title: Financial incentives to increase Canadian organ donation: quick fix or fallacy?
abstract: Unlike the United States, the potential to increase organ donation in Canada may be sufficient to meet the need for transplantation. However, there has been no national coordinated effort to increase organ donation. Strategies that do not involve payment for organs, such as investment in health care resources to support deceased donor organ donation and introduction of a remuneration framework for the work of deceased organ donation, should be prioritized for implementation. Financial incentives that may be permitted under existing legislation and that pose little risk to existing donation sources should be advanced, including the following: payment of funeral expenses for potential donors who register their decision on organ donation during life (irrespective of the decision to donate or actual organ donation) and removal of disincentives for directed and paired exchange living donation, such as payment of wages, payment for pain and suffering related to the donor surgery, and payment of directed living kidney donors for participation in Canada's paired exchange program. In contrast, it would be premature to contemplate a regulated system of organ sales that would require a paradigm shift in the current approach to organ donation and legislative change to implement.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, Canada. Electronic address: jgill@providencehealth.bc.ca.
authors.forename: John S
authors.initials: JS
authors.lastname: Gill
authors.affiliation: University of Alberta, Edmonton, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
authors.affiliation: University of Calgary, Calgary, Canada.
authors.forename: Lianne
authors.initials: L
authors.lastname: Barnieh
authors.affiliation: Faculty of Law, School of Population and Public Health, University of Alberta, Edmonton, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Caulfield
authors.affiliation: University of Ottawa, Ottawa, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Knoll
authors.affiliation: University of British Columbia, Vancouver, Canada.
authors.forename: Adeera
authors.initials: A
authors.lastname: Levin
authors.affiliation: University of Toronto, Toronto, Canada.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Cole
mesh_terms: D002170:Canada; D033161:Government Regulation; D006801:Humans; D019520:Living Donors / Q000941:ethics / Q000523:psychology / Q000706:statistics & numerical data; D020380:Needs Assessment / Q000191:economics / Q000706:statistics & numerical data; D016377:Organ Transplantation / Q000941:ethics / Q000523:psychology / Q000706:statistics & numerical data; D013219:State Government; D009927:Tissue and Organ Procurement / Q000191:economics / Q000941:ethics / Q000331:legislation & jurisprudence / Q000458:organization & administration