Today’s story on BBC news discusses a report by Nuffield Council of Bioethics on ways to increase the rates of bodily donation for medicine and research. Links here to the Full Report and a Short Guide.
The focus of the BBC story is on the recommendation that the NHS should pay for the funeral expenses of those donating their organs, as ‘the move could lead to more people donating their organs’.
I find this point particularly disagreeable and believe that organ donation should always be utterly without any form of financial incentive, whether it comes from the recipient of the organ(s) or from government funding. I will however post this excerpt from the short guide that highlights some rather surprising circumstances in which payment or benefit can be taken.
• Consent is almost always required before a person may donate material as a living donor, and they must be given information about what the procedure involves. After death, organs or tissue may be taken from the deceased if they had signed the Organ Donor Register or if their family give permission.
• It is against the law to offer or accept financial reward to donate blood, tissue or organs for the treatment of others. However, it is not explicitly illegal to offer or accept payment to donate these bodily materials for other purposes, such as research.
• Financial reward for donating eggs or sperm is against the law. However, women who agree to provide some of their eggs for another woman’s infertility treatment or for research (‘egg-sharers’) may receive free or reduced-cost infertility treatment for themselves from private clinics.
• People who donate their bodies after death to medical schools for medical education and training purposes may have their funeral costs paid by the medical school.
• People who volunteer to take part in clinical trials to test new
medicines may receive payment to compensate them for their time, and for any discomfort and inconvenience involved.
• People who donate organs or bone marrow as living donors have all their expenses, including any lost earnings, reimbursed by the NHS. People who donate eggs and sperm are reimbursed a maximum of £250 for lost earnings.
• Expenses are also incurred by the professionals and organisations involved in donation and transplantation. Payment for the many medical and technical services needed to handle and process bodily material does not count as ‘commercial dealings’ and is allowed.
In fairness to the report, it has come to the above conclusions as a result of a realistic analysis of what motivates people into actions, and the sad fact is there are a great many people who will only act in the knowledge of some financial reward.
The percentage of altruistically-minded people who seek to help others on their own intiative is incredibly low. Greater numbers of people will help if prompted or educated to do so. Making it as easy as possible and removing disincentives (such as costs incurred for travel and accommodation) for donating will help further. Ultimately it is a sad reflection on society that a significant minority would never do anything to help anyone unless they received a direct, tangible benefit as a result.
UK Transplant are quoted in the story:
“Currently in the UK, organ donation operates according to the fundamental principle that organs/tissues are donated altruistically and it is illegal to receive a payment for supplying an organ.”
Morally I believe this to be absolutely the right stance. The gift of an organ or tissue should be precisely that – a gift, utterly detatched from demographical considerations or thoughts of individual gain.
But I also appreciate that moral idealism is harder to defend while people continue to die waiting on the organ donor register. Direct monetary incentives, while probably effective, would create an incredible storm of opposition, particularly at a time of economic recession and future uncertainty that would see the increasingly impoverished members of society giving away pieces of themselves to make ends meet.
I can offer no conclusions on the issue, except to say that the BBC has unfortunately made a story of a relatively minor piece of the overall report that sensationalises the issue such that opposition to the other suggestions of the report are more probable. I consider the report to be a cogent, stark, though perhaps depressingly realistic overview on what would make more people donate their organs.
Education will be effective, of course. It’s a widely held view that 80-90% of all people would be willing to donate their organs after death, and yet only 29% of people are signed up to the register. The deficit is due to a general lack of awareness, and to quote Emily Thackray from the Live Life Then Give Life charity: “If there is money out there, it needs to go into education, it needs to go into infrastructure, and it needs to support the donor families who make this incredible gift”.
