People who sign up to be organ donors in the UK could be put on transplant priority lists or qualify their family for funeral cost cover under radical plans being considered to boost donor registration.
The proposals are included in a consultation paper published today by the Nuffield Council on Bioethics exploring ways to encourage organ and tissue donation.
About 8,000 patients are waiting for an organ in the UK, while sperm and eggs for fertility treatments are also in short supply, with 1,700 requests a year not being met.
Among the proposals from the Nuffield Council, a think-tank, are offering registered donors a place at the front of the queue should they need a new kidney, heart or other organ. The second would involve contributing to the funeral expenses of a dead donor’s relatives. Other options include personal “thank you” letters and certificates, souvenirs such as T-shirts and mugs, “presumed consent” systems and financial incentives are also explored.
The latter could encompass anything from modest expenses payments to the regulated selling of organs, eggs or sperm and a fully fledged free market.
There is a serious shortage of transplant organs, despite 16.5 million Britons having their names on the organ donor register.
The consultation is aimed at canvassing public opinion about what new approaches might and might not be acceptable. “We could try to increase the number of organ donors by providing stronger incentives, such as cash, paying funeral costs or priority for an organ in the future, but would this be ethical?” said Dame Marilyn Strathern, Professor of Social Anthropology at the University of Cambridge.
She said that in a sense, donation underpinned all medical treatments because cells and tissues were vital to research.
“Behind every treatment is someone who has been a donor and the question we want to ask is how far we should go to encourage more people to donate,” said Strathern.
At present, “presumed consent” — whereby organs are automatically made available after death unless objections are raised — is ruled out in the UK.
But Strathern said that this option was still up for future consideration along with the others.
She added that although financial incentives were controversial, they already existed in some areas. Women could get free IVF treatment from private clinics to encourage them to donate eggs, and healthy volunteers were paid significant amounts of money to act as human guinea pigs in trials of new medicines.
However, offering payments for organ and tissue donation might encourage people to “take risks or go against their beliefs in a way they would not have otherwise done”.
Israel has recently introduced a priority transplant waiting list for organ donors after a survey showed public support for the idea.
Keith Rigg, a transplant surgeon at Nottingham University Hospitals NHS Trust, said that such an approach would have to be thought about carefully in the UK. “There has to be fairness and equal access to all, as much as we’re able,” he said.
The public consultation will last until July 13 with a report containing recommendations due in the second half of next year.