Organ Donation-Linked Case Provides Horrific Example of Perverse Incentive Effect

Earlier this year, I wrote about the perverse incentive created by the organ donation system in America whereby some in the medical industry had an economic interest in declaring individuals brain dead, possibly before all hope was lost, to make harvesting of still-living organs possible. While some health care professionals expressed to me that such a scenario was incredibly unlikely due to certain safeguards, allegations arising out of a recent court case, if true, would suggest that is unfortunately not the case. From the New York Post:

"The New York Organ Donor Network pressured hospital staffers to declare patients brain dead so their body parts could be harvested — and even hired “coaches” to train staffers how to be more persuasive, a bombshell lawsuit charged yesterday.

 

The federally funded nonprofit used a “quota” system, and leaned heavily on the next of kin to sign consent forms when patients were not registered as organ donors, the suit charged.

 

“They’re playing God,” said plaintiff Patrick McMahon, 50, an Air Force combat veteran and nurse practitioner who claims he was fired as a transplant coordinator after just four months for protesting the practice."

 

While these allegations have yet to be proven, and while it should be remembered that this is a wrongful termination suit, not a case investigating these allegations themselves, such a situation, if true, is absolutely mortifying.

 

While the current system is set up to avoid one perverse incentive - individuals and their family members are not allowed to profit on organ donations, avoiding scenarios where people would sell their organs purely for profit* - it has seemingly led to another as hospitals are allowed to make money on donated organs. And while medicine is often (and often rightly) noted as a noble profession, that does not mean that all who work in the profession are noble.

 

There are many facts which need to be uncovered in this case. However, it seems unfortunately likely that it is a perfect example of what can happen when the law puts the wrong incentives in the wrong hands.

 

 

*If push came to shove, I would probably argue that this isn't even necessarily a perverse incentive, but rather freedom of choice followed by suitable compensation. At the very least, families getting a check for their loved one's self-chosen sacrifice would seem far superior to the outcome described here.