidneys via Medicaid or Medicare.

In light of the above discussion, it is stated that there should be a balance between developing a financial payment system and our scientific endeavours to find a solution to the problem which humanity and nations are facing. All human lives are precious. However, the prevailing laws and regulations are full of many grey areas, and there is a need to build trust among the donors and general public that the system will support the overall, and the donors and their families will have all the needed medical assistance during and after the procedures. The hidden cost of donations, as we discussed above, also needs to be covered with more comfortable Tax credit facilities or even through specializes health insurance covers. It is imperative to state that science will catch up in the near future, and we will have solutions to the health problems and organ implants very soon. Therefore we must strike a balance between the legal system of paid donations, which is somehow seen honourably in the eyes of religious stakeholders, medical societies as well as the general public. 




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