Organ Donation, Comprehensively Good Incentives, and the Family: A Comment on Hong Kong’s Interview Findings and Survey Results

This chapter provides conceptual and ethical comments on Hong Kong’s interview findings and survey results regarding the three types of incentive for organ donation. It focuses on three particular conceptual and ethical issues. First, it shows that there is not always a clear-cut distinction between an honorary and a compensationalist incentive measure for organ donation. Instead, a measure such as offering a public columbarium niche to a deceased donor in Hong Kong carries both honorary and compensationalist elements and can, as a mixed type of incentive measure, be ethically justified for adoption in that society, even if purely monetary incentives cannot be similarly ethically justified. Moreover, in relation to the proposal to offer a familist incentive in Hong Kong (namely, to give patients with a first-degree family member who was a cadaveric donor, or who have themselves previously been live donors, a priority right for a transplant over other medically similar patients), it is argued that no proposed opposing reason is ethically convincing. Finally, the chapter demonstrates that there are legitimate considerations to support maintaining Hong Kong’s familist decision-making model regarding organ donation. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023