Physicians’ ethical obligations to contribute to the health of the public and to support access to medical care extend to participating in efforts to increase the supply of organs for transplantation. However, offering financial incentives for donation raises ethical concerns about potential coercion, the voluntariness of decisions to donate, and possible adverse consequences, including reducing the rate of altruistic organ donation and unduly encouraging perception of the human body as a source of profit.
These concerns merit further study to determine whether, overall, the benefits of financial incentives for organ donation outweigh their potential harms. It would be appropriate to carry out pilot studies among limited populations to investigate the effects of such financial incentives for the purpose of examining and possibly revising current policies in the light of scientific evidence.
Physicians who develop or participate in pilot studies of financial incentives to increase donation of cadaveric organs should ensure that the study:
- Is strictly limited to circumstances of voluntary cadaveric donation with an explicit prohibition of the selling of organs.
- Is scientifically well designed and clearly defines measurable outcomes and time frames in a written protocol.
- Has been developed in consultation with the population among whom it is to be carried out.
- Has been reviewed and approved by an appropriate oversight body, such as an institutional review board, and is carried out in keeping with guidelines for ethical research.
- Offers incentives of only modest value and at the lowest level that can reasonably be expected to increase organ donation.
AMA Principles of Medical Ethics: I, III, V, VII, VIII, IX
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