Living organ donors shouldn’t have to pay for their altruism

American Medical News

A new AMA policy calls for legal guarantees protecting live organ donors from out-of-pocket expenses and future discrimination.

There was a striking reminder in recent news concerning supply, demand and the resulting grim proximity of money to organ transplantation.

A federal judge in New Jersey sentenced a New York City man to 2½ years in prison for being at the center of an international organ-selling scheme that set a price tag of $120,000 per kidney (the living “donors” got only a fraction of that amount). It is thought to be the first prosecution in the United States of this type of criminal operation that, sadly, is well entrenched and even more unscrupulous in other parts of the world.

Yet even in the reverse image of that gruesome scenario — a truly voluntary living donor working with a transplant program that would have caught any impropriety — there is a troubling financial element at play.

Donors in this country may face costs beyond the expected expense of the operation and related medical care. They may be left to pay the bills for travel, meals, accommodations, lost income and other expenses, including medical costs if their own health is compromised because of the operations. They also take on at least some risk of future discrimination from employers or insurers.

At the low end, the added expense of donating may be a few hundred dollars, but the range can rise to about $20,000. Federal law strictly prohibits the selling of any organs, but donors may be reimbursed legally for their expenses. Still, that hardly is a guarantee.

Low-income donors and recipients can get financial aid through the National Living Donor Assistance Center, which is federally funded. More affluent recipients also can choose to pay donors’ expenses directly. But there remain donors who nevertheless have reported being forced to bear a financial price for their good deeds.

That’s why the American Medical Association House of Delegates voiced its support in June for an important proposition: Living donors should not have to fear negative financial consequences for giving the gift of life. The recommendations call on governments, state and federal, to help remove financial barriers to living donation. That includes provisions for mitigating out-of-pocket expenses, ensuring access to health insurance, and guaranteeing freedom from discrimination in employment and in obtaining life insurance.
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