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The Honolulu Advertiser

Posted on: Tuesday, December 4, 2001

Editorial
Keep money incentives for organs modest

The American Medical Association is debating whether cash incentives would spur more people to donate kidneys, livers, bone marrow, corneas and other body parts that are in critical demand.

And that brings to mind some sinister urban legends, like the one in which a guy wakes up in an ice-filled bathtub with missing kidneys after a drink with a stranger at a bar.

However, many say altruism alone just isn't meeting the high demand for organs. About 5,000 people in America die each year while awaiting transplants.

Here in Hawai'i, more than 300 Islanders are on the organ transplant waiting list. Eighteen on the list died last year.

But this isn't necessarily a problem you can throw money at.

As yet there's no hard evidence that cash incentives would motivate more organ donations. Countries that do pay for organs don't necessarily enjoy higher rates of donations.

And what could be more frightening than an organ donor program run amok, where people cash in on their relatives' body parts? Such a system could easily end up benefiting the rich and exploiting the poor.

Robyn Kaufman, executive director of the Organ Donor Center of Hawai'i, says in her experience, most people don't know what their dying relatives want and err on the side of caution by not donating their organs.

Overall, she says, people don't want to "capitalize on their loved one's death."

Without providing cash incentives, Hawai'i has turned around its once-dismal organ donor record through public education efforts, partnerships between hospitals and donor programs and access to the Department of Motor Vehicles drivers license registry, which identifies willing donors.

Nonetheless, a proposal to offer modest financial compensation for hospital or burial costs is one that should be tested. Pennsylvania, for example, has created a program that would pay $300 toward the burial costs of an organ donor.

There are plenty of good reasons why health experts and policy-makers have been skittish about looking into cash incentives for organs.

Ultimately, though, there has to be a way to compensate families for the gift of life without creating an organ bonanza. Let's study the benefits of moderate compensation and reduce the number of people dying on the transplant waiting list.