Organ futures

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Organ futures is the short term used in academic proposals for futures contracts on organs from human cadavers. They are not legal anywhere at this time.

Contents

Organ futures would be used as an economic means to encourage organ donation by compensating transplant organ donors. Financial futures contracts are essentially agreements to pay a specified sum at a specified time.

The four key academic papers describing proposals for organ futures were published between the mid-1980s and mid-1990s.

Proposals

The explanations below focus on donation of cadaveric organs and ignore living donation.

Proposal by Schwindt, Vining 1986

Schwindt & Vining (1986) [1] suggest that the organ donor is paid at the time they agree to enter the life-time futures contract. The agreement is mutually revocable. They propose a single government broker as the buyer. Organ recipients would pay the supply price plus a load factor to the broker.

Proposal by Hansmann 1989

Hansmann (1989) [2] also suggests payment at the time of contract. Instead of direct payment, he proposes reductions to health insurance premiums as indirect incentive. The hospital where the organ donor dies is expected to verify a seller registry and determine the buyer. Buyers may be health insurance providers or specialist traders.

Proposal by Cohen 1989

Cohen (1989) [3] introduces a significant change to previous proposals by making payment conditional on organ extraction. Thus, the donor is not directly compensated during their lifetime. However, the payment is allocated to their estate or a designee. Hospitals are expected to notify buyers and preserve cadavers. They can be made liable for consequences of negligence. Buyers may be public or private organizations.

Proposal by Crespi 1994

Crespi (1994) [4] aims to integrate what he deems the most useful aspects of previous models into his own. Payment would be either guaranteed upon death or dependent on organ extraction. The money would go to the seller's estate; rights would not be assignable, and creditors would not have any claim on it. Hospitals are expected to notify the buyer, preserve the body and be prepared to harvest the organs if required. Any legally competent person can be a buyer and assign their rights freely.

Current status

Currently, organ futures are legally unfeasible because most countries follow international guidance that requires financial neutrality from the donor. [5] [6]

Related Research Articles

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Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.

<span class="mw-page-title-main">Organ transplantation</span> Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

<span class="mw-page-title-main">Futures contract</span> Standard forward contract

In finance, a futures contract is a standardized legal contract to buy or sell something at a predetermined price for delivery at a specified time in the future, between parties not yet known to each other. The asset transacted is usually a commodity or financial instrument. The predetermined price of the contract is known as the forward price. The specified time in the future when delivery and payment occur is known as the delivery date. Because it derives its value from the value of the underlying asset, a futures contract is a derivative.

Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).

<span class="mw-page-title-main">Kidney transplantation</span> Medical procedure

Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.

<span class="mw-page-title-main">Body donation</span> Gifts of bodies for research and education

Body donation, anatomical donation, or body bequest is the donation of a whole body after death for research and education. Donated bodies are mostly used for medical education and research. They are used for gross anatomy, surgical anatomy and for furthering medical education. For years, only medical schools accepted bodies for donation, but now private programs also accept donors. Depending on the program's need for body donation, some programs accept donors with different specifications.

A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education and allograft transplantation. A tissue bank may also refer to a location where biomedical tissue is stored under cryogenic conditions and is generally used in a more clinical sense.

Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.

Certain fundamental Jewish law questions arise in issues of organ donation. Donation of an organ from a living person to save another's life, where the donor's health will not appreciably suffer, is permitted and encouraged in Jewish law. Donation of an organ from a dead person is equally permitted for the same purpose: to save a life. This simple statement of the issue belies, however, the complexity of defining death in Jewish law. Thus, although there are side issues regarding mutilation of the body etc., the primary issue that prevents organ donation from the dead amongst Jews, in many cases, is the definition of death, simply because to take a life-sustaining organ from a person who was still alive would be murder.

<span class="mw-page-title-main">National Organ Transplant Act of 1984</span>

The National Organ Transplant Act (NOTA) of 1984 is an Act of the United States Congress which established the framework for the U.S. organ transplant system. The act clarified the property rights of human organs from deceased individuals and created a public-private partnership known as the Organ Procurement and Transplantation Network (OPTN), which was empowered to manage organ allocation on a national basis.

Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.

Organ transplantation in Israel has historically been low compared to other Western countries due to a common belief that organ donation is prohibited under Jewish law. This changed with the passage of new organ donation laws in 2008. If two patients have the same medical need, priority will now go to the patient who has signed an organ donor card, or whose family members have donated an organ. This policy was nicknamed don't give, don't get. The law also defines "brain death" as an indication of death for all legal purposes, including organ donation. Additionally the law provides financial reimbursement to living donors for medical expenses due to donation and lost time at work. Organ trafficking is explicitly banned. Health insurance plans can no longer reimburse patients who go abroad to receive transplants.

