Reforms Short of Open Donor Compensation
Reforms Short of Open Donor Compensation
This chapter reviews proposed reforms for the organ procurement system that fall short of donor compensation. In general, policies to reduce waiting lists within the existing procurement framework fall into three categories. First, many efforts are aimed at influencing the behavior of potential or actual organ donors. Public service advertising, appeals to people's moral decency, and propaganda efforts fall into this category. A second type of program aims to increase the extent to which the existing pool of potential organ donors is realized. These programs, such as the Organ Donation Breakthrough Collaborative in the United States and the “Spanish model,” provide hospitals with both incentives to actively pursue donations and additional resources to support such efforts. A third category of possible reforms has received little attention so far: the effort to reduce the need for transplants—what economists might term “demand-side management.” For example, many individuals needing kidney transplants suffer either from poorly managed diabetes or untreated hypertension that can lead to organ damage. Programs that effectively treat these preconditions would almost surely be economically efficient when the costs of ongoing dialysis and transplantation are considered.
Keywords: organ procurement system, organ donation, public awareness, organ donors, demand-side management, kidney transplants, diabetes, hypertension, dialysis, transplantation
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