Donation benefit to organ donor families: a current debate.

Since initiation of the Uniform Anatomical Gift Act in 1968, organ donation in the USA has been based upon a voluntary system of organ donation, with all states, territories, and districts adopting some form of the act. Subsequent federal legislation such as the National Organ Transplant Act (NOTA) has continued to refine this system. The basis of these laws was to provide the legal framework and to express public policy regarding organ donation and transplantation. The basic structure created by these laws includes a system of voluntary "altruistic" donation without benefit to the donor or the donor's estate or family. Since initiation of NOTA, the number of patients waiting for an organ transplant, and those dying while waiting because of the inability of the current system to keep pace with demand, has grown exponentially. According to the United Network for Organ Sharing, the waiting list of patients eligible for an organ transplant has doubled every 4 to 5 years since 1986. With <6000 donations occurring after death (cadaveric organ donors), the current system is failing most of the almost 80,000 patients waiting for an organ transplant.

Since the early 1990s physicians and ethicists have recognized the deficiency of the current system and have explored other concepts for the organ donation structure in this country. The 2 most discussed alternative donation structures are presumed consent and financial incentives. The presumed consent model is an opt-out model, as opposed to the opt-in model currently in place in the USA. In other words, people …