AMA Votes to Support Study of Financial Incentives for Organ Donation

The AMA's House of Delegates voted at its annual meeting to adopt the measure against the recommendation of one of its own committees. Congress banned such financial incentives in 1984.

Delegates appeared to be swayed by Dr. Phil Berry Jr. of Dallas, who said he would be dead if he had not received a liver transplant 16 years ago.

"In a perfect world, altruism would be all that would be needed" to encourage more organ donation, Berry said. "The fact is that we're losing the battle."

The AMA itself will not conduct pilot studies, saying they should be conducted by organ procurement organizations and transplant centers. But it said it would help guide the research so that it meets ethical and scientific standards.

"The AMA is not endorsing the use of financial incentives to increase organ donation; it is simply recommending that this concept be studied," said Dr. Frank Riddick, chairman of the AMA's Council on Ethical and Judicial Affairs. "Financial incentives should be of modest value."

Exactly what a pilot study might consist of hasn't been decided. One idea discussed by AMA delegates would be to see if a payment of $500 to $1,000 toward funeral expenses incurred by the donor family would increase donations.

The studies would only look at payments to the families or estates of cadaver donors. AMA policy opposes payment of financial incentives to living donors.

An advisory committee to Health and Human Services Secretary Tommy Thompson, the Advisory Committee on Organ Transplantation (ACOT), also has been looking at ways to alleviate the organ shortage, including whether payment is a good idea.

"It is something that needs to be looked at in a pilot study," said Dr. Michael Williams of Johns Hopkins University, who is also a member of ACOT. "Then we could take those results to see if there should be any change in the law or public policy."

Williams said he personally favors undertaking the trial, even though he believe financial incentives not only will not increase donations, but may actually have an adverse effect.

"But, if we don't do the study and get data we will never know the answer," he added.

The debate at the AMA annual meeting picked up on a heated discussion that took place at the organization's winter meeting six months ago, when its Council on Ethical and Judicial Affairs (CEJA) proposed such a pilot study.

The debate over ways to increase organ donation is driven by the continued growth of transplant waiting lists, with more than 80,000 Americans now waiting for life-saving organs to become available.