DIALYSIS PATIENT ATTITUDES TOWARD FINANCIAL INCENTIVES FOR KIDNEY DONATION

Offering financial incentives to families of brain-dead individuals ha s been proposed as a way to increase the supply of organs for transpla ntation. However, such incentives may lead to weakening of altruism an d exploitation of poor families, We investigated dialysis patient atti tudes toward the potential benefits and problems of incentives, Using a structured questionnaire, we interviewed 60 randomly selected patien ts at three chronic hemodialysis units, Subjects were asked to make an explicit trade-off between maintaining altruism versus increasing the supply of kidneys, They were also asked to make a trade-off between p rotecting poor families versus increasing the supply of kidneys, In ad dition, we asked subjects how they thought incentives would affect don ation by different types of families, We found that 37% of all subject s placed more emphasis on maintaining altruism, 42% placed more emphas is on increasing the supply of kidneys, and 22% placed an equal emphas is on maintaining altruism and on increasing the supply of kidneys, Si milarly, 35% of all subjects placed more emphasis on protecting poor f amilies, 33% placed more emphasis on increasing the supply of kidneys, and 32% placed an equal emphasis on protecting poor families and on i ncreasing the supply of kidneys. Subjects thought financial incentives would greatly increase donation by poor families while having little impact on rich families, In conclusion, even though dialysis patients are likely to benefit from increasing the supply of kidneys, many of t hem want to maintain altruism and protect poor families even if that m eans fewer kidneys, These concerns should be addressed in proposals to modify the transplant system. (C) 1997 by the National Kidney Foundat ion, Inc.