Free funerals!

About the smallest compensation that we might consider giving organ donors is payment of funeral expenses. In New Zealand, it's still illegal - organs can't be given in exchange for financial consideration, although Dunedin's medical school is allowed to pay some parts of the funeral costs for someone whose body is donated to science: they cover embalming and cremation, but not the funeral service.

In Britain, the Nuffield Council on Bioethics now endorses payment of organ donors' funeral expenses. But even that, apparently, is fraught with ethical peril.

What we should be concerned about when it comes to incentives for organ donation is not the purity of donors' motives, but the way that payments could facilitate coercion or exploitation of those in poverty.

Organ donation should be a fully free choice for each of us, and never an economically necessary one.

For this reason, it is important that organ donation never becomes the only way to pay for one's funeral. The government currently provides funeral payments from the Social Fund to those in poverty. It must continue to do so as a safeguard against coercion and exploitation, if funeral expenses for donors are introduced.

Surely the disutility felt by families who find the option of a free funeral to be painful ought to be weighed against the considerable gains to a transplant recipient. And I'm glad that Nuffield comes to the right conclusion on this particular issue - that payment of funeral expenses is worth it. I just don't get how so much weight has come to be placed on the losses from very hypothetical coercion against the very very real gains to transplant recipients.