title: 'Because you can't live on love': living kidney donors' perspectives on compensation and payment for organ donation.
abstract: OBJECTIVE
  Living kidney donation accounts for approximately half of all kidney transplantation in many countries and is central to health policy focused on increasing organ supply. However, little examination of the economic consequences of living kidney donation has been undertaken from the perspective of donors themselves. This article documents living kidney donors' views regarding recompense and payment for organ donation, based on their experience.
  
  
  METHODS
  Twenty-five living kidney donors from New Zealand participated in this study.
  
  
  METHODS
  This qualitative study, based on thematic analysis, uses semi-structured in-depth interviews to examine the experiences of living kidney donors. Themes were organized around altruism and the 'gift', perceptions of shared corporeality and identity, and donor support.
  
  
  RESULTS
  Most participants agreed the donation process was costly in terms of time and money. Many incurred personal costs, and some experienced financial hardship. All the participants viewed financial hardship as a barrier to organ donation and favoured recompense for direct and indirect costs. Most did not support payment for organs, and none supported commercialization.
  
  
  CONCLUSIONS
  The findings show that framing organ donation as a 'gift' can stymie discussion about reciprocity, remuneration and exchange, making talk about financial recompense difficult. Financial well-being, nonetheless, has implications for the ability to care for self and others post-operatively. We conclude that the economic consequences for living kidney donors in jurisdictions where recompense for direct and indirect costs is insufficient are unfair. Review of financial assistance for live organ donors is therefore recommended.
authors.affiliation: School of Social & Cultural Studies, Victoria University of Wellington, Wellington, New Zealand.
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Shaw
authors.affiliation: School of Social & Cultural Studies, Victoria University of Wellington, Wellington, New Zealand.
authors.forename: Lara J M
authors.initials: LJ
authors.lastname: Bell
mesh_terms: D000533:Altruism; D003362:Cost-Benefit Analysis; D005260:Female; D005382:Financing, Personal; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics* / Q000523:psychology; D019520:Living Donors / Q000523:psychology; D008297:Male; D009042:Motivation; D009392:Nephrectomy / Q000191:economics / Q000523:psychology; D009520:New Zealand; D036301:Qualitative Research; D009927:Tissue and Organ Procurement / Q000191:economics*
keywords: New Zealand; financial recompense; gift of life; live kidney donation; payment