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New Ways to Attract Organ Donors

Panel Calls for Revised CPR Methods to Increase Organ Donations
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Financial Incentives for Organ Donations continued...

Some ethicists have also called for the gradual phase-in of financial rewards for donations, essentially beginning a system of paying for organs. Such a system has been credited with eliminating the waiting list for kidneys in Iran.

"We're not going to get many more organs by making small adjustments to the current system," said Robert M. Veatch, a professor of medical ethics at Georgetown University who has called for experimentation with payment-for-donation systems.

Veatch and others have backed expanding organ donor criteria to include patients in permanent vegetative states and permanent comas if they are irreversibly unconscious. It would be a departure from current practices requiring such patients to be first removed from life support, often damaging organs in the intervening time while the heart stops pumping blood.

"It would add substantial numbers of persons who are dead with viable organs," said Veatch.

The United Network for Organ Sharing (UNOS) strongly opposes any financial or other incentives for organ donations. UNOS officials did not respond to requests for comment Tuesday, but Francis Delmonico, the network's president, told a White House bioethics panel two weeks ago that his group would "staunchly" oppose incentives.

The IOM panel also recommended against so-called "mandated choice" laws that would compel people to affirmatively choose on tax returns or driver's license applications whether or not they wish to donate.

A 'Conservative' Approach

Childress acknowledged that the IOM panel took a "conservative orientation" to expanding donations. Experts were concerned that more radical reforms could lead to a backlash among members of the public already largely reluctant to sign up to be organ donors.

He said the committee chose instead to urge American policy makers and hospitals to work to enhance existing organ donation systems. "Many of these things if they were implemented, they would just cause people to opt out," said Childress, who directs the Center for Practical Ethics at the University of Virginia.

Veatch argued that the thousands of people who die each year waiting for organs justifies drastic measures that the IOM report advocates.

"The time has come for some cautious experimentation," he said. "The unmet need is great and we need a new approach."

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