Paying Bone Marrow Donors Is Not Unethical

So says me and nearly two dozen others who work on questions of medical ethics, in a recent letter to The Department of Health and Human Services in response to an NPRM designed to reverse the decision in Flynn v. Holder.

Fellow Lounger Michelle Meyer and I have both written here a couple of times about current debates surrounding compensating bone marrow donors, as well as Flynn v. Holder (the 9^th Cir. case holding that bone marrow donors could be legally compensated for peripheral blood stem cells obtained through apheresis, and the HHS proposed rule that would overturn that ruling.

Now, a group of researchers (including myself and Michelle) have signed onto a letter in opposition to the proposed HHS rule. From the letter:

This Rule would effectively reverse the decision in Flynn v. Holder before the U.S. District Court of Appeals for the Ninth Circuit.1 That decision holds that compensating donors of hematopoietic stem/progenitor cells (hereafter: “hematopoietic cells”) through a procedure called apheresis was not contrary to the National Organ Transplant Act.

We oppose the Rule. We maintain that the ethical arguments against a compensatory model for hematopoietic cell donation through apheresis (hereafter: “the compensatory model”) fail. We further maintain that significant ethical considerations speak in favor of the compensatory model, and therefore against the Rule.

Below, we respond to the ethical arguments offered in favor of the Rule: that the compensatory model would result in wrongful exploitation (§2); that the compensatory model would promote the view that human beings, their bodies, or subparts thereof, are mere commodities (§3); and that the compensatory model would incentivize donation for personal gain over donation from altruistic motives (§4). Given the ethical importance of avoiding preventable death and the strong likelihood that the compensatory model would help avoid preventable death, as well as the ethical importance of free choice, we conclude that the Rule is unethical (§1).

Read the whole thing here.

Related Posts:

On To Bone Marrow

Flynn v. Holder – The Fight Continues

Flynn V. Holder Rehearing Denied

Cohen on Flynn v. Holder

HHS Proposes Rule to Amend NOTA, Nullify Flynn v. Holder

Comments

[Dr. Knows]

Maybe it's not unethical but it's unwise for the reason that it would be foolish to pay blood doners: those who would likely donate aren't the people we want donating blood since are ELISA tests are far from perfect.

[Kim Krawiec]

Thanks for the comment, Dr., but your conjectures are not supported by the empirical evidence. See, e.g. https://www.aeaweb.org/articles?id=10.1257/pol.4.1.186
Granted, more research is needed. But that is precisely why the HHS proposed rule is a bad idea. Current policies against paying donors impede research on the topic, resulting in speculation about crowding out, safety, and other issues based on little or no evidence.

[Captain Hruska Carswell, Continuance King]

We are already sliding down that ethical slippery slope. Our hyper Reaganesque free MARKET economy gave us all license to rip each other off in the name of profits. It has reached the point where life saving treatments from everything to cancer drugs to Eppi Pens are only sold to the top bidder. So what if some poor schmo wants to sell his organs or marrow to make a few bucks?