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Mateo Cuevas
Writing 39C
Erin McNellis
April 15, 2014
Organ Shortage Solution: An Incentive to Help Others
Humans by nature are instinctive creatures. If we see something frightening we react, we
react to situations all around us and we feel emotions and feel pity for people if they are
suffering. There are many people who would help a stranger if they know they need help. In the
U.S. there is a drastic shortage in the number of organs people need. The numbers from the
Organ Procurement and Transplantation Network, (OPTN) shows that there are currently
112,220 candidates on the waiting list as of April 15, 2014; while the number of donors, starting
this year January 2014 up to April 11, 2014, has only been 1,209. (OPTN: Organ Procurement
and Transplantation Network). Based on these numbers we do not meet the demand of donors,
because we do not have enough suppliers Most of the patients the waiting list will not make it if
they do not receive a transplant soon. The U.S. cannot accommodate for all those who are in
need of transplants and those who are able to help are not doing all they can in order to solve this
problem. Thus a solution I propose is to use incentives to get people to donate. These incentives
will not be things like just money to those who donate but will consist of other types of
compensation that will encourage people to donate. These incentives will differ depending on the
person and the type of donation that is made. There will be very different reimbursements for
those who are living donors (LD) compared to deceased donors (DD). The types of incentives I
propose are: tax breaks, covered funeral costs (DD), covered medical bills, medical leave from
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work, and priority on the waiting list. These incentives will be taken care of an external third
party, for example the American Association is one organization that agrees on offering these
types of benefits, but the government would also be involved in order to assist in the
compensation.
This organ shortage problem affects more people than one may think. Just as colds and
viruses affect adults, teens, young children, and the elderly, organ shortages affects all of these
people too. No one is safe from needing an organ transplant. Once they are in need, for the
majority of people, they are just added to the waiting list of thousands of people who need
transplants. In figure 1 from Nick Cenevivas Technical Writing Blog, A Technical Writing
Blog with a
Bioengineering
focus, we can
see that the organ
shortage is a
serious problem
that is constantly
increasing in
severity
(Ceneviva).
Although this
image also shows
that there is an increase in the number of donors that are signing up, based on the information
from this image, it will not be sufficient to close the large gap that already exists of people
Figure 1: In this figure taken from Nick Ceneviva's tecnchincal writing
blog, we can see a large gap of organ donor and patients.
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waiting to receive a transplant. There are many reasons why this problem exists and why there
are such a small number of donors. But the one I believe is most impactful is the fact that the
process for becoming a donor is very long and filled with tedious tests that take up a lot of the
donors time. It is easy to see why people would not want to become donors because of
everything they have to do, so why not make it more appealing to them. This is why we need
some sort of incentive system to get people to want to donate, so they can help someone and also
be compensated for all of their effort.
A solution to solve this shortage of organs is to offer incentives to possible organ donors.
If they see that they can help someone with a donation and also receive a type of reward in
exchange for helping someone, they will more likely chose to donate. When the word
compensation is talked about, many may immediately think money. But his solution is not going
to directly pay people in the form of cash reward because, as stated in the NOTA act (National
Organ Transplant Act of 1984), any individual convicted of buying or selling human organs
faces a five-year prison sentence and/or a hefty fine (Can I Sell an Organ). Because of this
reason there is a lot of controversial talk about whether offering incentives for people who
donate organs should be implemented or not. My proposed solution will offer things like tax
breaks, covered leave for time missed at work, medical bills covered, and even covered funeral
costs. In The Organ Trafficking Prohibition Act of 2009, there is talk of incentives which,
Among the benefits being discussed are coverage of burial costs for living donors, as well as
health insurance, life insurance and other benefits comparable with those granted to military
veterans. At the same time, the proposal would increase supervision to avoid the buying and
selling of human organs (Guttman). This proposition includes many of the benefits that I
believe should be offered to donors.
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The Organ Trafficking Prohibition act of 2009 has been discussed extensively for
example in that same bill by Guttman, he discusses the circumstances of this proposition made
by Democratic Senator Arlen Specter of Pennsylvania. He talks about how it has two co-
sponsors, but is yet to be officially introduced because it lacks the support House of
Representatives; however there are drafts that were being circulated in the senate (Guttman). The
purpose of this bill is to increase the donation of organs but it is currently stalled due to
disagreements within the two Houses. Even though it is not a clear indication that this bill will
become a law, this is evidence that there is a discussion and thought to putting a law like this into
practice. This solution has support at the government level and there has been so much thought
put into it that it is bound to through congress sooner or later. This proposed solution of offering
incentives to those who choose to become organ donors is a solution that could work.
My proposed
solution will affect
everyone on the organ
waiting list. This is
because, particularly with
deceased donors, having
one can yield many
donations to be performed.
For Example in Figure 2
we can see the HRSAs
post of a how much one donor can help. With this being said and from Figure 2 showing a brief
example with the picture we can see in Figure 3 that organs can be put to good use if someone is
Figure 2: This image from the HRSA organization, shows that one
person can make a large difference by donating their organs.
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a donor but if someone is not then it becomes
a waste. Also because the donation will be
more appealing to people in general there will
also be an increase in the number of live organ
donations which will help with the number
one needed organ which is kidneys (What
You Need To Know About Organ Donations).
Kidney donations are sure to spike if this type
of law is allowed to be implemented because we
have two kidneys but can survive with one. There are experts that currently support this idea of
offering incentives for something like a kidney. For example Dr. Sally Satel, being the recipient
of a kidney donation, of the American Enterprise Institute, and Dr. Benjamin Hippen, a
nephrologist on the ethics committee of UNOS( United Nation for Organ Sharing) both support
this idea where cash payment not be the primary or even one of the considered reimbursement
plans, but something financial that will be appealing to donors. They both suggest offering
something like lifelong health insurance in exchange for becoming a donor (Financial Incentives
For Kidney Donations?). Sally Satel is herself a recipient of a kidney donation and is a Doctor
who is in favor is this type of solution. Having a doctor who received an organ donation be on
board with this type of solution is a big step. It will make those skeptical realize that if doctors
are on board with it then maybe it is a good idea, especially since the doctor herself received a
transplant.
Figure 3: This is a cartoon creadted by Alifestyle
to illustrate the two paths organs can take.
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This solutions costs will not exceed the benefits that will be earned through
implementing the solution. This is because this policy will not give out compensations that are
too ridiculous to be carried out. For example no one will be paid money directly and there will
not be any type of bidding if an organ is direly needed from say a family. For example like this
court case involving a child who needed a lung transplant the judge, Micheal Baylson made a
ruling after hearing the arguments from the childs parents decided to allow this 10-year old
child to go on the adult transplant list for a lung even though the minimum age is 12-years old
(FoxNews). Incidents like this will not take place with this kind of system. There will not be
arguments to get an organ directly from someone because they feel that the patient really needs
it. This is because these compensations will be handled by a third party like the American
Medical Association, who clearly state in one of their code of medical ethics that: (2) Living
donors should not receive payment for any of their solid organs. However, donors should be
treated fairly; reimbursement for travel, lodging, meals, lost wages, and the medical care
associated with donation is ethically appropriate (AMA). These types of organization will not
be involved with the donor family, so there will be no influence from them. People who are
trying to get ahead in this system will not be able to directly talk to the possible donors because
of the third party affiliation that will handle the donors reimbursement. A key feature that will
be required for this type of system will need to be anonymity, and if there are those families who
do make this sort of attempt, trying to buy an organ directly from a donor, they will be in legal
trouble because bidding and directly buying an organ from someone is illegal, and according to
the 1994 National Organ Transplant Act, a felony that is punishable by a $50,000 fine (Satel).
My solution is feasible because there will be no outrageous payouts to any person. There
will be limits set on the specific donation that is made. For example there will be different
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incentives for those who will be live organ donors, compared to those who will be deceased
organ donors. The support for this comes from Sally Satel who suggests this type of solution
implementation about giving some type of compensation. Also an article for example in the
American Journal of Transplantation stated, Benets or incentives for family members who
consent to donation are among the more controversial (and as yet untested) strategies for
increasing organ supply (Bryce). These ideas are being talked about and very heavily
considered. This article also goes on to talk and discuss much more about this topic and how
these incentives will have an impact. What I understood was that these incentives will help give
a little nudge to those who have thought about becoming organ donors before but think it is a
very long and tedious process. Through the compensation donors can receive, it will not make
everyone donate but it will create a larger pool of donors. The amount or value of the
compensation has been thought of extensively. For example in an, Financial Incentives For
Cadaveric Organ Donation: An Ethical Analysis, there is a full view and analysis of the
problems that arise from implementing such a solution but this article also views the positive and
the alternative to problems that it causes. It stated as one of its primary concerns, Incentives are
of moderate value and at the lowest level that can be reasonably expected to increase organ
donation (Clark). There are not many people who are both for and against who expect a large
payout for donations and they even agree that a minimal amount would still boost donations a
significant amount.
One of the main arguments that will make people oppose this solution is the fact that
since there are incentives there will be desperate people who will want to take advantage of
them. People are afraid that those who are in not good situations will want to donate just so they
can get some sort of benefit from it. But this will not happen because as Satel stated, By
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providing in-kind rewardssuch as a down payment on a house, a contribution to a retirement
fund, or lifetime health insurancethe program would not be attractive to desperate people who
might otherwise rush to donate on the promise of a large sum of instant cash. Cash was never
the primary goal of this type of solution so indicating that someone will do it for money does not
seem reasonable. Also those people do not want to go through the tedious process that already
exists and should this solution be approved it could become an even more time consuming
process. Another main issue that pops up for this type of solution is the question of morals. Is it
still a donation if people get paid for something? I believe that this type of question is one that
will only be relieved over time. For example there are several incentives that are already out
there for blood donations. They key word is donations. No one ever complains that blood
donations should also be given with no incentive, because there are already many that exist and
work to draw in donors. Just because someone will get something out of it does not mean that
they are morally corrupt, that is the way the world works. A donation incentive will help boost
donations and over time the compensations given out will appear normal just as the incentives
that already exist for blood donations.






