UK: Public to have say on organ donation incentives

"Cash incentives and the payment of funeral expenses are two ideas being put forward to encourage people to donate human organs and tissue.

The Nuffield Council on Bioethics is asking the public if it is ethical to use financial incentives to increase donations of organs, eggs and sperm.

Paying for most types of organs and tissue is illegal in the UK.

The public consultation will last 12 weeks and the council's findings will be published in autumn 2011.

It will explore ways of boosting donations from living people of bodily material such as blood or sperm, as well as ways to encourage more people to sign up for the donor register and state their wishes for their organs to be used by others after their death.

As well as cash payments or contributions towards funeral costs, other options include priority for the donor if they require a transplant later in life, the payment of more generous expenses and the sending of certificates or 'thank you' letters to the donor or donor's family.

It will be interesting to see what people really think. Will they be willing to pay for some things and not others?

Mr Keith Rigg, transplant surgeon: 'Demand for organ donors has increased in recent years and now far exceeds supply. This is due to an ageing population and improvements in medicine that mean more people could benefit from transplants.'

Demand for sperm and egg donations has also risen due to new treatments and procedures to help infertility.

Morality check

Professor Dame Marilyn Strathern, who is chairing the Council's working party on this issue, said she wanted to explore all the issues involved in responding to that demand.

She said: 'We need to think about the morality of pressing people to donate their bodily material.

Offering payment or other incentives may encourage people to take risks or go against their beliefs in a way they could not have otherwise done,' she said.

Women can already get free IVF treatment from private clinics to encourage them to donate eggs. Sperm and egg donors are paid a nominal sum just to cover expenses.

But, on the whole, the current system relies on people donating altruistically, to help society or a loved one.

High demand

Each year, 1,000 people in the UK die while waiting for transplants.

Around 8,000 people are currently waiting for an organ, but there were 3,500 transplant operations last year.

There is also demand for approximately 1,200 more egg donors and 500 more sperm donors. Scientists also need people to donate human tissue for research.

The idea of paying living donors for organs is abhorrent as this would be tempting the poor to risk their lives

Joyce Robins of Patient Concern: 'The consultation will look at all kinds of donation including whole organs, blood, skin, corneas, bone, sperm, eggs and embryos, as well as clinical trials that test the safety of new medicines.

The aim is to bring all donations under one ethical framework.'

Keith Rigg, a transplant surgeon from Nottingham University Hospitals NHS Trust and a member of the Nuffield Council on Bioethics' working party, said: 'It will be interesting to see what people really think. Will they be willing to pay for some things and not others?'

As a result of the high demand for organs, he said, 30 people a year travel abroad for transplants, mostly kidney operations. And around 50 women per month are thought to go abroad for fertility treatment.

Mr Rigg said there was a whole range of different consent systems in different countries and that it would be part of the Council's remit to look at how well those work.

In response to the consultation paper, Joyce Robins, co-director of the campaigning group Patient Concern, complained that there was no patient representative on the working party.

She also queried whether the question of paying for donation of eggs, sperm and organs was even a priority in the current financial climate.

'The idea of paying living donors for organs is abhorrent as this would be tempting the poor to risk their lives.

Offers of payment to the family of someone who has just died could tempt them to go against the wishes of their loved ones at a time when they are most vulnerable,' she said."
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