Alireza Bagheri, Compensated Kidney Donation: An Ethical Review of the Iranian Model.

Alireza Bagheri, Compensated Kidney Donation: An Ethical Review of the Iranian Model, 16 KENNEDY INST. ETHICS J. 269 (2006).

Iran has had a program of compensated kidney donation from living unrelated (LUR) donors since 1997. The aim of the program was to address the increasing demand for kidney transplantation in a morally sound manner. The program successfully increased the number of kidneys available for transplantation. The article presents a critical review of the program and its ethical status. Denying organ donors legitimate compensation because of the understandable fear of an organ trade is not morally justifiable, and the Iranian model of compensated LUR kidney donation offers substantial benefits that overcome these concerns. Despite its benefits, the program lacks secure measures to prevent the risk of a direct monetary relationship between donors and recipients, and it must be revised in order to be morally justifiable.

The critical disparity between supply and demand in organ transplantation, and the related loss of life, has been documented worldwide. Many commentators call for the urgent consideration of any option that would fill the gap. There have been many proposals to address the desperate need for organs by expanding the donor pool, such as providing financial and nonfinancial incentives, providing compensation for organ donors, establishing exchange programs, giving people the right to make decisions about selling a body part, and adopting necessary legislation and revision of organ transplantation laws based on current socio-cultural changes. Since the application of transplant technology began, fears about an unethical organ trade, exploitation, and immoral conduct have forced health policymakers and many ethicists to oppose any kind of compensation...