April PFD Topic

While the shortage of organ donors in the United States is indeed an issue demanding a solution, financial incentives in order to promote the practice are not the way to go about resolving such a delicate issue. Therefore, I negate the resolution; Resolved: The United States federal government should permit the use of financial incentives to encourage organ donation. Contention 1. Financial incentives may actually decrease donations. According to Sanders, Devney, Young, and Raffin, "Not only is an incentive-based system unethical, but payment to the donor family may disproportionately decrease organ donation rates where they are most needed. Monetary reimbursement destroys the altruism of the donation process, a component that many donor families find alluring and therapeutic." (Full citation: LM Sanders, P Devney, E Young, and TA Raffin, An ethically responsible approach to increasing the organ donation rate, 1992, Chest) One of the biggest benefits derived from organ donation is the positive feelings that families of the deceased get from helping save lives. Financial incentives offered to the family could cheapen their feelings of altruism or even destroy them altogether, leaving donation rates to fall or experience no significant increase. With the organ donation system in such dire straits, any proposals to reform the system cannot come with the risk of decreasing the number of organ donors. That is a cost we simply cannot afford. Contention 2. Organs cannot be treated as commodities. Although financial incentives do not necessarily mean that a direct cash exchange will take place, they are still assigned a monetary value in some regard by the use of financial incentives. According to Dr. Richard A. Demme, "The point is, that if everyone accepts that organs are commodities like anything else that could be bought or sold, then organs could be treated like other things of value that we barter. In such a system, it would be logical that creditors might have a say about what happens to your assets. If you list your organs along with the rest of your assets, others might have a claim on them, and that is morally repugnant." (Full citation: Richard A. Demme, Ethical Concerns About an Organ Market, January 2010, Journal of the National Medical Association) Opening the doorway to financial incentives for organ donation places organs in a new, exchangeable light. Although human gametes are commonly sold, they are to an extent renewable tissue and not vital organs. The uniqueness of vital internal organs demands different ethical standards. Contention 3. Financial incentives exploit the poor. Based on the meaning of the word incentive, it is reasonable to argue that the poor will be more likely to sell their organs, as their financial need would be greater and the incentives thus more alluring. According to Devney, Sanders, Young, and Raffin, "In other words, a financially desperate family that holds a moral objection to organ donation may be coerced by a financial incentive. Since a financial incentive system for organ donation demonstrates the potential for coercion, it is by definition unethical." (Full citation: LM Sanders, P Devney, E Young, and TA Raffin, An ethically responsible approach to increasing the organ donation rate, 1992, Chest) A system that preys on those who are already disadvantaged cannot be allowed to be implemented. In the event of monetary incentives offered to a family after death, these concerns are still not assuaged. According to J. Andrew Hughes, "Even payments after death can coerce a poor person through his concern about how his family will survive after his death and lead to donation based on financial motives rather than altruism--whether the pressure of monetary incentives is internal to the poor seller or externally applied." (Full citation: J. Andrew Hughes, You Get What You Pay For? Rethinking U.S. Organ Procurement Policy in Light of Foreign Models, January 2009, Vanderbilt Journal of Transnational Law) A system that will unavoidably lead to exploitation is not an acceptable answer to the problem of the organ donation shortage. Because of the aforementioned reasons: 1. Financial incentives may actually decrease donations, 2. Organs cannot be treated as commodities, and 3. Financial incentives exploit the poor, I urge the negation of the resolution in this debate. Thank you.