The Organ Donation Dilemma: Ethics, Economics, and Life-Saving Solutions

I took part in this debate last week at Johns Hopkins, as part of their Business of Health Initiative. I’ll be back with some follow up thoughts on the day’s discussion and related issues, but for now am providing the video, for those interested.

More than 100,000 Americans are waiting for an organ transplant. About 90,000 of them need a kidney. Thousands die each year before one becomes available. Does that gap call for carefully designed financial incentives, or would payment undermine the donation system we have?

In this Conversations on the Business of Health webinar, four leading voices in transplant medicine, bioethics, law, and advocacy debate the End Kidney Deaths Act, a bipartisan bill that would offer a refundable $50,000 tax credit, paid over five years, to non-directed living kidney donors. The panel takes up what the empirical evidence actually shows about paid donation, what “making donors whole” should mean, how to think about the line between reimbursement and incentive, and whether a 10-year pilot is the right way to test the question.

CHAPTERS
00:00 Welcome and series introduction
01:02 Framing the debate
03:53 Meet the panelists
06:10 What’s working, what isn’t: opening diagnostic
18:48 Inside the End Kidney Deaths Act
25:01 First reactions: crowding out, institutional design, and the wedge issue
41:00 Bioethics principles and the cost of the status quo
46:16 Common ground, safeguards, and why $50,000?
55:36 Audience Q&A: what role for public opinion?
59:13 Closing remarks

PANELISTS
Alexander Capron, University Professor Emeritus, USC Gould School of Law
Gabriel Danovitch, MD, Distinguished Professor of Medicine, David Geffen School of Medicine at UCLA
Kimberly Krawiec, Charles O. Gregory Professor of Law, University of Virginia
Elaine Perlman, President, Coalition to Modify NOTA; Executive Director, Waitlist Zero

MODERATOR
Mario Macis, PhD, Professor, Johns Hopkins Carey Business School

This webinar is part of the Conversations on the Business of Health series hosted by the Hopkins Business of Health Initiative (HBHI) at Johns Hopkins University. These monthly webinars convene leaders in health economics, health policy, and academia to explore emerging questions about Medicare payment reform, market competition, and the business of health care in America.