Families' Self-interest and the Cadaver's Organs:  What Price Consent?

Edmund D. Pellegrino, MD
JAMA. 1991;265(10):1305-1306. doi:10.1001/jama.1991.03460100107035.
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IT IS TRAGIC for an eligible recipient to die for want of a lifesaving organ. The profession and society are under a clear moral compulsion to seek ways to prevent such deaths. But it would be equally tragic, even in order to save lives, to resort to such a morally dubious and destructive policy to increase the supply of donated organs as Peters suggests. His proposal that a $1000 death "benefit" be offered to motivate families to consent to removal of organs from their deceased relatives is logically, ethically, and practically flawed.

In his sincere and understandable commitment to save lives, Peters follows an oversimplified line of reasoning: people die waiting for organ transplants. Organs are scarce because we have relied on altruism to motivate donors. Therefore, self-interest must replace altruism as a motive. With the obstacle of activism out of the way, Peters believes that an adequate supply, and


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