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Dominion Post - 7 July 2015

Editorial: Organ donors penalised for altruism


Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.

Elsie Howarth donated her kidney to her father Robin Howarth and is struggling with the consequences financially and health wise while her dad's health is improving.



OPINION: People are dying because they cannot get an organ transplant. Elsie Howarth's story shows one of the reasons why. Live donors suffer a big financial penalty for their altruism.

Howarth gave a kidney to spare her father Robin 10 hours of dialysis every second day.  Since the operation she has been in too much pain to return to work – and she will be paid miserably little for her trouble. Donors get a payment equivalent to the sickness benefit: in her case, a maximum of $175 a week.

Donors should not face this kind of penalty.

A new member's bill before parliament would increase the payments to donors to 80 per cent of their income for 12 weeks, matching the ACC model. This is the least the state can do. After all, donors not only save lives and put an end to avoidable misery. They also save the government money. Elsie Howarth is saving the taxpayer about $3000 week, the cost of Robin's dialysis.

The Financial   Assistance for Live Organ Donors Bill, originally drafted by MP Michael Woodhouse and picked up more recently by MP Chris Bishop, would make it easier for live donors. Some suggest, however, that the payments should be even higher.

In January Canterbury University researcher Elizabeth Prasad suggested that based on donor's costs the minimum compensation should be $15,000. This raises the traditional taboo against "paying for organs", but it's important to be clear about what this actually means.

The World Health Organisation opposes creating a market for human organs, but it supports recompensing donors for their costs. So the issue lies in what compensation for these costs is fair.

The bill would help fix one of the barriers to organ donation, but nobody thinks it will dramatically improve New Zealand's pitifully low organ donation rate. At present there are about eight or nine deceased organ donors per million people in this country. This compares with Australia's rate of nearly 17. In Spain, the world leader in the field, the figure is 35.

The Government gave an extra $4m in organ donation funding last year, a tiny sum which has made no real difference. Dealing with this problem will be difficult and expensive. Australia, for instance, spent $150m on it after Labour prime minister Kevin Rudd told health officials to "stop stuffing around." Australia's rate has improved from a low base, but it remains unimpressive.

Spain raised its rate from 14 per million to 35 by creating a nation-wide network of healthworkers who specialise in dealing with the families of potential donors. This is where the really important decisions are made – by families of people in intensive care units.


More than half of New Zealand's drivers have "organ donor" stamped on their driver licence, but often family members refuse to allow the donation to go ahead. In Spain, families also have the right to override a relative's wishes, but they do so far less frequently than they do here.

Training specialist staff along Spanish lines would be expensive. So would a big publicity campaign to alert New Zealanders to the problem. But that's probably what is needed to make a real difference.   

 - The Dominion Post

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