Statement of Task

        In response to a request from the Department of Health and Human Services, the Institute of Medicine (IOM) will convene an expert committee to examine issues surrounding organ donation and to evaluate the ethical implications of proposals to increase deceased organ donation.  The purpose of this study is to provide advice to the Secretary of Health and Human Services in support of legislative requirements of the Organ Donation and Recovery Improvement Act. The committee will examine a broad range of proposals to identify ethical implications; evaluate their impact on donation efforts, public perception, and, especially, on disadvantaged or disproportionately affected groups; and make recommendations about how proposals can be effectively implemented to reduce ethical problems. 

Specifically, the committee will:

   Conduct a review of proposals and efforts to increase organ donation including but not limited to educational activities, media campaigns, financial incentives, presumed consent laws, and presumptive consent approaches. Various kidney exchange arrangements, including living donor and/or deceased donor organs, will also be included. This will include a literature review as well as a review and evaluation of grants funded by the Health Resources and Services Administration's Division of Transplantation, interviews with grantees, and review of donation efforts by other organizations such as the Coalition on Donation and various organ procurement organizations will also be included.

Examine the potential impact (cost or savings and benefit) of increasing deceased organ donation rates in the United States.

Evaluate the ethical implications of the proposals or efforts and identify which proposals are considered ethically acceptable or ethically controversial by ethical, religious, and moral standards commonly found in the United States.

Further evaluate the ethically controversial proposals. These include, but are not limited to:  proposals for reimbursement for funeral expenses; proposals to use a life insurance vehicle to increase commitment to organ donation and registries; proposals for tax credits/deductions; proposals for direct payment to donors or families; presumed consent proposals; first person consent proposals and other proposals that the background research may discover. For the ethically-controversial proposals, the committee will:

-Evaluate and address the impact that these proposals may have on existing donation efforts and public perceptions regarding organ donation.


-Evaluate and address the impact that these proposals may have on specific groups such as ethnic minorities (specifically African-Americans), the socioeconomically disadvantaged, those likely to be disproportionately affected by the proposal, and on living donors. 

-Make recommendations about whether particular alterations can be made to various proposals to reduce ethical problems. 

-Provide recommendations regarding the cost-effectiveness, feasibility, and practicality of implementing such proposals. 

-Provide recommendations on evaluation methods for grants issued to increase organ donation based on the experiences of other social/behavioral campaigns or marketing efforts.