New England Organ Bank, Boston, MA.
Am J Transplant. 2015 May;15(5):1187-91. doi: 10.1111/ajt.13232. Epub 2015 Mar 31.
The supply of organs—particularly kidneys—donated by living and deceased donors falls short of the number of patients added annually to transplant waiting lists in the United States. To remedy this problem, a number of prominent physicians, ethicists, economists and others have mounted a campaign to suspend the prohibitions in the National Organ Transplant Act of 1984 (NOTA) on the buying and selling of organs. The argument that providing financial benefits would incentivize enough people to part with a kidney (or a portion of a liver) to clear the waiting lists is flawed. This commentary marshals arguments against the claim that the shortage of donor organs would best be overcome by providing financial incentives for donation. We can increase the number of organs available for transplantation by removing all financial disincentives that deter unpaid living or deceased kidney donation. These disincentives include a range of burdens, such as the costs of travel and lodging for medical evaluation and surgery, lost wages, and the expense of dependent care during the period of organ removal and recuperation. Organ donation should remain an act that is financially neutral for donors, neither imposing financial burdens nor enriching them monetarily.
在美国，捐献者捐献的器官（尤其是肾脏）的供应量低于每年新增的移植等待名单上的患者人数。为了解决这个问题，许多著名的医生、伦理学家、经济学家和其他人发起了一场运动，要求暂停 1984 年《国家器官移植法》（NOTA）中关于买卖器官的禁令。有人认为，提供经济利益将激励足够多的人出售一个肾脏（或一部分肝脏），以清除等待名单，这种观点是有缺陷的。这篇评论文章驳斥了以下观点，即提供经济激励措施是克服捐赠器官短缺的最佳方式。我们可以通过消除阻止无偿活体或已故肾脏捐赠的所有经济障碍，来增加可用于移植的器官数量。这些障碍包括一系列负担，例如医疗评估和手术的旅行和住宿费用、工资损失，以及在器官移除和康复期间的受抚养人护理费用。器官捐赠对捐赠者来说应该是一个经济上中立的行为，既不施加经济负担，也不使他们在经济上受益。
