The New York Times' Nicholas Kristof had an op-ed piece in yesterday's paper making an argument for paying people to donate their organs.

There is an unecessary shortfall when it comes to organ donation in this country -- and its almost criminal. I have no doubt that there are many people who decline to donate a loved ones organs, thinking that they want to keep the now-useless body whole and there's nothing in it for them. If offering $5,000-$10,000 cash to the family -- to be used however they want -- in return for donating organs would save some lives -- it'd be well worth it.

Who supplies the cash? I don't think it'd be a bad idea for the federal government to supply the money -- after all, the government would benefit -- people living longer means people paying taxes longer.

One letter-writer to the Times even had an idea that could further increase the rate of organ donation.

As a nephrologist who has seen too many patients on dialysis die waiting for a kidney, I agree with Nicholas D. Kristof that the time has come to allow financial incentives for organ donation. The cost of maintaining altruism, already a shaky concept, is excessively high.

Mr. Kristof quotes Francis Delmonico, a professor of surgery at Harvard Medical School, who suggests "a reimbursement of funeral expense, for consent to donation of that family member's organs and tissues."

The distinction between a cash payment and covering funeral costs is simple hypocrisy.

The fairest way to carry out an incentive plan for organ donation is through the tax code. A cadaver donation should result in suspension of the estate tax and the final year of income tax. A live donation should be rewarded by a lifetime income tax exemption.

The old saw that paid organ donation exploits the poor to benefit the rich would be turned upside down.
RICHARD AMERLING, M.D.
New York, Nov. 12, 2002

Organ donation should be the norm in this country, not the exception.