Saturday, August 15, 2009

New Thoughts on Organ Compensation

The idea of organ compensation has been raised in Singapore, and with considerable controversy. While there are many arguments on both sides, my view is that some forms of compensation, such as lifelong medical insurance, may be more morally (and politically) acceptable than other forms of compensation, such as outright monetary reimbursement. But that is not the point of this post, which is to question the basic assumptions of organ compensation.

Setting aside the moral assumptions of the policy (which is the idea of providing appropriate compensation to the donor such that he is not adversely affected by his altruistic act), the core motivation of organ compensation is to increase organ donations. Hence, the key assumption of the organ compensation policy is that by providing adequate compensation to a donor, there may be less hesitance or reluctance for a potential donor to donate his organ.

From an intuitive perspective, this assumption seems sound. After all, before one decides to donate an organ, one must invariably be hesitant due to the great negative impact such an act causes to oneself. Conversely, if one receives sufficient compensation to offset these valid concerns, such as a lifelong medical insurance plan to offset the risks to health caused by the act of donation, one would be more inclined to donate his organ.

The theory does seem intuitive. However, intuition is not always reliable, particularly when money is involved. I've recently read a book on social psychology, in which research notes that money causes people to think in different frames of thought. In particular, consider the example of the Swiss town of Wolfenschiessen, where a nuclear repository was proposed to be built. Then, a poll was conducted to test the receptiveness of the townspeople to the construction of the nuclear repository in their area. 50.9% were willing to accept this, as it was considered a sort of national duty. When a later scheme proposed some monetary compensation for building the repository, contrary to expectations, only 24.6% were willing to accept the building of the nuclear repository.

The example illustrates that contrary to belief, monetary compensation may actually have a negative effect, in that altruistic considerations are unwittingly converted to more monetary considerations. Hence, if not implemented correctly, the organ compensation scheme may backfire and reduce the number of organ donations.

I have previously written on organ transplantation; these articles are linked below. Note that not all views are consistent, some being explorations on the topic.

Goodworks Organ Bank
Organ Trading
Applying the Principle of Desert to Organ Allocation
The Dignity of a Corpse

No comments: