Organ Donation Regulation and Reimbursement Programming Through A Policy Coherence Perspective

Abstract

There is a substantial unmet need for donor organs for transplantation purposes throughout Canada (Blood, Organ and Tissue Donation 2016). Each of the provinces and territories has legislation governing organ donation, and each of these pieces of legislation contains a prohibition on the exchange of organs for what is officially termed ‘valuable consideration’. These prohibitions operate alongside public programs intended to encourage organ donation through the use of incentives. Programs reimbursing costs associated with being an organ donor are a common type of incentive to donate. The common prohibition on the exchange of organs for valuable consideration draws attention for its apparent incompatibility with public programs offering incentives to donate (Caulfield 2014). This apparent incompatibility, combined with the unmet need for donor organs, calls for an examination of the regulatory regime governing organ donation. This research examines the relationship between prohibitions on the exchange of organs for valuable consideration and public programs offering incentives to organ donors using a policy coherence theoretical framework. I have created a framework to measure the policy coherence between the regulatory regimes governing organ donation and programming within the provinces and territories. Policy coherence is examined both within and between provincial and territorial jurisdictions. This policy coherence framework examines the objectives of organ donation legislation, and public organ donation programming for conflicts and complementarities. My findings reveal relatively coherent policy domains between provinces and territories but identify policy conflict in the relationship between organ donation regulation and reimbursement programming operated by the primary organ donation agencies in the provinces and territories.