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March 13, 1991, Vol 265, No. 10 >
ARTICLE | March 13, 1991

Life or Death: Title and subTitle BreakThe Issue of Payment in Cadaveric Organ Donation FREE

Thomas G. Peters, MD
[+] Author Affiliations

Reprint requests to Jacksonville Transplant Center, 580 W Eighth St, Jacksonville, FL 32209 (Dr Peters).


JAMA. 1991;265(10):1302-1305. doi:10.1001/jama.1991.03460100104034
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References

IN 1989, 1878 people died while awaiting organ transplantation. Public awareness programs, professional education, and legislation have not increased organ donation; the motive for consent in organ donation remains altruism. I shall argue that because of an ever larger number of patients listed as candidates for lifesaving organs, the policy of a death benefit payment to motivate families of potential organ donors should be studied. A death benefit of $1000 paid through organ procurement organizations would not necessarily be coercive. Laws now prohibiting organ brokerage and assuring fair organ allocation would continue unchanged. A death benefit payment may most favorably affect the socially disenfranchised through increased organ transplantation in minority populations. Because so many salvageable lives are now lost, only because organs cannot be obtained, pilot programs to determine the impact of death benefit payment to the enabling (consenting) next-of-kin should be initiated. If organ recovery increases sufficiently, a nationwide

REFERENCES

1 +
Evans RW, Manninen DL, Garrison LP, Maier AM.  Donor availability as the primary determinant of the future of heart transplantation . JAMA. 1986;;255:1892-1898.
2 +
Starzl TE, Demetris AJ, Van Thiel D.  Liver transplantation . N Engl J Med. 1989;;321:1014-1022.
3 +
Strawn J. UNOS Monthly Activity Reports . (October) 1987 to April 1990;.
4 +
Evans RW.  Organ donation: facts and figures . Dialysis Transplant. 1990;;19:234-240.
5 +
Caplan AL.  Sounding board: ethical and policy issues in the procurement of cadaver organs for transplantation . N Engl J Med. 1984;;311:981-983.
6 +
Rettig RA.  The politics of organ transplantation: a parable of our time . J Health Polit Policy Law. 1989;;14:191-227.
7 +
Chatterjee SN, Payne JE, Berne TV.  Difficulties in obtaining kidneys from potential postmortem donors . JAMA. 1975;;232:822-824.
8 +
Hanto DW.  Midwestern regional report . Chimera. 1990;;1:12-13.
9 +
Caplan AL.  Professional arrogance and public misunderstanding . Hastings Cent Rep. April/May 1988;:34-37.
10 +
Caplan AL.  Letter . Hastings Cent Rep. (March) /April 1989;:45.
11 +
Overcast TD, Evans RW, Bowen LE, Hoe MM, Livak CL.  Problems in the identification of potential organ donors . JAMA. 1984;;251:1559-1562.
12 +
Sutton EC.  Organ donation legislation: the role of the physician . Med Staff Couns. 1989;;3:43-50.
13 +
Peters TG, Vaughn WK.  Organs for transplantation: analysis of 27 000 cadaveric donor organs . South Med J. 1990;;83:889-892.
14 +
Batten HL, Prottas JM:  Kind strangers: the families of organ donors . Health Aff (Summer) 1987;:35-47.
15 +
Diethelm AG.  Ethical decisions in the history of organ transplantation . Ann Surg. 1990;;211:505-519.
16 +
Englehardt HT.  Special report: Shattuck Lecture—allocating scarce medical resources and the availability of organ transplantation . N Engl J Med. 1984;;311:66-71.
17 +
Callender CO, Bayton JA, Yeager C, Clark JE.  Attitudes among blacks toward donating kidneys for transplantation: a pilot project . J Natl Med Assoc. 1982;;74:807-809.
18 +
Johnson LW, Lum CT, Thompson T, Wilson J, Urdaneta ML, Harris R.  Mexican-American and Anglo-American attitudes toward organ donation . Transplant Proc. 1988;;20:822-823.
19 +
Manninen DL, Evans RW.  Public attitudes and behavior regarding organ donation . JAMA. 1985;;253:3111-3116.
20 +
Miles MS, Frauman AC.  Public attitudes toward organ donation . Dialysis Trans. 1988;;17:74-76.
21 +
Hagle ME, Rosenberg JC, Lysz K, Kaplan MP, Sillix D.  Racial perspectives on kidney transplant donors and recipients . Transplantation. 1989;;48:421-424.
22 +
Rostand SG, Kirk KA, Rutsky EA, Pate BA.  Racial differences in the incidence of treatment for end-stage renal disease . N Engl J Med. 1982;;306:1276-1279.
23 +
Sells RA.  Commerce in human organs: a global review . Dialysis Transplant . 1990;;19:10-17.
24 +
The Council of the Transplantation Society.  Commercialization in transplantation . Transplantation. 1986;;41:1-3.
25 +
Kramer NC, Peters TG, Rohr MS, Thacker LR, Vaughn WK.  Beneficial effect of cyclosporine on renal transplantation . Transplantation. 1990;;49:343-348.
26 +
Fernandez-Bueno C, Samimi F, Reinmuth B, Baker JR, Peters TG.  Improved results in cadaveric renal transplantation for black recipients . Transplant Proc. 1988;;20:398-400.
27 +
National Organ Transplant Act, Pub L No. 98-507,3 USC §301.
28 +
Uniform Anatomical Gift Act §4,8A ULA15 (1987).

