
There are many types of volunteers or donations. For example, people go to other places to help others, or indirect way of helping people would be donating money. If someone was willing to help people, then these examples were the common ways to help others. However, there is a type of donations that requires more participation other than simply willing to help one another. Living organ donations are one of the hard decisions that humans can make because it is not a simple and easy process to donate their organs. This donation is valuable decision that could save one's life. However, it is hard to make decision as much as its value of saving people's lives. 

Every year, the amount of kidney diseases have been increasing in the United States, which means more people need to get kidney transplant surgeries. In 2007, patients on the waiting list for kidney donations were 71,601. In 2008, the amount of patients on the waiting list reached 76,089. Two data's gap is only a year, but there was a huge increase of waiting list for kidney donations. It means more kidney donations are needed in the United States. Unfortunately, the corresponding data reflects reverse situation. Deceased kidney donation increased from 10,082 to 10,101 from 2007 to 2008. However, living kidney donations decreased from 6038 to 5966 from 2007 to 2008. Therefore, total amount of kidney donations decreased from 16,120 to 16,067 (Wolfe 962). This comparison of data indicates that the number of people in need of kidneys and number overall kidney donations are reciprocally proportional. Even though there is high medical technology to transplant organs safely from donors to savers, it would be useless if there are not enough kidneys to do the transplants. In the United States, the lack of kidney donations are leading to the death of people. Therefore, by taking into account a large portions of articles that explored this topic, different types of financial compensations should be allowed for living kidney donors in order to increase the amount of donations to save human's lives.

Dialysis is one of the well-known kidney failure treatment, but it has a lot of negative effects to the patients behind it. For example, Mr. Hil's daughter, who was only 10 years old, looked like she had a serious flu symptoms, so she went to the emergency room. The result was that she had kidney failure, so she had to do dialysis immediately. It could save her life, but it worsened her at same time. Dialysis causes obesity, anemia, low blood pressures, etc. Only benefit of the dialysis would be the extension of patient's life, but the patient begins his or her painful life from the point whenever they start dialysis. The usual schedule is to do the dialysis about 3 hours for 3 days per week. Because of this, regular everyday life such as going school, work, or travel are almost impossible for the patients (Postrel 1).

However, the kidney transplant surgeries, which are another method of kidney failure treatment, allows the patients to live like normal people with a little bit medicines. They can go to the schools, work, and eat what they want. Unfortunately, there are not enough amount of kidney donations that can make all people happy and healthy. Every year, about 4,000 people died while they were waiting for kidney donations. According to the University of California, San Francisco, their transplant center's patients on the waiting list need to wait about 21 years in average. Therefore, the patients get sicker and sicker while they are waiting for kidney donations no matter deceased kidneys or living kidneys (Postel 1). 

Even though if we assume that more people register to donate their kidneys after their death, it is not enough to cover all people on the waiting list because the number of people on the waiting list is increasing every year. It means that more living kidney donations are needed in the United States in order to cover more patients' kidney transplantations (Postel 1). Therefore, we need to find some ways that can increase the amount of living kidney donations. 

In most of the countries in the worlds, buying or selling kidneys and other organs are illegal. Even though there is a high possibility of increasing 5% of kidney donations if the government provides financial compensations to the living kidney donors, there are many opponents who disagree with the legalization of financial compensations because of couple reasons. For example, it could lead the coercive decision for people with the low income or poor people. If selling kidneys become legalized in the United States, then it would only target the low incomed people or poor people, which means the law will force them to sell kidneys since they need money to survive. Furthermore, it could have negative effects to them because even though poor people's kidneys are good enough to donate now, but if they have some other health problem, then the rushed decision of kidney donations could affect their health negatively in the future because they do not think the risk of donations that could happen after surgeries (Allen et al 2031-2033). 

However, according to Dr. Halpern, who is professor at the University of Pennsylvania, School of Medicine, he claimed that people do not need to worry about whether the donors would not recognize the risk of donations because the money would not affect the awareness of the risk of surgeries. Also, financial compensation does not necessarily target low incomed people because $10,000 of financial compensation would have same influence to the low incomed people and high incomed people, which means a person who has lesser than $20,000 income and a person who has more than $100,000 income will be attracted to the $10,000 compensation equally ("Concerns" 1). 

Another reason for the rejection of financial compensation is altruism. In general, people think that the donations should be done only when the donors have altruistic mind when they donate organs. Altruism is the idea of self-sacrifice and the devotion, so the ethicists claim that altruistic donations cannot be accompanied with remunerations, which is financial compensation for this case. If financial compensation was provided to donors, then it could not be considered as altruistic donations because there are always the possibilities that the receivers get worse after the transplantations if their bodies reject the transplanted organs. If that happens, only donors are getting benefits because they already got paid for their donations (Moorlock 134). The altruism is connected to the crowding out problem. If the financial compensation is allowed in the United States, then donors who are willing to donate without receiving money will decrease. It means that altruistic donors would not donate their kidneys anymore (Allen et al 2031-2033).

However, according to the Nuffield Report, they claim that the altruism is not a required to donate someone's organs including kidneys because some people just donate their kidneys for self-interest of just helping others by donations (Moorlock 138). Also, financial compensation would not decrease the altruistic donations because if someone was willing to donate his or her kidney with both altruism and self-interest of helping other, and if they had to receive financial compensation but did not want it, then he or she can simply donate the money to the kidney receivers that they got from financial compensation. 

