title: Between Scylla and Charybdis: charting an ethical course for research into financial incentives for living kidney donation.
abstract: New approaches to address the kidney scarcity in the United States are urgently needed. The greatest potential source of kidneys is from living donors. Proposals to offer financial incentives to increase living kidney donation rates remain highly controversial. Despite repeated calls for a pilot study to assess the impact of financial compensation on living kidney donation rates, many fear that financial incentives will exploit vulnerable individuals and cast the field of transplantation in a negative public light, ultimately reducing donation rates. This paper provides an ethical justification for conducting a pilot study of a federally regulated approach to providing financial incentives to living kidney donors, with the goal of assessing donors' perceptions.
authors.affiliation: Scripps Center for Organ and Cell Transplantation, Scripps Clinic/Green Hospital, La Jolla, CA.
authors.forename: J S
authors.initials: JS
authors.lastname: Fisher
authors.forename: Z
authors.initials: Z
authors.lastname: Butt
authors.forename: J
authors.initials: J
authors.lastname: Friedewald
authors.forename: S
authors.initials: S
authors.lastname: Fry-Revere
authors.forename: J
authors.initials: J
authors.lastname: Hanneman
authors.forename: M L
authors.initials: ML
authors.lastname: Henderson
authors.forename: K
authors.initials: K
authors.lastname: Ladin
authors.forename: H
authors.initials: H
authors.lastname: Mysel
authors.forename: L
authors.initials: L
authors.lastname: Preczewski
authors.forename: L A
authors.initials: LA
authors.lastname: Sherman
authors.forename: C
authors.initials: C
authors.lastname: Thiessen
authors.forename: E J
authors.initials: EJ
authors.lastname: Gordon
mesh_terms: D004992:Ethics, Medical; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics / Q000941:ethics / Q000379:methods*; D019520:Living Donors / Q000941:ethics*; D009042:Motivation; D009392:Nephrectomy / Q000191:economics*; D010817:Physician-Patient Relations; D010865:Pilot Projects; D051437:Renal Insufficiency / Q000601:surgery*; D012107:Research Design; D020858:Tissue and Organ Harvesting / Q000191:economics / Q000941:ethics; D009927:Tissue and Organ Procurement / Q000191:economics* / Q000941:ethics; D014481:United States; D035862:Vulnerable Populations
keywords: Clinical trial design; donors and donation: incentives; editorial/personal viewpoint; education; ethics; ethics and public policy; ethnicity/race; kidney transplantation/nephrology; kidney transplantation: living donor; social sciences