Improving organ donation: compensation versus markets.

Proposals suggesting monetary compensation of organ donors to increase donation rates for transplantation are founded on the ethical premise that the principal criterion for organ procurement policy should be patients' health and not the personal preferences and philosophies of policymakers. In this paper, we argue that a market-based organ procurement system is superior to both the current altruistic-based system and a system based on compensation without a market. A market system would address both the problem of potential donors refusing to donate and that of their never being asked, whereas the altruistic system addresses neither problem and a system of compensation addresses only the former. Empirical evidence suggests that the latter (not being asked) is the predominant cause of the current shortage of organs. Our discussion shows that collection rates are likely to be substantially higher under a market system.