Should governments encourage their citizens to become organ donors by offering tax credits to the loved ones they leave behind?
That’s one of the proposals being made by a Montreal ethicist to increase family support for organ donations.
About half of all organs from donors are “wasted” because grieving relatives block their harvesting, says Jurgen De Wispelaere
Offering a tax credit to a family member who helps a loved one fulfill a wish to donate organs would be a formal recognition of the public good they are doing, he said.
“I know this is somewhat controversial, but this has nothing to do with creating a market. No organs will be sold,” said Prof. De Wispelaere, who presented his research recently at the Congress of the Humanities and Social Sciences in Montreal. “It is really acknowledging this is something that is good for society as a whole.”
His work, conducted with lawyer Lindsay Stirton
As an alternative to such emotionally charged bedside conversations, the researchers propose involving family in the decision to donate organs well in advance and offering tax incentives to survivors who ensure those wishes are upheld.
A second proposal calls for donors to designate an another individual – most likely a close family member – to act as their “living advocate,” or “second consenter” to make sure their organs are harvested according to their wishes. Such a process, Prof. De Wispelaere said, would prompt family members to discuss their intensions when they are not under emotional stress.
He predicts such a system would give families a greater sense of control and increase organ donations by decreasing the likelihood of families blocking a donor’s decision. It also could cause those asked to be a second consenter to consider their own wishes about organ donation, he said.
While many countries are looking at boosting donation rates with systems of presumed consent that require individuals to opt out of donating, Prof. De Wispelaere said such plans do not address the concerns of loved ones.
“The most important thing is to move the focus to the family,” he said in an interview.
Organs often are not taken from donors because medical staff are reluctant to approach grieving families, the researchers found. In other cases, next of kin cannot be located in time or do not know about their relative’s intensions. Even when relatives do not have a legal right to overrule a potential donor’s wishes, the researchers found medical staff were reluctant to remove organs if the family opposed it.
“You want to have this discussion well before hand,” Prof. De Wispelaere said. “When a family is grieving, it is the wrong time to give them information about organ harvesting. This is a time when they want to be left alone.”
The idea of a tax credit is still a work in progress, he said, and sprang out of other work on general tax credits and welfare states. Some jurisdictions offer to pay a portion of funeral expenses, but this option still focuses on the donor, he said.
In order to promote their concepts, the researchers are submitting both proposals to the British-based Nuffield Council on Bioethics, which is examining the use of human bodies in medicine and research.
They note that in Britain alone, 506 patients died in 2007 and 2008 waiting for a transplant, while many more experienced a significant loss of quality of life.
