title: Does financial compensation for living kidney donation change willingness to donate?
abstract: The potential use of financial compensation to increase living kidney donation rates remains controversial in potentially introducing undue inducement of vulnerable populations to donate. This cross-sectional study assessed amounts of financial compensation that would generate motivation and an undue inducement to donate to family/friends or strangers. Individuals leaving six Departments of Motor Vehicles were surveyed. Of the 210 participants who provided verbal consent (94% participation rate), respondents' willingness to donate would not change (70%), or would increase (29%) with compensation. Median lowest amounts of financial compensation for which participants would begin to consider donating a kidney were $5000 for family/friends, and $10,000 for strangers; respondents reporting $0 for family/friends (52%) or strangers (26%) were excluded from analysis. Median lowest amounts of financial compensation for which participants could no longer decline (perceive an undue inducement) were $50,000 for family/friends, and $100,000 for strangers; respondents reporting $0 for family/friends (44%) or strangers (23%) were excluded from analysis. The two most preferred forms of compensation included: direct payment of money (61%) and paid leave (21%). The two most preferred uses of compensation included: paying off debt (38%) and paying nonmedical expenses associated with the transplant (29%). Findings suggest tolerance for, but little practical impact of, financial compensation. Certain compensation amounts could motivate the public to donate without being perceived as an undue inducement.
authors.affiliation: Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL; Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: E J
authors.initials: EJ
authors.lastname: Gordon
authors.forename: C H
authors.initials: CH
authors.lastname: Patel
authors.forename: M-W
authors.initials: MW
authors.lastname: Sohn
authors.forename: B
authors.initials: B
authors.lastname: Hippen
authors.forename: L A
authors.initials: LA
authors.lastname: Sherman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035881:Compensation and Redress; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics*; D019520:Living Donors / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020858:Tissue and Organ Harvesting / Q000191:economics* / Q000379:methods / Q000523:psychology*; D055815:Young Adult
keywords: donors and donation: living; ethics; ethics and public policy; health services and outcomes research; kidney transplantation; kidney transplantation: living donor; nephrology; organ sale/trade; social sciences; survey