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Economist Suggests Using Tax System to Solve Shortage of Human Organs

Originally Published 23 February 2001
Society faces a huge shortage of organs - yet in principle there are more than enough natural, though tragically untimely, deaths to provide sufficient donors for all of our citizens who need them. University of Warwick Economist Professor Andrew Oswald believes the UK can solve this problem through a tax incentive. Professor Oswald says:

"Paradoxically, economic progress is worsening our difficulties. First, seatbelts and improved safety have decreased the number of organ donors. Second, medical advances in preservation techniques and immune-system suppressants has raised the usefulness of donations, so the effective shortage has gone up - 90% of US kidney transplant patients are alive and well a year from the operation. Even for heart transplant operations, the US figure is 85% after a year. Third, people in the west are living longer, so demand for healthy organs is rising.

This is a tricky problem but we could solve it in the UK by use of a tax-incentive solution such as a small lump sum reduction on a person's income tax bill if they agree to be a potential future donor. The size of the incentive would not have to be big. The tax break would itself be good advertising. Human altruism and the tax incentive would do the rest.

If the tax reduction for a person were ?10 pounds a year the cost to the UK would be ?200 million but there is a good chance that the tax incentive and publicity would double the stock of officially registered potential organ donors from its current 8 million people. If so, it would be feasible to increase the number of transplants by around 2000 a year.

Some people may view tax breaks for potential organ donation as morally objectionable but the alternatives, too, are unattractive. Most people feel that to allow the buying and selling of organs would be wrong. The main alternative, so-called compulsory opt-in, is unappealing. This is the idea that all citizens should be presumed, unless they have signed a waiver, to have agreed to allow their organs to be used in the event of, for example, their death in a car crash. Yet 'automatic opt-in' is unreasonable and undemocratic.

Yet remember the need. In the UK approximately 6000 people are waiting at any one time for transplants of major organs - especially kidney, pancreas, heart, lung, liver. Only 3000 transplants are done each year in the UK. Thousands die needlessly. In the US, at any time 70,000 men and women are waiting for a transplant of a major body organ. But the annual number of transplants in the US is only about 20,000. The National Kidney Foundation of the USA estimates that 50 Americans die every week for want of a kidney donor alone.

Voluntary sign-up donation mechanisms are not as successful as required - probably because people prefer not to think about death. Here we have an area where governments must step in. In this sphere of life, things cannot simply be left to market forces."

For further information please contact:

Professor Andrew Oswald, Professor of Economics
University of Warwick Tel: 024 76 523510 (Office),
01367 860005 (Home)
email (office) (home)