Increasing health care supply, with organ donation tax credits

Organ donation might seem like a purely health care related issue, but ethicist Dr. Jurgen De Wispelaere of Montreal University is introducing the concept of monetary incentives to increase supply. Up to half of all organs that could be donated are lost because families aren't able to provide consent in time. The sometimes-long wait for an available organ is one of those rare health care moments where system inefficiency may not be to blame, but supply truly is limited. Loved ones may disagree about whether donation is the right choice, and even if a loved one has consented ahead of time, families may not be contacted in time, or may not consent because they feel the deceased may have changed his or her mind since agreeing to be an organ donor. Because it ranks among the most sensitive health care decisions families might be asked to make, doctors are generally unwilling to pressure them into consenting to donation.

To increase organ supply, and reduce wait times, Dr. De Wispelaere is proposing the creation of a "second consenter," essentially a health care proxy, or someone whom you trust to make the donation decision for you should it become necessary. Health care proxies are people you have designated to make decisions for you should you become incapacitated. But De Wispelaere is proposing an even more radical idea: Offering a tax credit to the second consenter, regardless of whether the organs are used or not. On the surface this may sound like a horrible idea, amounting to the selling of your loved-ones organs for profit. But tax credits are often used as a means of incentivizing socially beneficial actions, and we provide tax incentives for many behaviors that shouldn't be undertaken for monetary reasons, such as having children.

The proposal was presented this week in Montreal at Concordia University's Congress of the Humanities and Social Sciences. Dr. De Wispelaere is a visiting professor at the University of Montreal's ethics center known as CREUM. What's your opinion, genius, or crummy idea?