It has been dubbed ‘cash for kidneys’ but a Charles Sturt University (CSU) medical ethicist believes payments for living organ donors will increase equality rather than exploit the poor.

 

A Federal Government trial will see living donors paid the minimum wage for up to six weeks to help cover medical costs.

 

CSU’s Dr Alberto Giubilini from the Centre for Applied Philosophy and Public Ethics (CAPPE) said the scheme promises significant health and financial benefits but ethical issues also need to be considered.

 

“The prospect of receiving payments is likely to encourage people to donate organs, which will in turn reduce long waiting lists for organ transplants in particular for kidneys.

 

“The $1.3 million the government has committed over the next two years is a worthy long-term investment, considering the high costs of treating people with organ failure,” Dr Giubilini said.

 

Critics fear that offering a financial reward for what so far has been seen as an altruistic transaction might exploit those most vulnerable.

 

Dr Giubilini argues government control over the payments can ensure that a reasonable, and no more than reasonable, sum of money is paid to donors.

 

“In this scheme people will not be paid by the recipient for their organs, but by the government for their time and the health risks they take,” he said. “In this respect, the limitation that only people who already have at least a minimum wage can receive payments should prevent inducement and exploitation of the unemployed.”

 

Dr Giubilini said Australians usually donate organs to family members or close friends out of love or pure altruism.

 

“A minimum wage payment is certainly not enough to alter this motivation but it is enough to guarantee that poor people who want to help their loved ones can afford to do it, which is presumably already the case for high-income earners. Equality would actually be improved, rather than weakened,” he said.

 

Dr Giubilini said even if this scheme is successful it will not solve the problem of long waiting lists for organs.

 

“People who are not fortunate enough to have someone willing to donate them an organ might not benefit at all from this trial. Other policies might be needed to supplement the scheme, for example an opt-out system for cadaveric organs, where people are presumed to consent to donating their organs after death, unless they record their unwillingness to donate.

 

“Evidence from countries like Austria and Spain shows that such a system can result in a significant increase in donation rates without violating the autonomy of those unwilling to donate. As with the Australian donor payment scheme, a great benefit might come from an ethically acceptable and feasible policy,” he said.