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Works Cited
Alifestyle. Video Donor. February 21, 2014. Web. http://blog.videodonor.com/2014/02/organ-
donation-cartoon-by-comic-artist21.html May 14, 2014.
Bryce C, Siminoff L, Ubel P, Nathan H, Caplan A, Arnold R. Do Incentives Matter? Providing
Benefits to Families of Organ Donors. American Journal Of Transplantation [serial
online]. December 2005;5(12):2999-3008. Available from: Academic Search Complete,
Ipswich, MA. Accessed May 12, 2014.
This source is credible because it was published in a credible journal along with
contributing authors who are experts in their field. Also I believe it is relevant to what I
was discussing for my solution because it talks about the types of incentives that there
may be for an organ donation. It also briefly mentions why maybe it is not a good idea
which is the other side that I should also be focusing on.
Can I Sell an Organ? Find a Law. http://healthcare.findlaw.com/patient-rights/can-i-sell-an-
organ.html Web. 18 May 2014.
Cenevivas, Nick. "The Shortage of Donor Organs." Nick Cenevivas Technical Writing Blog.
http://sites.psu.edu/nickceneviva202cblog/2013/09/18/the-shortage-of-donor-organs/.
Web. April 22 2014.
Clark, Peter A. Financial Incentives For Cadaveric Organ Donation: An Ethical Analysis. The
Internet Journal of Law, Healthcare. Volume 4 issue 1. http://ispub.com/IJLHE/4/1/4568.
Web. May 19, 2014.
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"Dying Girl Intubated as She Awaits Lung Transplant." Fox News. FOX News Network, 10 June
2013. http://www.foxnews.com/health/2013/06/10/parents-file- lawsuit-in-girl-lung-
transplant-case/. Web. 12 May 2014
Financial Incentives For Kidney Donations? American Association of Kidney Patients.
aakpRenalife. September 2008 issue. https://www.aakp.org/advocacy/public-
policy/item/financial-incentives-for-kidney-donations.html Web. May 18, 2014.
This website is credible because it is a well-known organization and they do not post
false information to the public. Their url is .org meaning non-profit, and they just want to
get the right information out there. This website mentions two experts Dr. Sally Satel,
and Dr. Benjamin Hippen, who are both in high positions in their organizations. This is
why I feel I can trust the opinions they have to say. Also because these are opinions from
real people they go well with my argument to offer incentives to those who choose to
become donors. The site supports my view and also addresses the possible reasons why
others may be against it. But then goes on to explain why it is a good solution. This is the
type of argument I want to make in my paper so wanted to use some of their ideas to help
strengthen the arguments I want to make.
Guttman, Nathan. "Kidney Donation Scandal Sparks New Debate Over Specter's Organ
Legislation." The Jewish Daily Forward. Agust 05, 2009.
http://forward.com/articles/111473/kidney-donation-scandal-sparks-new-debate-over-
spe/ Web. 19 May 2014.
This source talks about a bill that is proposed called, The Organ Trafficking Prohibition
Act of 2009. This is real law that was being discussed in 2009 and continues to stir
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debates today because laws do not get passed immediately. I think it relates to my topic
because it is a government level organization that supports the solution that I am
advocating for. It is credible because this information is a recent debate that took place in
congress. This makes it a serious and current topic that I can tie into my argument of why
this solution is what can help solve the organ shortage problem.
"Organ Transplants: What You Need to Know." WebMD.
http://www.webmd.com/a-to-z-guides/organ-transplants-what-you-need-know. Web. 12
May 2014.
Satel Sally. American Enterprise Institure. How to fix the Organ Transplant Shortage.
http://www.aei.org/article/society-and-culture/how-to-fix-the-organ-transplant-shortage/.
Web. 12 May 2014.
Sally Satels article was very interesting to me she started off with a story to get readers
to care more about the subject and I think it works. She later foes on to explain her
reasons for why this is an issue, that related closely to issues I discussed in my
composition 1 so I thought it would be a good fit. She also looks at both the good and bad
about this type of system and how there will always be two sides to it.
Save8lives. National Donation US Challenge. June 12, 2011.
http://save8lives.wordpress.com/2011/06/12/one-organ-donor-can-save-8-lives/. Web.
May 18, 2014.
Transplantation of Organs from Living Donors. American Medical Association.
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-
ethics/opinion215.page. Web. May 17. 2014.
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Uniting People and Information to Help save Lives." OPTN: Organ Procurement and
Transplantation Network. http://optn.transplant.hrsa.gov/. Web. 13 April 2014