Incentives for organ donation in the United States: feasible alternative or forthcoming apocalypse?
OBJECTIVE
Several factors have generated interest in proposals to offer incentives in exchange for kidneys from living donors, including the growing shortage of available organs, the apparent asymptote of traditional means of organ procurement, and the intimate link between the inadequacies of organ procurement policies in developed countries with the flourishing of underground organ trafficking in developing countries.


RESULTS
Herein, we review the scope and dimensions of the growing shortage of organs in the United States, with attention to how each of the proposed solutions to same has proven insufficient. With special attention to the concerns leveled by Gabriel Danovitch in his 'Open Letter,' we conclude that each of his concerns are unfounded, and offer a prospectus on how a trial of such systems might be pursued in the United States.


CONCLUSIONS
The failure of current approaches to organ procurement in the United States and other developed countries has led to unnecessary suffering and death, with morally unacceptable consequences for developing countries. For these reasons, a structured trial of incentives for organ procurement in the United States is a moral imperative.
Hippen
Benjamin
B
Metrolina Nephrology Associates, P.A., Charlotte, North Carolina, USA. benjaminhippen@gmail.com
Matas
Arthur
A
D003132:Commerce / Q000191:economics / Q000941:ethics / Q000331:legislation & jurisprudence; D035881:Compensation and Redress / Q000941:ethics / Q000331:legislation & jurisprudence; D033161:Government Regulation; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility; D006801:Humans; D007391:International Cooperation; D016030:Kidney Transplantation / Q000191:economics / Q000941:ethics / Q000331:legislation & jurisprudence; D019520:Living Donors / Q000941:ethics / Q000331:legislation & jurisprudence / Q000600:supply & distribution; D028681:Moral Obligations; D009042:Motivation; D028701:Patient Rights; D016730:Program Development; D012959:Socioeconomic Factors; D009927:Tissue and Organ Procurement / Q000191:economics / Q000941:ethics / Q000331:legislation & jurisprudence; D014195:Travel; D014481:United States