Pennsylvania State University College of Medicine, Division of Nephrology, Hershey, PA, USA.
Nephrol Dial Transplant. 2013 Jun;28(6):1610-21. doi: 10.1093/ndt/gft079.
Payment for organ donation, whether in the form of incentives, rewards or compensation is highly debated and has been denounced by many professional and legislative bodies. Despite the passionate discussion in the literature, there is very limited data on attitudes and perceptions of physicians about providing rewards or compensation to organ donors. We investigated the relationship between demographic and practice characteristics of nephrologists and their perceptions and attitudes about rewards and compensations for organ donation.
Using a web-based survey, we explored the views of nephrologists around the world about rewards and compensations for kidney donation. The relationship between attitudes and demographic characteristics of 1280 nephrologists from 74 countries was examined by univariate and multivariable analyses.
Seventy-five percent agreed with donor health insurance, 26% favored direct financial compensation and 31% agreed with financial rewards for unrelated donors. Sixty-six percent believed that rewards will lead to increased donation. Seventy-three percent indicated that rewards will lead to exploitation of the poor and 78% agreed with legislation prohibiting organ sales. Thirty-seven percent believed that rewards will negatively impact deceased-donor transplantation. Nephrologists from India/Pakistan and the Middle East had more favorable views about rewards, while respondents from Latin America and Europe, older than 50, female nephrologists and those practicing in rural areas had less favorable views.
We conclude that a minority of nephrologists favor rewards for donation, many agree with some compensation and a considerable majority favor donor health insurance. Perceptions of nephrologists about rewards and compensation are influenced by age, sex, urban versus rural location and geographic region of practice.
器官捐献的付费形式，无论是激励、奖励还是补偿，都存在很大争议，许多专业和立法机构对此予以谴责。尽管文献中对此进行了激烈的讨论，但关于医生对器官捐献者提供奖励或补偿的态度和看法的数据非常有限。我们调查了肾科医生的人口统计学和实践特征与他们对器官捐献奖励和补偿的看法和态度之间的关系。
我们使用基于网络的调查，探讨了全球肾科医生对肾脏捐献奖励和补偿的看法。通过单变量和多变量分析，研究了 74 个国家的 1280 名肾科医生的态度与人口统计学特征之间的关系。
75%的人同意为器官捐献者提供健康保险，26%的人赞成直接经济补偿，31%的人赞成向非亲属捐献者提供经济奖励。66%的人认为奖励将导致捐赠增加。73%的人表示奖励将导致对穷人的剥削，78%的人赞成立法禁止器官买卖。37%的人认为奖励会对已故供者移植产生负面影响。来自印度/巴基斯坦和中东的肾科医生对奖励的看法更为有利，而来自拉丁美洲和欧洲、年龄在 50 岁以上、女性肾科医生和在农村地区行医的医生对奖励的看法则不太有利。
我们的结论是，少数肾科医生赞成对捐赠进行奖励，许多人赞成给予一些补偿，绝大多数人赞成为器官捐献者提供健康保险。肾科医生对奖励和补偿的看法受到年龄、性别、城市与农村地区以及执业地理区域的影响。
