Free Ride

Organ donation debate


If all goes well, thrifty Vermonters will soon have a new way to save a few bucks. All they have to do is hand over their hearts, kidneys, and corneas.

State Reps. James Fitzgerald (D–St. Albans) and Francis McFaun (R–Barre Town) have introduced a bill offering to wave the driver's license renewal fees of Vermont residents who become organ donors, a system similar to one that has already been tested in Georgia. Nearly 100,000 people are on the national transplant waiting list, but Vermont currently provides a measly four or five dozen organs a year from a pool of about half a million licensed drivers.

Despite the staggering statistics about the miles of maple syrup–soaked intestines going to waste in the Green Mountain State, even this small incentive has proved controversial. Financial compensation for organ donation is prohibited by federal law, with opponents of organ markets arguing, in the words of the Harvard surgeon Francis Delmonico, that "payments eventually result in the exploitation of the individual." Some Vermont bloggers have extended this argument to Fitzgerald and McFaun's proposal, arguing that a driver's license is a "necessary document" and that waving the $40 fee in exchange for an organ donation pledge puts "inappropriate pressure" on low-income drivers.

The University of Chicago economist Gary Becker, who has found that even small organ donation incentives can be powerful, writes that "monetary incentives would increase the supply of organs for transplant sufficiently to eliminate the very large queues in organ markets." Nearly all economists agree. In recent years, major arbiters of medical ethics have softened their stance on compensation, with the American Medical Association, the American Society of Transplant Surgeons, and the United Network for Organ Sharing supporting some compensation experiments.