One of the reasons that the amount of the donations is low is because the donors become the stakeholders after donating their living kidneys because they struggle financially. According to the United Network for Organ Sharing (UNOS), one fifth of the donors do not have appropriate health insurance to cover their aftercare of donation surgeries. It happens because there are lack of follow-up data from the transplantation centers to the living kidney donors. Furthermore, it is likely to happen to the donors who do not have good health insurance, which more likely to happen to the low incomed donors. Also, many of African American donors were low incomed donors. According to the UNOS, the follow-up system in clinical and laboratories in transplantation center has been improved year by year. However, the follow-up percentage is increasing just about 1% each year, which is not significant improvement to cover all living kidney donors (Schold et al 2394-2403). 

Like above, since the follow-up care for living kidney donors are not enough to cover all donors, financial compensation to them could help to get better aftercare system. The donors will not have to hesitate to donate their kidneys because of anything related to financial problems such as healthcare or insurances if financial compensations becomes available. It will lead to the increase of living kidney donations because the donors would have less concerns about financial problem after transplant donations. 

In most of countries in the world, it is illegal to sell or buy organs mostly because of same reasons that the United States have. Even though the law restricts transactions, there is a black market not also for kidneys but also for other organs because people want to survive, but there are not enough kidneys to receive. Some Americans make trips to other countries such as Turkey, Russia, and South Africa to find kidneys in the black market. The black market is the illegal hidden market that organ transactions happen. The flight to the other countries to find organs and get transplantation is called "health tourism" (Major 67-69).  

There is a country which did not ignore the problems of the black market, Iran. They faced the problems of black markets, and they decided to legalize the financial compensation to the living kidney donors and living nonrelated organ donors to increase the amount of donations in their country so that they can protect their citizens from illegal transactions. They started to compensate the living kidney donors by supporting transplant funding and compensating the donors since 1988. Surprisingly, the amount of transplant surgeries had almost doubled, which four fifth of the transplant donations were from living nonrelated organs including living kidneys. Furthermore, they also provided the free health insurance to the donors. According to the Hashemi Nejad Hospital (HNH) in Iran, they could do 2,000 transplant surgeries in 2006, which three quarters of them were living nonrelated organ organs, Since the donations increased, more people on the waiting list could get the transplants, which means the legalization of financial compensation had positive effects that led to save more people's lives in Iran (Major 67-69). 

Even though financial compensation system for the living kidney donors has lots of benefits to increase donation amounts, it is still illegal in the United States. Then what could solve the lack of kidney donations in the United States? The best ways to approach this problem is to find different types of financial compensations.

The basic financial compensation to the kidney donors would be direct monetary compensations. However, there could be many other types of financial compensations. For example, instead of monetary direct financial compensation the U.S. government also could provide free or better health insurances. This might be able to protect poor people's right from rich people if rich people try to buy poor people's kidneys by offering huge money (Major 67-69). Since now we have the Obama healthcare system in the United States, people already have insurances. However, this insurance is not enough to cover donors with low incomes because they pay less for the Obama care insurance, so they get less insurance benefits. However, if the government provides higher leveled health insurance to those who donate their kidneys, both donors and the government get benefits because donors can get better health care for rest of their lives, and the government can gain the living kidney donations. 

Even though the living kidney donors should not have any disincentives by donating their kidneys, a lot of donors get negative results from the donations. Therefore, another method of financial compensation could be tax benefit to the living kidney donors. Some donors need more health care after donating their living kidneys. This unfortunate situations lead to the financial struggle and time consuming situations. They need to go to the hospitals more often, so they need to spend more money and spend their time to go to the hospitals to get the aftercare treatments. As a result, many living kidney donors end up losing money after their donations, which is unfair to the donors because they are doing valuable thing but get disadvantages for doing thing that can save human lives. Therefore, one of the financial compensations that could help them to decrease this disadvantage is tax benefits so that they can spend less money after the donation surgeries (Rettner 1). 

Increasing the number of donations by financial compensations not only benefits the kidney failure recipients but also the government. The U.S. government is already funding kidney failure patients' dialysis, and it costs around $65,000 to $75,000 per year for each patients (Retter 1). Furthermore, according to the National Kidney and Urologic Diseases Information Clearinghouse presented that the total amount of the funding for end stage of kidney failure was $40 billion in 2009 (Bushak, 1). However, if the government provided around $10,000 per donor, which is less than funding one patients' annual funding, as financial compensations and increase transplant amount, then the government could save money from dialysis funding (Retter 1). For example, if the amount of the kidney donations increased by ten to twenty percent, then the government could save between $1,600 and $4,000 of funding for each kidney failure patient (Bushak, 1). 

If people do not know how donation system works, then financial compensation for kidney donors would be useless. Therefore, here are the steps on how organ donation system works. First, if a patient is a good candidate for transplant receiver, then they can be put in National Transplant Waiting List. Then, the National System finds the donors that match with patients based off of blood types, body size, distance from donors, level of sickness of patients, tissue types, and the length on the time that patients waited for transplant. Usually, deceased organ donations happen when injured patients fail to live after surgery, their family can sign up whether they are going to donate deceased patients' organs or not. If their family agree to donate deceased patients' organs, then the National System uses waiting list to find matching kidney failure patients. Otherwise, people can sign up through the office of motor vehicles (DMV) or though organdonor.gov ("Donations" 0:00-4:57). 

There are many reasons for opposing financial compensations for living kidney donors such as altruism, possibility of poor people only targeting law, leading coercive decisions, and becoming unaware of risk of donations. However, these counterarguments could be justified if the U.S. government makes different types of financial compensations such as direct monetary compensation, tax benefits, and better health cares and insurances for donors. These financial compensations could benefit all 3 components. The donors will concern less aboutdonate their living kidneys, which will increase the amount of living kidney donations. The increase of kidney donations will save more kidney failure patients by transplant surgeries. Also, the government will get benefit because transplant funding cost less than dialysis funding. Therefore, variety financial compensation system for living kidney donors should be allowed in the United States because it can save more patients on the waiting list. 

