Dynamist Blog

The National Kidney Foundation's Bad Math and Guilty Conscience

USA Today has endorsed (very) limited financial incentives for organ donation. The editorial concludes, "More than 6,000 patients die each year while on waiting lists. Demanding patience, when the price of delay is death, is no answer. It's time to try new ideas."

The National Kidney Foundation, represented by its chairman, Charles B. Fruit, takes the "just let them die" view. Fruit's article includes this misleading little math exercise:

Payment stands as an affront to those families that have already donated organs of loved ones out of charity. There is evidence to suggest it might prove similarly offensive to future donors. In 2005, the National Survey of Organ Donation found that 10.8% of those polled would be less likely to grant consent for the organs of a deceased family member to be used for transplant if they were offered payment; 68% said they would be neither more nor less likely to grant consent. Thus, there is little data to show that financial incentives would increase donation rates.

So, to round the figures a bit, 70 percent would be unaffected, and 11 percent would be less likely to grant consent. What happened to the other 19 percent? They were, ahem, conveniently left out--because they would be more likely to grant consent. That's what's called a net increase.

The argument that paying organ donors is "an affront" to unpaid donors is disgusting. Are unpaid donors giving organs to save lives or just to make themselves feel morally superior? Even in the latter case, they shouldn't care if other people get paid. They can still hold their noses in the air. Underlying this argument, which the NKF loves, seems to be a nagging sense of guilt: The current system takes something valuable without offering anything in return. It is, in other words, highly exploitative. If that exploitation suddenly goes away, the people who've been exploited in the past will realize they've been used and be mad. Personally, I don't think that's terribly likely, because most of today's donors are, in fact, motivated by sympathy for recipients. But the fact that defenders of the system keep making the argument suggests they know they're doing something a little shady.

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