Bone Marrow as a commodity

Why It’s OK to Pay Bone-Marrow Donors

By Sally Satel
Bloomberg View, December 1, 2013 Locating a marrow donor is often a needle-in-a-haystack affair. The odds that two random individuals will have the same tissue type are less than 1 in 10,000, and the chances are much lower for blacks. Allowing compensation for donations could enlarge the pool of potential donors and increase the likelihood that compatible donors will follow through. So the ruling by a three-judge panel of the U.S. Court of Appeals for the Ninth Circuit was promising news for the 12,000 people with cancer and blood diseases currently looking for a marrow donor. Shaka Mitchell, a lawyer in Nashville, Tennessee, and co-founder of the nonprofit MoreMarrowDonors.org… invited a team of economists to evaluate the effects of the ruling on people’s willingness to join a registry and to donate when they are found to be a match. The researchers were to specifically assess whether cash payments would be any more or less persuasive than noncash rewards or charitable donations. Now comes the bad news. On Oct. 2, the U.S. Department of Health and Human Services proposed a new rule that would overturn the Ninth Circuit’s decision. The government proposes designating a specific form of bone marrow — circulating bone-marrow stem cells derived from blood — as a kind of donation that, under the 1984 National Organ Transplant Act, cannot be compensated. The strongest opposition to compensation comes from the National Marrow Donor Program, the Minneapolis-based nonprofit that maintains the nation’s largest donor registry. Michael Boo, the program’s chief strategy officer, says of reimbursement, “Is that what we want people to be motivated by?” HHS is presumably under pressure from the National Marrow Donor Program. The department does not otherwise explain its proposed rule except to claim that compensation runs afoul of the transplant act’s “intent to ban commodification of human stem cells” and to “curb opportunities for coercion and exploitation, encourage altruistic donation and decrease the likelihood of disease transmission.” Each year, 2,000 to 3,000 Americans in need of marrow transplants die waiting for a match. Altruism is a virtue, but clearly it is not a dependable motive for marrow donation. (Sally Satel, is a psychiatrist and a resident scholar at the American Enterprise Institute.) http://www.bloomberg.com/news/2013-12-01/why-it-s-ok-to-pay-bone-marrow-donors.html

Comment:

By Don McCanne, M.D. Imagine trading bone marrow in the commodities market. It could be very lucrative. In no time at all, the prices could be driven over what we are now paying for the newer cancer drugs – $100,000 and more – maybe much more. And don’t stop at bone marrow. Think of the trade that could be generated in other human organs. Is there no end to the commodification of health care? How did we end up here? Is the compulsion to look for market solutions so great that we abandon all sense of humanity? People who think like this – do they have a soul?

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