Every day in the US, 20 people waiting for organs die on the wait list without receiving the organs they need to survive.
Different countries have tried several methods to encourage organ donation, from increasing infrastructure and access to organ donation services to both direct and indirect compensation for organ donors.
The London-based Nuffield Council on Bioethics recently recommended paying funeral expenses for donors to incentivize organ donation without directly purchasing a person’s organs.
The system would not only increase organ donation and save lives, but also save money since the average British funeral costs around $11,000, but an organ donation saves taxpayers roughly $20,000 by eliminating the need for costly dialysis. A similar system could work in the U.S. where Medicare spends billions on dialysis annually.
Selling organs is currently illegal in the U.S. due to fears of an emerging organ black market and the potential for the rich to harvest organs from the less fortunate to prolong their lives.
Existing organ black markets have been discovered around the world and have been responsible for the injury and death of impoverished children and adults, but there is no reason to believe an official market for organs in the U.S. would encourage these activities.
A regulated organ market would minimize risk from amateur organ transplants and potential complications while allowing donors reasonable compensation for their time and organs.
While the potential to create a gulf between the medical care offered to the rich and the poor is concerning, it is a structural problem with our current health insurance system, not organ compensation. The wealthy already receive preferential medical care in the U.S. by virtue of purchasing more expensive health insurance than the poor, who either pay for fewer benefits or forgo health insurance entirely.
Critics fear if organ compensation is legalized, our finite supply of donated organs would preferentially go to the wealthy, but they fail to recognize the increase in organ supply a compensation program would yield. Replacing expensive life-sustaining treatment with a one-time compensation and transplant could also reduce costs on insurers and the government.
In Iran, the only nation in the world to support a legitimate organ market, there is no organ shortage. The Iranian government pays kidney donors $1,200 and recipients pay an additional $2,300 to $4,500. Charitable organizations also help pay the recipient’s contribution if the patient is unable to pay for the organ unassisted.
There is currently no incentive — beyond altruism — for donors to give organs to strangers. Compensating donors would increase the supply of available organs, plain and simple.
Other countries are trying to boost organ donations with less drastic measures.
Spain, which has the highest per capita organ donation rate in the world, has implemented an “opt-out” donation policy in which citizens are registered as organ donors by default compared to the U.S. “opt-in” model. Spain appoints a donation coordinator in every hospital who works to facilitate organ donations.
An opt-out style system could also increase organ donation in the U.S., where I believe our lack of registered organ donors is more attributable to apathy and ignorance than a desire to hold onto our organs after death.
Israel has recently adopted a “no give, no take” policy, in which registered organ donors are given preferential placement on transplant lists over non-organ donors. The American nonprofit LifeSharers operates on a similar principle, allowing members first access to other member’s organs before they are placed on general transplant lists.
As demand for vital organs continues to outstrip supply, people around the world are beginning to recognize the need for policy changes. Small changes in infrastructure and priority may help assuage the world’s need for organs ,and a regulated organ market could solve our organ shortage once and for all.
 
Andrew Shockey is a 21-year-old biological engineering junior from Baton Rouge. Follow him on Twitter @TDR_Ashockey.
 
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Contact Andrew Shockey at [email protected]