Quote-of-the-day mailing list
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Subject: qotd: Bone Marrow as a commodity
Date: Tue, 3 Dec 2013 11:07:12 -0800
From: Don McCanne <email@example.com>
To: Quote-of-the-Day <firstname.lastname@example.org>
December 1, 2013
Why It's OK to Pay Bone-Marrow Donors
By Sally Satel
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
Comment: 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?