Many different major religious groups and denominations have varying views on organ donation of a deceased and live bodies, depending on their ideologies. Differing opinions can arise depending on if the death is categorized as brain death or cease of the heartbeat. It is important for doctors and health care providers to be knowledgeable about differentiating theological and cultural views on death and organ donations as nations are becoming more multicultural.

A beating heart cadaver is a body that is pronounced dead in all medical and legal definitions, connected to a medical ventilator, and retains cardio-pulmonary functions. This keeps the organs of the body, including the heart, functioning and alive. As a result, the period of time in which the organs may be used for transplantation is extended. The heart contains pacemaker cells that will cause it to continue beating even when a patient is brain-dead. Other organs in the body do not have this capability and need the brain to be functioning to send signals to the organs to carry out their functions. A beating heart cadaver requires a ventilator to provide oxygen to its blood, but the heart will continue to beat on its own even in the absence of brain activity. This allows organs to be preserved for a longer period of time in the case of a transplant or donation. A small number of cases in recent years indicate that it can also be implemented for a brain-dead pregnant woman to reach the full term of her pregnancy. There is an advantage to beating heart cadaver organ donation because doctors are able to see the vitals of the organs and tell if they are stable and functioning before transplanting to an ailing patient. This is not possible in a donation from someone pronounced dead.

<span class="mw-page-title-main">Kidney trade in Iran</span> Legal and government-regulated practice in Iran

The practice of selling one's kidney for profit in Iran is legal and regulated by the government. In any given year, it is estimated that 1400 Iranians sell one of their kidneys to a recipient who was previously unknown to them. Iran currently is the only country in the world that allows the sale of one's kidney for compensation ; consequently, the country does not have either a waiting list or a shortage of available organs.

<span class="mw-page-title-main">MOHAN Foundation</span>

MOHAN Foundation is a not-for-profit, registered non-government charity organisation in India that works in the field of deceased organ donation and transplantation. MOHAN is an acronym for Multi Organ Harvesting Aid Network. It has offices in Chennai, Hyderabad, Bengaluru, Delhi, Mumbai, Chandigarh, Nagpur, Jaipur and information centers at Kerala and Imphal.

Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.

A body broker is a firm or an individual that buys and sells cadavers or human body parts.

Human organ trafficking in Egypt, mainly practiced in Cairo and the Sinai Peninsula, include organ harvesting with induced consent, coercion, and outright theft. Egypt has become the largest hub of organ transplant in North Africa as one of the few countries that prohibited organ donation from deceased donors until 2010, with over 500 kidney transplant operations a year and the majority of these organs come from living donors. Organ sources in the trafficking process mainly come from vulnerable populations including domestic rural migrants, undocumented asylum seekers and informal labor. The emergence of cultural and religious increase in organ trade and transplant tourism contribute to the rocketing demand for organ trafficking market in Egypt. Human organ trafficking poses both physical and mental health consequences for victims. Although Egypt has been gradually updating legal frameworks to combat organ trafficking, the regulation has failed in reality protecting survivors and governing transplant professionals.

Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.

References

  1. Vining, Aidan R.; Schwindt, Richard (1986-06-01). "Proposal for a Future Delivery Market for Transplant Organs". Journal of Health Politics, Policy and Law. 11 (3): 483–500. doi:10.1215/03616878-11-3-483. ISSN   0361-6878.
  2. Hansmann, Henry (1989). "The Economics and Ethics of Markets for Human Organs". Journal of Health Politics, Policy and Law. 14 (1): 57–85. doi:10.1215/03616878-14-1-57. hdl:20.500.13051/4592.
  3. Cohen, Lloyd R. (1989). "Increasing the supply of transplant organs: the virtues of a futures market". The George Washington Law Review. 58 (1).
  4. Crespi, Gregory S. (1994). "Overcoming the Legal Obstacles to the Creation of a Futures Market in Bodily Organs". Ohio State Law Journal. 55 (1).
  5. "WHO | Transplantation of human cells, tissues and organs" (PDF). WHO. Retrieved 2019-08-17.
  6. "Organ Tourism, Organ Trafficking, news and what you need to know - declarationofistanbul.org" (PDF). www.declarationofistanbul.org. Retrieved 2019-08-17.