Should organ donation be incentivized?

The govt. is considering giving financial incentives to persons and/or their families who donate their organs. The Union health ministry has recommended that state health departments offer ‘cash rewards’ for organ donation. As per the recommendations and as per TOI reports, the donor’s family may get anything between Rs 1 lakh–Rs 5 lakh per year for five years and the organ retrieving hospital will get Rs 50,000.

Deceased organ donation is the main source of organs, but it requires informed consent of the family or the legal heir. Live organ donation is also an option in some cases.

Organ donation has so far been voluntary. It is a truly altruistic gesture, one which also indicates the tremendous courage of the family, which makes this selfless decision in their time of immense grief. While there is a long list of patients waiting for an organ, the number of available organs is too few to meet the requirement. So, could this step be an attempt to bridge this huge gap?

Being a govt. policy, may be considered ok, but only for cadaveric donation and as long as the policy is uniform and does not promote organ trade, which should be of great concern given the social inequalities in the country and the tremendous divide between the rich and poor, which provide ample opportunities for organ trade. Therefore, there should be no direct communication between the donor and the recipient family.

In its “Guiding Principles on Human Cell, Tissue and Organ Transplantation”, the World Health Organization (WHO) in the commentary on Principle 5, notes, “Payment for cells, tissues and organs is likely to take unfair advantage of the poorest and most vulnerable groups, undermines altruistic donation, and leads to profiteering and human trafficking. Such payment conveys the idea that some persons lack dignity, that they are mere objects to be used by others… National law should ensure that any gifts or rewards are not, in fact, disguised forms of payment for donated cells, tissues or organs. Incentives in the form of ‘rewards’ with monetary value that can be transferred to third parties are not different from monetary payment.”

In my opinion, if the govt. wants to offer incentives to encourage voluntary organ donation, it can look for non-monetary options. The govt. can recognize and honor those people who have donated their organs after death and their families by according them a national honor. Or, they could be given benefits and facilities similar to those given by the Govt. to the Freedom Fighters. Else, they could be given insurance benefits under Ayushman Bharat National Health Protection Scheme or education for the children of the family can be funded through scholarships or they can be given free train tickets etc. And, if by any chance, they happen to require organ donation themselves, they should be given priority.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA