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SAN FRANCISCO – As the nation’s need for organ transplants continues to outstrip supply, the American Medical Association on Sunday grappled with a possible solution once thought taboo: paying dying would-be donors and their families for vital organs. 

Such financial incentives are illegal, banned by Congress in 1984. So people needing organ transplants must rely strictly on volunteers, a system that is clearly not working. Only 25 percent of 78,000 organ transplants currently needed will occur in time to save a life, according to the United Network for Organ Sharing, the nonprofit agency the U.S. government pays to oversee the nation’s organ donor network. The agency says 15 people die each day waiting for an organ transplant. 

Most donation decisions are made by families of people who have died suddenly and unexpectedly — like in a car crash. Most families in those situations decline to offer up their dead relatives for donations. 

“We have a nationwide crisis and altruism doesn’t seem to be hacking it right now,” said Dr. Frank Riddick Jr., chairman of the AMA’s Council on Ethical and Judicial Affairs. So Riddick’s council is urging the AMA to begin scientific studies on what effect financial incentives will have on organ donations. The full AMA will decide later this week if it will adopt the council’s recommendation. 

If the AMA does agree with testing financial incentives, Congress will have to change current law to allow for any study. One such program passed by the Pennsylvania legislature in 1999, which would have the state pay $300 toward the funeral of every donor, has never been implemented because of the federal ban. 

At the time Congress enacted the ban, most in the organ donor field found financial incentives unethical and abhorrent. Only two professionals spoke out in favor of incentives at the time, including a defrocked doctor who shocked the medical community by going into business as a for-profit kidney broker. 

Even today, many in the organ donation field find financial incentives distasteful. 

“Most donor families we talked to are quite offended at the thought that financial incentives would have made a difference,” said Phyllis Weber, executive director of the California Transplant Donor Network, which collects about 700 organs a year in Northern California. “In fact, financial incentives could backfire.” 

The United Network, too, remains skeptical of financial incentives. 

“There’s a thought that to offer financial incentives will open up a Pandora’s Box,” said agency spokesman Joel Newman. 

A Congressional bill introduced in May dubbed the Gift of Life Tax Credit Act would allow a donor family a $10,000 tax credit in exchange for donated organs. 

Blood and reproductive material can be sold. 

“There seems to be no compelling reason why viable solid organs should be treated differently from less complex tissues on moral grounds,” the council report states. “Moreover, donation itself implies a property right in organs.”