Ethical Incentives — Not Payment — for Organ Donation

To the Editor: The way medicine is practiced in the United States has a strong influence on the rest of the world, for better or for worse. Rumors that Congress may allow a hypothetically regulated market system therefore arouse concern in many countries. However, some people already feel encouraged to promote policies that have been regarded as ethically unacceptable, including transplantation tourism with hardly paid, Third World, unrelated living donors. 1 In this context, the proposals of Delmonico et al. (June 20 issue) 2 are welcome because they preserve the symbolism of generosity, reward altruism, and respect the fundamental democratic principles of . . .