Voo Teck Chuan
Bioethics. 2015 Mar;29(3):190-202. doi: 10.1111/bioe.12078. Epub 2014 Feb 19.
Acts of helping others are often based on mixed motivations. Based on this claim, it has been argued that the use of a financial reward to incentivize organ donation is compatible with promoting altruism in organ donation. In its report Human Bodies: Donation for Medicine and Research, the Nuffield Council on Bioethics uses this argument to justify its suggestion to pilot a funeral payment scheme to incentivize people to register for deceased organ donation in the UK. In this article, I cast a sceptical eye on the above Nuffield report's argument that its proposed funeral payment scheme would prompt deceased organ donations that remain altruistic (as defined by and valued the report). Specifically, I illustrate how this scheme may prompt various forms of mixed motivations which would not satisfy the report's definition of altruism. Insofar as the scheme produces an expectation of the reward, it stands diametrical to promoting an 'altruistic perspective'. My minimal goal in this article is to argue that altruism is not motivationally compatible with reward as an incentive for donation. My broader goal is to argue that if a financial reward is used to incentivize organ donation, then we should recognize that the donation system is no longer aiming to promote altruism. Rewarded donation would not be altruistic but it may be ethical given a persistent organ shortage situation.
帮助他人的行为往往基于多种动机。基于这一观点，有人认为使用金钱奖励来激励器官捐赠与在器官捐赠中促进利他主义是相容的。在其报告《人体：医学与研究捐赠》中，英国纳菲尔德生物伦理委员会运用这一观点为其建议进行试点丧葬支付计划以激励人们在英国登记成为已故器官捐赠者的提议提供正当理由。在本文中，我对上述纳菲尔德报告的观点持怀疑态度，即其提议的丧葬支付计划会促使进行符合利他主义（如该报告所定义和重视的）的已故器官捐赠。具体而言，我阐述了该计划可能引发各种形式的混合动机，而这些动机并不符合该报告对利他主义的定义。就该计划产生对奖励的预期而言，它与促进“利他主义视角”完全相悖。我在本文中的最低目标是论证利他主义在动机上与作为捐赠激励手段的奖励不相容。我的更广泛目标是论证，如果使用金钱奖励来激励器官捐赠，那么我们应该认识到捐赠体系不再旨在促进利他主义。获得奖励的捐赠并非利他行为，但鉴于持续存在的器官短缺情况，它可能是符合伦理道德的。
