intro paragraph

At the beginning of my research into organ donation, I truly felt that financial compensation would be the best way to increase donation rates. In 1998 my father received a life saving liver transplant. The wait for a donor liver was to say the least very excruciating. My father was in a comma for six weeks prior to that wonderful day when through some other families grief we were able to see our father receive the life saving gift. The doctors told us that it had come down to a matter of days if not hours that separated my father from one who was saved to one who died while waiting for a needed transplant. This is why I feel that there has to be something that can be done to increase organ donation rates. Financial compensation seemed to make sense for me because I always felt that the family that so selfishly offered the greatest gift to my father should have benefited in some way. As I have looked at this idea more closely I can see that besides the moral dilemma it offers, there are several other issues that are of concern. My research has taken a new approach of deciding all different ways that need to be considered when it comes to increasing organ donation.

William DeJong; Jessica Drachman; Steven L. Gortmaker; Carol Beasley; Michael J. Evanisko. Options for Increasing Organ Donation: The Potential Role of Financial Incentives, Standardized Hospital Procedures, and Public Education to Promote Family Discussion.The Milbank Quarterly, Vol. 73, No. 3 (1995), pp. 463-479.

Organ donation rates are not keeping up with the need. People who need these life saving operations are dying everyday not because there is a lack of potential donors but because there are not enough people who say yes to organ donation. The Authors of this article look at various ways of increasing donation rates. The discuss financial compensation but ultimately come to the conclusion that it may not help and could possibly hurt organ donation. They do agree that more needs to be done in the way of research into how financial compensation might work and say that it will take time to determine it's effects. Time is what so many people do not have and so the authors look more heavily into what can be done now to increase organ donation rates. Education seems to be the key. First, health care professionals need to be better equipped to deal with identifying potential donors and then better protocols need to be implemented into how families are approached. Second, the general public needs to be made aware that discussing your desire to be an organ donor with family is vital in helping them make the decision if they are ever faced with it.
This article helped me decide that I needed a new avenue for my paper. Instead of focusing solely on financial compensation for organ donation I have decided to make the focus of my paper "How can we increase organ donation rates?" Financial compensation can be one of the ideas, but there are so many different ways that this subject can be approached. I understand the ideas proposed by the authors and agree that while many people may sign an organ donation card it is still the discussion with your family that is going to help in the end since your family has the final say into whether your organs are donated or not.

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Goodwinn, Michele(2006). Black Markets:Supply and demand of body parts. New York. Cambridge University Press.

I decided to read this book because I previously read an essay about the book. In her book, Goodwinn relates organ donation with slavery. One reason she makes this comparision is because there are many African Americans who are currently on the list to receive organs, but that few African Americans are organ donors. Her reasons for making the comparison to slavery is that body parts can be considered spare parts that can be bought and sold just like people were during the time of slavery. The title of her book also does double duty because she makes many references to the illegal sale of organs in the black market. Goodwinn goes through all the legalities of organ donation, mentions why our current system is not working and that we cannot rely on the altruistic nature of the human race to increase organ donation. She suggests that Financial compensation could be the answer and gives insight into why selling organs would not be comparable to slavery.
This book was a little bit confusing to me because I wasn't exactly sure where she was going with the slavery thing except to say that selling body parts could compare to selling slaves, but then she turns around and says they are not really the same and that the African American community should not be offended. She does talk a lot about how minorities are at greater risks to need an organ, but have far lesser donation rates. I am left wondering if this has to do with the fact that many more minorities are under insured or have no insurance at all, the author suggests that minorities lack the education needed to fully understand the procurement system and that age old ideals of racism are still in place when it comes to the attitudes of giving someone of another race the opportunity to live. The book gave me further insight into the black market of organ selling and that it really does exist as a serious problem. Perhaps regulation would solve this as the author believes or maybe it would put it further under ground which could result in less than substandard practices of obtaining these organs. The ideas in this book were interesting to me and I will use several of the authors ideas in my research.

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Hazony, O. (1993). Increasing the supply of cadaver organs for transplantation: Recognizing that the real problem is... Health Matrix: Journal of Law Medicine, 3(1), 219.

Hazony's psychological approach to organ donation is a unique approach to the subject. He mentions all the obvious reasons for donation rates being low starting from the legality of organ procurement to the public's general mistrust of the medical institution. He discusses several of the ideas that have been put out there to increase donation rates; campaigns that make an appeal to being an altruistic/selfless person, presumed consent laws, and offering financial compensation to name a few. He offers ideas as to why these ideas are beneficial and how they are flawed. Ultimately, Hazony suggests, none of these ideas will increase donation rates because we fail to recognize what is truly at the root of the problem, psychology. From the medical personnel's uneasy feelings about approaching a family about donating organs to the families own grieving process, it's all psychological undermining that keep organs from being donated. The author recommends that we take a new approach to increasing organ donation by educating medical staff at hospitals and educating the general public about how important organ donation is before they are faced with the choice in a difficult time such as the death of a loved one.
I agree that this is one of the main problems faced with organ donation. Most people believe that given the opportunity to be an organ donor in the event of their death then that would be the choice made. In reality not enough organs are being donated, and a lot of this has to do with the emotions of all parties involved. This article also had some information in it that I hadn't thought of before, like how offering financial compensation could possible decrease organ donation rates because people would feel less motivated because it would no longer be a selfless gift. Sounds a little backwards but the author offers great insight into how this could come about. I found this article very helpful in my research process, and it will be used to branch out into new avenues of research for my paper.

Bard, J. (2008). Black Markets: The Supply and Demand of Body Parts. Journal of Health Politics, Policy & Law, 33(1), 117-133.

This article was a essay review of a Book called Black Market. Bard discusses the main ideas of the book which are; offering financial compensation for organ donation, and how doing so is like slavery because it sends an impression that the body is something that can be bought and sold. In Bard's article he discusses and mostly disagrees with the ideas that are presented in the book. A few key points I found interesting are that Bard believes that if we were to go with an altruistic/market approach to organ donation, then eventually the altruistic side would die out,thus making it all that much harder for the average person to obtain an organ transplant. He also discusses how consent from family members is a big issue, and is the more important issue that needs to be addressed. In order to increase organ donation rates we should be looking at why individuals choose not to donate rather than offering them money to do so. He mentioned several studies that suggest that financial compensation would not alter the choice, these studies that he references contradict previous studies that I have researched. I will need to look into the studies he quotes and compare them with my previous research. He suggested that some of the reasons that individuals choose not to donate are because of the general public misunderstanding of how organ donation works, and the public's mistrust in the health care system.
Once again I have found an article that gives me new insight into subjects that I would like to further research. I plan on checking out the book that his essay is about. I don't really know if I believe that offering financial compensation for organ donation would be considered a form of slavery but I am interested in seeing how the author of the book represents her opinion. I had never thought about how an altruistic/market system would affect the people who donate unselfishly, but I am left to wonder if this would be the case. This article only mentions preplanned arrangements were individuals benefit form selling their organs, and I am focusing more on compensation in the form of medical and funeral arrangements. I am left with so many more questions that I will need to further research.

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Koch,Tom.(2002) Scarce Goods: Justice,Fairness, and Organ Transplantation.

This book focuses on organ transplantation and the ethical dilemmas that surround it. The author is a bioethicist and journalist and found the topic of how organs are distributed to be very interesting. He notes that there are so many variables that are considered when allocating organs. Ethics play an important role, but the author himself feels that the way our current system works is somewhat unethical. He compares the current system to a lifeboat, where people have to choose who lives or dies. One comment he makes struck me profoundly, he says, "We sculpt a world in which altruism and benevolence become words used to seduce the poor into supporting the rich. With best intentions we ensure the continuation of scarcity that defines the limits of the lifeboat that carries us all." While no one wants to think about it but the author suggests that those that are of greater financial means are going to benefit from the current transplant system. He suggests that the current system is broken and just like seats in a lifeboat, it never can be quite fair how they are distributed.
I liked this book because the author was honest in the way he viewed things and was not afraid to speak out. I would like to be able to do the same as I write my paper. It makes me wonder if the stories you hear about wealthy people being able to buy their way to the top of the transplant lists are true. I agree that the current system is broken in a sense because it does not provide for every person who is waiting for a transplant, and people die every day waiting. The author never mentions financial compensation as a solution, but I believe he would view this as one more way for the rich to gain better access to organ transplants. This book gave me insight into my research topic that I hadn't considered before and therefore it will be beneficial to my paper.

Sque, Magi, et al. "Why relatives do not donate organs for transplants: ‘sacrifice’ or ‘gift of life’?." Journal of Advanced Nursing 61.2 (2008): 134-144.Print.

