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      Incentives and organ donation: what’s (really) legal in Canada?

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          Abstract

          Purpose of review

          To date, there has been little analysis of the degree to which emerging incentive initiatives are permissible under Canadian law. The purpose of this review is to examine the relevant law – including legislation and case law – in order to clarify the legality of existing proposed incentive schemes.

          Sources of information

          Legislation and case law.

          Findings

          Organ donation is governed by provincial legislation that, in general, bans the exchange of any “benefit” or any form of “valuable consideration” in return for an organ. As such, these laws are tremendously restrictive and could have significant implications for emerging and proposed procurement policy.

          Implications

          Given the need for innovative, ethically appropriate policies to increase donation rates, we suggest that the time is right to rethink the potentially restrictive nature of Canada’s organ donation laws.

          Résumé

          But de l’article

          À ce jour, il y a eu peu d’analyse légale des incitatifs pour le don d’organes au Canada. Le but de cet article est d’examiner les lois relatives au don d’organes afin de déterminer la légalité de différents incitatifs.

          Sources d’informations

          Les textes de loi et la jurisprudence.

          Résultats

          Le don d’organes relève de compétences provinciales, lesquelles, de manière générale, interdisent au donneur de recevoir tout avantage ou compensation en échange de son organe. Ces lois sont extrêmement restrictives et peuvent donc avoir des conséquences significatives sur de futures politiques de don et de prélèvement d’organes. Ceci étant dit, il est cependant difficile d’émettre des prédictions définitives sur les interprétations possibles de la loi par les tribunaux.

          Implications

          Compte tenu la nécessité d’augmenter le don d’organes via des politiques innovatrices et éthiquement acceptables, nous croyons qu’il est opportun de revoir les lois canadiennes sur le don d’organes afin d’éliminer les aspects restrictifs de ces dernières.

          Related collections

          Most cited references14

          • Record: found
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          • Article: not found

          Ethical incentives--not payment--for organ donation.

            • Record: found
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            Attitudes toward strategies to increase organ donation: views of the general public and health professionals.

            The acceptability of financial incentives for organ donation is contentious. This study sought to determine (1) the acceptability of expense reimbursement or financial incentives by the general public, health professionals involved with organ donation and transplantation, and those with or affected by kidney disease and (2) for the public, whether financial incentives would alter their willingness to consider donation. Web-based survey administered to members of the Canadian public, health professionals, and people with or affected by kidney disease asking questions regarding acceptability of strategies to increase living and deceased kidney donation and willingness to donate a kidney under various financial incentives. Responses were collected from 2004 members of the Canadian public October 11-18, 2011; responses from health professionals (n=339) and people with or affected by kidney disease (n=268) were collected during a 4-week period commencing October 11, 2011. Acceptability of one or more financial incentives to increase deceased and living donation was noted in >70% and 40% of all groups, respectively. Support for monetary payment for living donors was 45%, 14%, and 27% for the public, health professionals, and people with or affected by kidney disease, respectively. Overall, reimbursement of funeral expenses for deceased donors and a tax break for living donors were the most acceptable. The general public views regulated financial incentives for living and deceased donation to be acceptable. Future research needs to examine the impact of financial incentives on rates of deceased and living donors.
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              Payment for egg donation and surrogacy.

              This article examines the ethics of egg donation. It begins by looking at objections to noncommercial gamete donation, and then takes up criticism of commercial egg donation. After discussing arguments based on concern for offspring, inequality, commodification, exploitation of donors, and threats to the family, I conclude that some payment to donors is ethically acceptable. Donors should not be paid for their eggs, but rather they should be compensated for the burdens of egg retrieval. Making the distinction between compensation for burdens and payment for a product has the advantages of limiting payment, not distinguishing between donors on the basis of their traits, and ensuring that donors are paid regardless of the number or quality of eggs retrieved.

                Author and article information

                Contributors
                caulfield@ualberta.ca
                erin.nelson@ualberta.ca
                goldfeld@ualberta.ca
                swk@ualberta.ca
                Journal
                Can J Kidney Health Dis
                Can J Kidney Health Dis
                Canadian Journal of Kidney Health and Disease
                BioMed Central (London )
                2054-3581
                29 May 2014
                29 May 2014
                2014
                : 1
                : 7
                Affiliations
                [ ]Faculty of Law and School of Public Health, Health Law Institute, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada
                [ ]School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 – 87 Avenue, Edmonton, AB T6G 1C9 Canada
                [ ]Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada
                Article
                8
                10.1186/2054-3581-1-7
                4349723
                25780602
                03bc03bb-ada8-44dd-8165-e7dfd72390c7
                © Caulfield et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 March 2014
                : 9 May 2014
                Categories
                Review
                Custom metadata
                © BioMed Central Ltd 2014

                organ donation,legal,ethics,incentives
                organ donation, legal, ethics, incentives

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