SYSTEMS OF DONOR TRANSFER

The development of medical knowledge has resulted in a demand in socie ty for donor organs, but the recruitment of donor organs for transplan tation is difficult. This paper aims to provide some general insights into the complex interaction processes involved. A laissez-faire polic y, in which market forces are relied on, is not acceptable from an eth ical and legal point of view in most western European countries. Espec ially at the demand side of the exchange of donor organs, commercialis m is to be opposed. We judge the use of commercial incentives at the s upply side less unacceptable in theory but not feasible in western Eur opean countries. Since market forces are deemed unacceptable as instru ments for coordinating demand and supply of donor organs, donor procur ement has to be considered as a collective good, and therefore governm ents are faced with the responsibility of making sure that alternative interaction and distribution mechanisms function. The role of organ p rocurement agencies (OPAs) in societal interaction concerning postmort em organ donation is described using a two-dimensional conceptualisati on scheme. Medical aspects of living organ donation are described. An international comparative description of legal systems to regulate liv ing organ donation in western European countries completes this survey .