Paying donors for organs sparks hot ethics debate

Physicians are divided on this financial incentive issue as well as on charging drug representatives for office visits.

By Tanya Albert, AMNews staff. Dec. 24/31, 2001.

San Francisco -- The AMA's Council on Ethical and Judicial Affairs will spend the coming months hammering out more explicit guidelines for potential studies on whether financial incentives would boost the number of cadaveric organs available for transplants.

After heated debate at the Association's House of Delegates Interim Meeting earlier this month, delegates said CEJA needs to rework a report that says it is ethically justifiable to support limited, carefully designed pilot studies to measure what effect financial incentives would have on the organ donation rate.

Some physicians who supported studies said the report needs to more specifically address what the ethical safeguards should be, how physicians should communicate with the groups they are studying, what are acceptable financial incentives and where to get the money.

"If we do that, I think we can get it passed next time," said CEJA Chair Frank A. Riddick Jr., MD. "We do not think it is intrinsically unethical to do the study."

Some physicians see financial incentives as a way to relieve the severe organ shortage. An estimated 15 people die every day waiting for an organ.

"To stand by idly and let people die is a mistake," said Stephen L. Schwartz, MD, a psychiatrist from Huntington Valley, Pa. "I see little moral value in burying organs that can save lives."

" My duty is to the living," added Philip Cascade, MD, a radiologist from Northville, Mich. "If we don't do everything we can to increase organ donation, we are morally responsible." [...]