Some transplantation leaders in the US are starting to push for a compensation system to increase the number of kidney living donation. This is a very ethical debate where both sides of the argument have good points. With a waiting list approaching 90,000 patients hoping to receive a kidney transplant some argue that it is time to implement a compensation system to increase the number of living donation.

For the past 10 years the number of persons waiting for a kidney transplant almost doubled and the actual number of transplantation remained about the same. It has for consequence to dramatically increase the wait time for kidney transplant. Some regions of the US have wait time closing in on 10 years for kidney transplant. Living kidney donation is already legal but is on a voluntary basis and federal laws prohibit any kind of compensation. With treatment of dialysis running in the $70,000 per year per patient some claim money will be saved by transplanting patient faster with the help of a compensation system. Opponents to this system are afraid that people would become kidney donor with the intention of making a quick buck and not thinking about the risks and benefits of the operation.  It also could be an easy way out of debt for some but with unknown long term consequences on finances. Experts against the compensation system also see that as an opportunity for rich to exploit poor and potentially making the system unfair where wealthy patient would bypass patients with less means. In response to this argument the pro-compensation people say that compensation should not be under the form of money but more like free education or other perks like that.

I expect this debate to pick up steam within the next few months as more people are dying everyday while waiting but it will take years before something changes. There are too many variables and questions that need to be answered. What would be the legal age to receive compensation for an organ? Who pays for the compensation? The recipient? The government? The Transplant Center itself? Who will cover the cost of complications for the kidney donors? What should be the total compensation package in $$?  Should it be money or other form? Should deceased donor family be also compensated? Would it open the door to a black market for organs in the US? There are countless of questions that need to be addressed and answered in order to have a fair compensation system in this country. I think it could be possible to have a compensation system fair and equitable as long as the right people are including in the debate. But, it is going to be a long debate and until then the waiting list will keep growing.


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