A fair exchange: why living kidney donors in England should be financially compensated

Journal article


Rodger, D. and Venter, B. (2023). A fair exchange: why living kidney donors in England should be financially compensated. Medicine, Health Care and Philosophy. https://doi.org/10.1007/s11019-023-10171-x
AuthorsRodger, D. and Venter, B.
Abstract

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England.

KeywordsTransplantation; organ donation; kidney; renal transplant; compensation; autonomy; altruism; coercion; exploitation
Year2023
JournalMedicine, Health Care and Philosophy
PublisherSpringer
ISSN1572-8633
Digital Object Identifier (DOI)https://doi.org/10.1007/s11019-023-10171-x
Web address (URL)https://link.springer.com/article/10.1007/s11019-023-10171-x
Publication dates
Print24 Aug 2023
Publication process dates
Accepted04 Aug 2023
Deposited30 Aug 2023
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