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Evans RW, Manninen DL, Garrison LP, Maier AM.  Donor availability as the primary determinant of the future of heart transplantation . JAMA. 1986;;255:1892-1898.
2 +
Starzl TE, Demetris AJ, Van Thiel D.  Liver transplantation . N Engl J Med. 1989;;321:1014-1022.
3 +
Strawn J. UNOS Monthly Activity Reports . (October) 1987 to April 1990;.
4 +
Evans RW.  Organ donation: facts and figures . Dialysis Transplant. 1990;;19:234-240.
5 +
Caplan AL.  Sounding board: ethical and policy issues in the procurement of cadaver organs for transplantation . N Engl J Med. 1984;;311:981-983.
6 +
Rettig RA.  The politics of organ transplantation: a parable of our time . J Health Polit Policy Law. 1989;;14:191-227.
7 +
Chatterjee SN, Payne JE, Berne TV.  Difficulties in obtaining kidneys from potential postmortem donors . JAMA. 1975;;232:822-824.
8 +
Hanto DW.  Midwestern regional report . Chimera. 1990;;1:12-13.
9 +
Caplan AL.  Professional arrogance and public misunderstanding . Hastings Cent Rep. April/May 1988;:34-37.
10 +
Caplan AL.  Letter . Hastings Cent Rep. (March) /April 1989;:45.
11 +
Overcast TD, Evans RW, Bowen LE, Hoe MM, Livak CL.  Problems in the identification of potential organ donors . JAMA. 1984;;251:1559-1562.
12 +
Sutton EC.  Organ donation legislation: the role of the physician . Med Staff Couns. 1989;;3:43-50.
13 +
Peters TG, Vaughn WK.  Organs for transplantation: analysis of 27 000 cadaveric donor organs . South Med J. 1990;;83:889-892.
14 +
Batten HL, Prottas JM:  Kind strangers: the families of organ donors . Health Aff (Summer) 1987;:35-47.
15 +
Diethelm AG.  Ethical decisions in the history of organ transplantation . Ann Surg. 1990;;211:505-519.
16 +
Englehardt HT.  Special report: Shattuck Lecture—allocating scarce medical resources and the availability of organ transplantation . N Engl J Med. 1984;;311:66-71.
17 +
Callender CO, Bayton JA, Yeager C, Clark JE.  Attitudes among blacks toward donating kidneys for transplantation: a pilot project . J Natl Med Assoc. 1982;;74:807-809.
18 +
Johnson LW, Lum CT, Thompson T, Wilson J, Urdaneta ML, Harris R.  Mexican-American and Anglo-American attitudes toward organ donation . Transplant Proc. 1988;;20:822-823.
19 +
Manninen DL, Evans RW.  Public attitudes and behavior regarding organ donation . JAMA. 1985;;253:3111-3116.
20 +
Miles MS, Frauman AC.  Public attitudes toward organ donation . Dialysis Trans. 1988;;17:74-76.
21 +
Hagle ME, Rosenberg JC, Lysz K, Kaplan MP, Sillix D.  Racial perspectives on kidney transplant donors and recipients . Transplantation. 1989;;48:421-424.
22 +
Rostand SG, Kirk KA, Rutsky EA, Pate BA.  Racial differences in the incidence of treatment for end-stage renal disease . N Engl J Med. 1982;;306:1276-1279.
23 +
Sells RA.  Commerce in human organs: a global review . Dialysis Transplant . 1990;;19:10-17.
24 +
The Council of the Transplantation Society.  Commercialization in transplantation . Transplantation. 1986;;41:1-3.
25 +
Kramer NC, Peters TG, Rohr MS, Thacker LR, Vaughn WK.  Beneficial effect of cyclosporine on renal transplantation . Transplantation. 1990;;49:343-348.
26 +
Fernandez-Bueno C, Samimi F, Reinmuth B, Baker JR, Peters TG.  Improved results in cadaveric renal transplantation for black recipients . Transplant Proc. 1988;;20:398-400.
27 +
National Organ Transplant Act, Pub L No. 98-507,3 USC §301.
28 +
Uniform Anatomical Gift Act §4,8A ULA15 (1987).

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