When a family faces the death of a loved one under circumstances that would allow for organ donation, a choice has to be made. The authors researched why it is that families choose not to donate by talking to the families that made this decision. They found that the participants main reason for not donating organs was best describes as ”protecting the dead body”. At the time they were approached about donation the participants still viewed their deceased family members body as a person. Thinking of them being cut up was unimaginable. One thing that surprised the authors was the fact that most of these families had pro-donation beliefs, but failed to act on those feelings. Some participants reported feeling regrets about their decision. I think that this article will help me answer the questions I have about why families would choose not to donate. I believe that, given the authors surprise findings of most families having pro-donation beliefs, this could help me explore if financial compensation would have helped them to overcome the feelings which prevented them from donating.

“Paying for Organs: Who Benefits?”Hospital and Health Networks 81.7 (2007):150. Print.

This was a small box article that very briefly gave some statistics. The first was that only one in four people have informed family members that they would want to donate. The next statistic was how many people are waiting for a kidney donation: 95,000 people. The article then mentions how people have begun to throw around different ideas as to how we can increase donation, including offering financial compensation. The public seems to be split: 49 percent in favor and 51 percent against. Then the article provided three pie graphs on the issue of “Providing financial compensation will...” make it easier for people, regardless of income, to get a needed transplant--46 percent agreed; make it easier only for wealthy people to get a transplant—67 percent agreed; encourage poor people to donate organs as a means of making money-- 71 percent agreed. This article wasn't exactly what I was looking for and I am unsure if I will use it but the statistics could be helpful in forming a strong argument regarding how people view the ethical problems that arise from offering financial compensation.

Brams, Marvin "Transplantable Human Organs: Should Their Sale Be Authorized by State Statutes?." American Journal of Law & Medicine 3.2 (1977): 183. Print.

Brams has some very strong points about changing the way organ donations are made by implementing a combined altruistic-market system. Bram first points out that as noble of an idea that we view organ donation the fact is most choose not to do so. He suggests that economically, human behavior would increase the number of donations if an incentive were offered. The point is made that people view compensation for organs as illegal when in fact the Uniform Anatomical Gift Act does not forbid organ sale. The need for living donors and the risks that go along with it would be greatly reduced. Brams makes a very strong statement that it is not as unethical to sell organs as most people think; he uses the idea that people say it is an inferior means of obtaining organs but he views it as ethically superior if it offers more people the chance to live. This article gave me a lot of valuable information. I believe his ideas are on the right track. I will use the information in this paper to help me provide the economics of financial compensation.

Joralemon, Donald, and Phil Cox "Body Values." Hastings Center Report 33.1 (2003): 27-33. Print.

Joralemon and Cox have the opinion that the body is not separate from the perception of self and thus is not property to be divided up and sold at a cost. They liken the selling of organs to that of a prostitute selling part of her self for monetary gain. Joralemon and Cox mention the already illegal sale of organs in third world countries where people sell their organs as a means of providing their families with shelter and food. They say this would get even worse and cause many people to be put at risk if it were made legal to sell your organs. Joralemon and Cox then challenge the economics: were would the money come from and wouldn't we be better off as a society if that money were put into the healthcare system for other causes? They mention that a high percent of recipients of transplants die within several years any way, so was that money well spent? It was interesting to look at the opposite view of my own beliefs. Joralemon and Cox obviously have very strong opinions against financial compensation. Comparing organ donation to prostitution was offensive to me. This article will be beneficial to me in defending my own beliefs by looking at the opposition.

Evans, John H. "Commodifying Life? A Pilot Study of Opinions Regarding Financial Incentives for Organ Donation." Journal of Health Politics, Policy & Law 28.6 (2003): 1003-1032. Print.

Evans used several hypothetical scenarios that he presented to his subjects to find out how they would respond to each case, and whether or not financial compensation would alter their response. Evans mentions several ways that this compensation could be paid out including death benefits and vouchers for unpaid medical costs. The results were that most respondents would be persuaded to donate if they were offered compensation, and that the higher the amount the more likely they would agree. The way that Evans presented hypothetical scenarios to the subjects was in my opinion a great way to get responses. Merely asking people what they might do in the event that at a future time they may have to make the decision of donating or not would have not yielded many responses. I really liked this article since it was exactly the type of response that I was looking for. Having the information that Evans provides in his article will help me to persuade my readers that others believe financial compensation is a good idea. I will be using this paper as the starting point for my thesis.