Organ Transplant Regulation
VII. Key Issues: Regulation & Reform >> B. Health Care Regulation >> Health Facilities Regulation >> Organ Transplant Regulation (last updated 1.17.15)
Overview
To ensure an equitable distribution of organs for transplant, Congress established a regionalized system of organ distribution in 1984. However, despite this system, by the mid-1990’s, more than 4,000 potential transplant patients still died each year waiting for organs. With the objective of increasing cadaveric organ transplants, further rules were developed to ensure that families of dying patients were better informed about the potential benefits of organ donations. The rules regarding organ transplants and notification of potential donor families cover all hospitals participating in Medicare, nearly 4,900 short-term general hospitals nationwide. The Duke Center for Health Policy and Inequalities Research has developed a draft working paper assessing the costs and benefits of organ transplant regulation, including hospital provision of transplant-related data and the organ transplant sales ban (pdf).
Analysis
Julio J. Elias, Nicola Lacetera, Mario Macis. Sacred Values? The Effect of Information on Attitudes Toward Payments for Human Organs. Many economic transactions are prohibited—even in the absence of health or safety concerns—because of ethical concerns that make these exchanges perceived as repugnant if conducted through a market. Establishing a system of payments for human organs is a particularly relevant example given its implications for public health; in almost all countries, these payments are prohibited because they are considered morally unacceptable—a prohibition that societies seem to accept despite the long waitlists and high death rates for people needing a transplant. We investigate how deeply rooted these attitudes are and, in particular, whether providing information on how a price mechanisms can help alleviate the organ shortage would change people’s opinions about the legalization of these transactions. We conducted a survey experiment with 3,417 subjects in the US and found that providing information did significantly increase support for payments for organs from a baseline of 52% to 72%, and this increase applied to most of the relevant subgroups of the analyzed sample. Additional analyses on the support for other morally controversial activities show that attitude changes in response to information depend on the type of activity under consideration and interactions with other beliefs.