My freshman year of high school taught me a life lesson that I will always remember. I played and currently play softball and during that year, I tore my ACL in my right knee. I would have to have surgery in order to continue playing and have a full recovery. I received a cadaver (a transplanted ligament) in order to repair my knee. After having this procedure done, I was sought out by a handful of colleges, including the University of South Carolina to play softball for their schools on scholarship. I didn't think a school would want me to play for their school because I was injured, but the coaches knew that the surgery was only a small hurdle in the sport of softball. I ended up committing to the University of South Carolina and have nearly finished my freshman year. If it weren't for the kindness and selflessness of another human being, then I would not be playing the sport that I love today or getting my college paid for. Since I was directly affected by the generosity of someone donating their body and helping others, I took the step of becoming an organ donor. Not everyone is directly affected by organ donation, therefore, they do not know what it is like act selflessly and feel the gratitude of people's generosity. 

There are currently "more than 78,000 people in the United States that are active on the organ transplant list" while there is a shortage of vital organs (Arbour). The amount of people in need of an organ transplant dramatically outweighs the number of organ donors. Therefore, everyday, "more than 100 people on then national transplant waiting list die" because not enough organs are available for transplant (Arbour). To put this into perspective, 7,665 people die every year because they don't want to be organ donors due to preconceived myths. The idea of organ donation often has a negative connotation connected to it. Many people are unaware of the procedures and medical advances that American medicine has made over the past decades. Myths have been conceived about the care of the patient (if they are an organ donor) and the protocols that are in place to extract and preserve organs. It has been rumored that doctors will not try to save a patient's life if they're dying because their organs can go to others in need of life preserving organs. Although there is a staggering amount of people waiting for organ transplants, the doctors' main job is to save lives. Another concern that people have when becoming an organ donor is that they lose the ability to have an open casket at their funeral. This is false because the absence of one's organs does not affect their ability to have an open casket. 

Even though most of the public is knowledgeable of these facts, people are not signing up to become organ donors. The self-rewarding act of saving lives is not enough for some people to donate their organs. This issue has grabbed the attention of many scholars. The solution that most of them have proposed is the compensation of organ donors. They believe that if the population was rewarded for their donation, they would be more willing to donate their organs. This has become a controversial issue because the act of selling and buying of organs questions people's ethical viewpoints. The solution for this staggering issue is the act rewarding of organ donors and the implementation of a well-regulated system that monitors and controls the buying and selling of the organs. 

For years the public has been aware of the nation's organ shortage and have been debating solutions. America has tried alternative ways to solve this issue. Those waiting on the transplant list are often promised "[that] breakthroughs are coming in artificial hearts, xenografts, and tissue engineering" when the technology is not perfected yet, therefore, they are waiting with false hope (Pence). An example of this was that a surgeon named Christiaan Barnard predicted in 1968 that pig hearts would be routinely transplanted into humans within twenty years and we've yet to make strides in the development (Pence). As a global issue, the medical field in Europe had tried a "presumed consent" approach that deemed any patient an organ donor if it wasn't clear that they were not (Pence). As one could imagine, this caused many problems and failed to increase organ donation resulting in another failure. America has tried to commercialize other body entities other than major organs to test the success of the system. A former used-car salesman, in 1955, started the first commercial blood bank in order to make more money (Pence). The problem that this idea proposed was that it created competition for the nonprofit, hospital-based blood banks. This competition also brought blood banks to buy blood from unreliable resources. "Americans bought blood from money-seeking alcoholics and prisoners, both of whom carried blood-borne diseases who were motivated to lie" because they wanted the money (Pence). Those in need of blood suffered because of the poor and unregulated system that was in effect. This has taught American the right and wrong ways of compensating citizens for their donations, which in turn will help America form a well-regulated system that compensates organ donors. 

The first step in creating this system, is seeing if the majority of the public would even consider the theory and support it. In the NPR-Thomson Reuters Health Poll, "87 percent of respondents [were] in favor of compensation though it was OK for kidneys ... 85 percent felt that way about livers, and 83 percent for bone marrow" (Hensley). This poll also asked what monetary value would be sufficient enough to compensate those who donated and "thirty-seven percent of respondents said it should be less than $10,000, and 27 percent said it should be more than $10,000 and less than $25,000" (Hensley). Monetary values are not the only forms of compensation that were preferred by respondents. In a study conducted in Chicago, participants were asked what forms would they prefer if this system of compensating organ donors were to be enacted. Sixty-one percent said they would prefer a direct payment of money, twenty-one percent said they would prefer a paid leave, eight percent said they prefer a tax credit, four percent said they would prefer a tax reduction, and three percent said they would prefer a health insurance rebate (Gordon). The sixty-one percent that preferred a direct payment were then asked what would they use the money for and thirty-eight percent of respondents said they would use the money to pay off debt and twenty-nine percent said they would use the money to pay for nonmedical expenses associated with the transplant, and fourteen percent they would put the money into their saving account (Gordon). The debate on whether people would take advantage of the system is lessened by this data. The question that still is to be answered is whether or not this reward would bring more incentive to the people and increase their willingness to donate. 

Many studies have been performed that attempt to answer this question. What is often an obstacle to this question is, is it ethical to donate one's organs for a reward? Participants have internal arguments that debate which side they agree with because they don't want to be donating just for money but they would not mind the security that this reward would give them or their family. During the process of organ donation, whether is be live donation or donation after death, the only person not benefiting from the donation is the donor. As Scott Hensley points out in a NPR interview, would it be so wrong to reward or "give any form of benefit to the person who's going to make this sacrifice" since everyone else in the process is getting paid or benefiting majorly. He does not down-play nor underestimate the power of the 'spiritual benefit' and praises the thousands and thousands of people who have already donate through their generosity. 

It is known that if the compensation of organ donors were to become an available choice, a well-regulated system would have to be enacted. This system could not only be enacted but understood, so that, each individual knew what they were signing up to do. To justify the ethical validity of compensated donation "the concept of principlism is commonly used to justify [it], because it contains the ethical principles of autonomy, beneficence, justice, and non-maleficence" (Potter). When Potter talks about autonomy he states:

Three conditions are necessary for autonomous action: intentionality, understanding, and noncontrol. For the act to be autonomous, the action must be intentionally willed, and the agent must adequately understand the action and its consequences. The agent must also not be under the controlling influence of another, because an agent can only act autonomously when the act is not directly affected by an impressionable factor or influence that affects the agent's plans (Beauchamp and Childress, 2013). 

Under these conditions the ethical view on the system would be validated and uncontroversial. By allowing all the information to be admitted to the participant, he/she can make an educated decision and know the risks and rewards. Through this process, it is still an act of generosity to donate one's organs.  Laws would be implicated in this well-regulated system, in order to prevent the abuse of the system. The poor might resort to the system and become financially dependent and desperate. Since there is a current organ trafficking problem, implementing this system will regulate and lessen the illegal activity. 

The compensation of organ donors has and is currently a controversial topic in not only the United States but worldwide. The selfless act of saving lives by voluntarily donating one's organs isn't the same anymore. Not enough organs are being donated in order to save the amount of people waiting for organ transplants. Compensating organ donors is the answer to alleviate the organ shortage. Having an incentive for those who are on the borderline for becoming an organ donor will increase the number of organ donors. The incentive would go directly to the organ donor or to their families. A well-regulated system is the solution to control the income of organs and the payment of each donor. Although money is involved, the act of donating one's organs does not diminish the generosity of the act. So many people are in need of organs and you may never know if you might be one of those people on the waiting on the transplant list. If America wants to alleviate the organ shortage, the government should implement the system and compensate organ donors. 

