Part 2: Pay Bone Marrow Donors?

As will be evident in this podcast, Myra Christopher and I do not agree on the question of compensation for marrow or blood stem cells "donation."

I think we would agree (do we?) that federal policy ought not to be driven by one heart-rending case, as depicted in the Rock Center with Brian Williams piece from June 14, 2012.

It also seems to me less than civil and fair to depict those who disagree with compensation proposals, like Dr Boo of the National Marrow Donor Program, as simply cold-hearted rationalists (and possibly self-interested). That is what NBC's Dr Snyderman appeared to be doing, however. Hardly a stellar bit of journalism, in my opinion.

Yet the issue is quite interesting, even as the particular case (the Flynn family) is tragic and troubling. It is noted by the journalist that the Flynn twins had controversially been conceived, using IVF procedures and pre-implantation genetic diagnosis, specifically for the purpose of becoming their older sister's marrow and stem cells donors. 

I think they glossed over, however, some ethical implications of the fact that this normative stretch, by Kantian measures, yielded the unintended consequences of the twins themselves having Fanconi anemia. So now there are three children in need of a stem cell transplant, and not just the one.

The mother's response? To propose yet another normative stretch, or break: Reclassify marrow as a non-organ blood product, hence not subject to NOTA (1984 law), and commodify stem cells from marrow and blood.

Dr Boo and most BMT physicians asked thus far are opposed, in part on grounds of reaping further unintended consequences including that of a possible net loss of available stem cell donors for transplantation.

Some of us also think it is begging the question, a circular argument, to claim that it ought to be permissible to pay marrow "donors" on grounds that we already do so for human plasma, sperm, ova, hair, and loaner wombs for surrogate pregnancy. Perhaps, instead, we ought not to pay anyone for any human body part or product?

I wish that Dr Snyderman, Brian Williams and Rock Center had done a bit of ethics in the process of reporting a sad story with a moralistic spin.

Terry

Tarris Rosell, PhD, DMin

Rosemary Flanigan Chair

Center for Practical Bioethics