It's the sort of thing that a strong regulator can mandate, but generally doesn't; and the sort of thing that an airline would promote heavily, but not in a way

It's the sort of thing that a strong regulator can mandate, but generally doesn't; and the sort of thing that an airline would promote heavily, but not in a way that anyone could rely on: "We donate tickets to Charity X who uses them to fly very sick children to world-class hospitals! Why not donate your airmiles right now, relieving us of some of this obligation without getting the usual tax deduction!"