Applied Health Economics and Health Policy

, Volume 17, Issue 1, pp 1–14 | Cite as

Ethically Acceptable Compensation for Living Donations of Organs, Tissues, and Cells: An Unexploited Potential?

  • Trine Tornøe PlatzEmail author
  • Nikolaj Siersbæk
  • Lars Peter Østerdal
Current Opinion


The number of living donations of human organs, tissues, and cells falls far short of the need. Market-like arrangements to increase donation rates have been proposed, but they are broadly considered unacceptable due to ethical concerns and are therefore not policy relevant in most countries. The purpose of this paper is to explore a different approach to increasing living donations, namely through the use of ethically acceptable compensation of donors. We review the compensation practices in Europe and find a lack of reimbursement of incurred costs and lack of compensation for non-monetary losses, which create disincentives for donation. We draw on a well-known philosophical theory to explain why donors are rarely fully compensated and why many existing proposals to raise donation rates are seen as controversial or even unethical. We present and discuss three categories of compensation with the potential to increase donation rates in an ethically acceptable way.



We thank Trine Kjær, Anne Sophie Oxholm, Peter Zweifel, two anonymous referees and the conference participants in Uppsala (NHESG 2015) and Odense (DSSØ 2015) for very useful feedback and comments. All views and errors are our own.

Author Contributions

All authors participated in the design of the study. NS gathered the data and prepared the first draft of the manuscript. All authors reviewed drafts. TTP prepared the final manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards


Financial support from the Independent Research Fund Denmark (Grant ID: DFF—6109-00132) is gratefully acknowledged.

Conflict of interest

Nikolaj Siersbæk, Trine Tornøe Platz and Lars Peter Østerdal declared no conflict of interest.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Trine Tornøe Platz
    • 1
    Email author
  • Nikolaj Siersbæk
    • 2
  • Lars Peter Østerdal
    • 1
  1. 1.Department of EconomicsCopenhagen Business SchoolFrederiksbergDenmark
  2. 2.Department of Business and EconomicsUniversity of Southern DenmarkOdenseDenmark

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