Friday, March 12, 2010

"Lawsuit Urges Payment for Bone Marrow Donors"? Nonsense.

Tarris Rosell, PhD, DMin
Rosemary Flanigan Chair at the Center for Practical Bioethics

March 12, 2010

An article in USA Today asks, “Should people be paid to donate bone marrow?”

Journalist Rita Rubin reports on a lawsuit filed by a stem cell transplant physician and other plaintiffs against U.S. Attorney General Eric Holder. They contend that the government ought to make a legal distinction between bone marrow and solid organs so as to allow compensation of up to $3,000 to persons willing to sell their marrow for stem cell transplants.

Buying and selling either organs or marrow is currently illegal. I think it should remain so.

Proponents of marrow sales want to save lives by increasing the stem cell pool. They claim this could help up to a thousand Americans who die each year for lack of a matching donor. The ends are worthy, though the numbers are speculative.

Mostly it’s the means that trouble me, along with the unintended outcomes one could reasonably expect as a sort of iatrogenic effect of this supposedly curative innovation to expand the donor pool.

The quality of marrow collected and stem cells extracted is expected to diminish even if the quantity were to increase. However, there is no guarantee that more and not fewer people actually would give up their marrow for pay. If the altruistic impulse is removed by means of compensation, we might see a net loss instead. An idea that potentially threatens both quality and quantity of a scarce resource is an idea to be shelved.

Plaintiffs argue that marrow is more similar to blood plasma than to kidneys, and that we do allow people to sell their own plasma. But this begs the question of whether we ought to have commodified blood products—or sperm and ova, for that matter. Many of us would be inclined to argue from exactly the opposite direction. i.e., since our society and virtually all others already ban sales of organs and marrow, we ought also to forbid any and all selling of one’s bodily self.

We have significant data from experiences with organs sold on the “black market” and with legal sales of plasma, sperm and eggs. What happens? In some nations, the poor sell their kidneys to shady brokers who re-sell to wealthier “medical tourists” at many times the original cost. Clinical outcomes from these transplants are relatively awful, and no one except the broker ultimately benefits.

Plasma sellers in this country get a mere $25 to $30 dollars a crack—and too many apparently use the money to buy crack or other harmful substances that result in the generally lower quality of blood collected. Sperm sellers get paid a bit more for their product, but have to lie awake at night sometimes wondering how many dozens of children they now have fathered and whether any will ever search “Dad” out.

Ova sellers reportedly are recruited from Ivy League campuses for as much as $15,000; and many of us with feminist sensibilities suspect that unsuspecting young women are in reality being pimped. It appears to me that a society is not improved by marketing of our bodies in whole or in parts.

Donation—the “gift of life”—rather than commodification of body parts, is a norm deeply embedded in the human moral community. We hardly know how to speak of this in words other than “donate.”

The journalist’s question itself is self-negating nonsense: “Should people be paid to donate . . .?” Clearly not.

Tarris Rosell, PhD, DMin
Rosemary Flanigan Chair, Center for Practical Bioethics
1111 Main St, Suite 500, Kansas City, MO 64105 (816.979.1361)
Professor--Ethics & Ministry Praxis, Central Baptist Theological Seminary
Clinical Associate Professor (Ethics), KUMC, School of Medicine
Mobile: 913.909.3863 Pager: 913.917.0152



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