Transplantation
Volume 100, Issue 9, 2016, Pages 2006-2009

Statement of the declaration of istanbul custodian group regarding payments to families of deceased organ donors (Article)

Capron A.M.* , Delmonico F.L. , Dominguez-Gil B. , Martin D.E. , Danovitch G.M. , Chapman J.
  • a Pacific Center for Health Policy and Ethics, University of Southern California, 699 Exposition Blvd., Los Angeles, CA 90089-0071, United States
  • b Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States, New England Organ Bank, Boston, MA, United States
  • c Organización Nacional de Trasplantes (ONT), Madrid, Spain
  • d Health Ethics and Professionalism, Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia
  • e Kidney and Pancreas Transplant Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
  • f Division of Medicine and Cancer, Westmead Hospital, Sydney, NSW, Australia

Abstract

Governmental and private programs that pay next of kin who give permission for the removal of their deceased relative's organs for transplantation exist in a number of countries. Such payments, whichmay be given to the relatives or paid directly for funeral expenses or hospital bills unrelated to being a donor, aim to increase the rate of donation. The Declaration of Istanbul Custodian Group-in alignment with the World Health Organization Guiding Principles and the Council of Europe Convention Against Trafficking in Human Organs-has adopted a new policy statement opposing such practices. Payment programs are unwise because they produce a lower rate of donations than in countries with voluntary, unpaid programs; associate deceased donation with being poor and marginal in society; undermine public trust in the determination of death; and raise doubts about fair allocation of organs. Most important, allowing families to receive money for donation from a deceased person, who is at no risk of harm, will make it impossible to sustain prohibitions on paying living donors, who are at risk. Payment programs are also unethical. Tying coverage for funeral expenses or healthcare costs to a family allowing organs to be procured is exploitative, not "charitable." Using payment to overcome reluctance to donate based on cultural or religious beliefs especially offends principles of liberty and dignity. Finally, while it is appropriate to make donation "financially neutral"-by reimbursing the added medical costs of evaluating and maintaining a patient as a potential donor-such reimbursement may never be conditioned on a family agreeing to donate. © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Author Keywords

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Index Keywords

cultural anthropology economics compensation health care policy donor human dignity Tissue Donors motivation human payment program ethics payment reimbursement medical ethics Turkey (republic) priority journal social interaction health care practice religion conflict of interest organ donor Tissue and Organ Procurement health care cost health program transplantation family Humans social belief Compensation and Redress Social Stigma social welfare Article public opinion world health organization cause of death organ trafficking health economics
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84976406288&doi=10.1097%2fTP.0000000000001198&partnerID=40&md5=7fe0825f78ca36a4de35b1539d62b1e2
DOI: 10.1097/TP.0000000000001198
ISSN: 00411337
Original Language: English