Had an honour to be invited to deliver a talk at the 32nd Annual Congress of the Malaysian Society of Nephrology at Johor Bahru on "Incentives in kidney donation - a global perspective". A review on experiences of selected countries was presented namely Australia, Canada, Iran, Israel, Malaysia, Saudi Arabia, Spain, United Kingdom and United States. It is interesting to note that there is a wide range of options of incentives, both financial and non financial, are already being offered in these countries. Direct payment to living donors (via regulated compensated unrelated living donation) poses many ethical concerns, while incentive to prioritise pledgers in the national wait list (should the individual requires a transplant in later part of his life) warrants further delibration. Incentive however is not the only strategy to increase donation and transplantation rates. Countries with high organ donation rates like Spain and UK do not practise donor incentive as yet suggesting intrinsic motivation as possibly one of factors of success in transplantation programme. ‪#‎dermaorgan

2. Outline of presentation
• Introduction
• Strategy to improve organ donation
• Incentive initiatives by country
• Conclusion

3. INTRODUCTION
Incentives in Kidney Donation : A Global Perspective

4. Definition of incentives
A thing that motivates or encourages someone to do something
Late Middle English: from Latin incentivum 'something that sets
the tune or incites', from incantare 'to chant or charm'.
oxforddictionaries.com, (2015). Oxford Dictionaries Official Website. [online] Available at: http://www.oxforddictionaries.com/
definition/english/incentive [Accessed 20 Apr. 2016].

5. Classes of incentives
CLASSES OF INCENTIVES DESCRIPTION
Remunerative / financial
incentive
are said to exist where an agent can expect some form of material reward –
especially money – in exchange for acting in a particular way.
Moral incentive are said to exist where a particular choice is widely regarded as the right
thing to do, or as particularly admirable, or where the failure to act in a
certain way is condemned as indecent. A person acting on a moral incentive
can expect a sense of self-esteem, and approval or even admiration from his
community; a person acting against a moral incentive can expect a sense of
guilt, and condemnation or even ostracism from the community
Coercive incentive are said to exist where a person can expect that the failure to act in a
particular way will result in physical force being used against them (or their
loved ones) by others in the community – for example, by inflicting pain in
punishment, or by imprisonment, or by confiscating or destroying their
possessions.
Natural incentive such as curiosity, mental or physical exercise, admiration, fear, anger, pain,
joy, or the pursuit of truth, or the control over things in the world or people
or oneself

6. Incentives in kidney donation
For the purpose of this review, incentive in kidney donation refers
to institutionalised incentive initiatives both financial and non-
financial to encourage people to donate organ either as living or
deceased donors.
NOTES: Incentives to staff and incentives to medical institutions are not
included in this review. Illegal financial or non-financial transactions in
exchange for organs are non-institutionalised measures and therefore not
regarded as incentives.

7. Incentives in kidney donation

8. STRATEGY TO IMPROVE
ORGAN DONATION
Incentives in Kidney Donation : A Global Perspective

10. INCENTIVE INITIATIVES BY
COUNTRY
Incentives in Kidney Donation : A Global Perspective

20. CONCLUSION
Incentives in Kidney Donation : A Global Perspective

22. Conclusion
• Incentives to donors are not the only strategy to improve
donation / transplantation rates
• More evidence is needed to establish effectiveness of
incentives
• Regulated compensated unrelated living unrelated donation
poses many ethical concerns
• Waiting list prioritisation shall be further deliberated
• Incentive to staff and medical institution shall be considered in
future review on incentives

23. THANK YOU
Incentives in Kidney Donation : A Global Perspective
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