ORGAN DONATION: Life Insurance Incentive Bill Proposed

      To encourage more people to become organ donors, Rep. James Greenwood (R-PA) has proposed legislation that would establish a five-year, $125 million pilot program to offer life insurance to individuals who choose to donate their organs when they die, the Philadelphia Inquirer reports. Under the proposal the donor's beneficiaries would receive the insurance payments. Greenwood's measure stems from a campaign by his constituent, Eugene Epstein, who has spent more than three years and $50,000 of his own money to get lawmakers to push the legislation. Epstein's brother, a heart transplant patient, lived an additional 12 years after receiving a new heart. While some organ donation advocates applaud the effort to increase organ donation awareness, some are concerned that providing life insurance -- or any kind of financial incentive -- raises serious ethical questions. Howard Nathan, executive director of the organ-procurement organization Gift of Life, said, "This just isn't well thought out. There needs to be a lot more discussion about this type of proposal, by ethicists, philosophers and some experts in the field." Although he praised the provision that pays travel and living expenses for those who agree to live- donations, Nathan indicated that any financial incentive may be seen as the establishment of an "organ market." Brian Broznick, director of the Center for Organ Research and Education, said that any financial incentive-based program was "doomed to fail." Instead he advocated a "presumed consent" program, similar to those used in European countries, that automatically uses organs unless a person has officially declined to be an organ donor. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said, "This life insurance is a bad idea that won't work," particularly at a time when people are skeptical of the care they receive from the managed care industry. He said, "A $10,000 prize for their kidneys is not going to make that better." In addition, some contend that the measure violates a 1984 federal law that prohibits any "valuable consideration" of human organs. Pennsylvania adopted a law in 1994 that allows the state to reimburse an organ donor's family up to $300 for funeral expenses, but the legality of such payments remains an issue five years later. Health officials are expected to rule on that law next month. Greenwood argued that many people waiting for a transplant do not have time to wait for such lengthy discussions, saying "Five years of discussion will generate a lot of dead bodies, people waiting for transplant." He added, "I want to be sensitive to the ethical issues, but one of the things that I know is ethical is to stop letting people die prematurely" (La Hay, 11/22).