From a recent thread on a woman arrested for prostitution:
Now let’s talk about bone marrow.
The National Organ Transplant Act (NOTA), 42 U.S.C. § 274e(a), provides:
The penalty is $50,000 and five years in prison.
This means that I can’t pay you to donate a kidney to me. This itself would seem to fly in the face of, “It’s my body and I can do anything I want with it…” philosophy expressed about prostitution.
But perhaps kidneys are special. After all, they don’t grow back.
But bone marrow does.
MoreMarrowDonors.org wants to give scholarships, housing allowances, or donations to designated charities to certain bone marrow donors who have desperately needed types of marrow. However, they cannot legally do this, because scholarships and housing allowances and gifts to designated charities are “valuable consideration” within the meaning of the law. Donors can give marrow out of the goodness of their hearts, but can’t be compensated for it.
So – what should the law be here?
I believe there are problems associated with a “do whatever I want with my body” approach to the problem, because Montgomery Burns can buy organs from poor people who willingly accept the risks associated with the donation for the cash payout.
But I also think that the current law is unworkable, because it stops an activity we should not seek to prohibit: encouraging rare bone marrow donors.
I think this seems like something of an overstatement. One approach offers problems, but the other is unworkable? It would seem to not be unworkable, because it’s currently working.
I’m on the fence on this issue. I don’t believe i’m really convinced one way or the other; certainly, both of the problems you highlight are what i’d say were considerable problems. But I can’t say which is the worse. It’s an idea which to me seems, inherently unuseful, against an idea which seems reasonable but which seem open to considerable abuse. Do you have any particular ideas which might minimise that potential abuse?
Such things are “valuable consideration” by any reasonable meaning, of course.
What surprises me is that bone marrow is apparently regarded as an “organ” within the meaning of the law. As you say, bone marrow is a renewable resource, like blood. And people have been selling their blood for money for decades. Is blood now an organ as well? And if not, how does one classify marrow as an organ, but not blood?
I know this is something of a side issue, but I’m curious.
Not around here they haven’t. A few months ago I was considering selling plasma for cash, only to find out the great state of California won’t let me. I could drive to Nevada to do it, but that makes it rather less economical. Especially if i ended up at a roulette table.
One solution to the Montgomery Burns problem might be to tweak the law so that private citizens can’t buy bone marrow, but hospitals can. That is, hospitals could be allowed to use their pro bono funds to purchase rare bone marrow, if they wished. This way, it wouldn’t be just rich people buying all the marrow - hospitals could use their pro bono funds to buy rare marrow for indigent patients, if they chose.
It’s your body, you should be able to sell it. Even piecemeal. We had a discussion on this in the recent organ donation thread.
I think a market for organs (including bone marrow) would increase the supply and put money in the hands of the (mostly poor) people who would be the sellers. We could still encourage organ donation by the upper classes for the poor patients who can’t afford to buy their own.
I don’t see this as a problem. Inform the public of their risks and let them make their own decisions. If I think the risks are worth the rewards, and nobody else has to bear the consequences of those risks but me, who are you to deny me that choice?
Of course you should be able to sell your bone marrow. Why shouldn’t you?
We should have legal markets for organs from living donors. As for fears that millionaires will exploit the poor, well, you only need to pay a million dollars for a kidney if it’s illegal to buy a kidney. If it’s legal to buy a kidney, you only need a few thousand dollars.
The specter of rich millionaire ghouls sucking the life out of helpless proletarians is nonsensical. Under our laws transplant doctors make thousands of dollars every time they perform a transplant. The doctor gets paid, the hospital gets paid, the lawyers get paid, everybody gets paid except the sucker who donated the freaking kidney.
If you could buy organs, it wouldn’t mean millionaires would jump to the head of the line, because the cost of transplants is so high that a couple thousand bucks for the donor is a rounding error. If a poor person is getting a kidney transplant someone somewhere is paying multiple tens of thousands of dollars for it. If a poor person can afford a $100,000 kidney transplant, is a $5000 fee to the donor going cause the deal to fall apart?
So yeah, bans on payments to organ donors are wrongheaded. What else did you expect people to say?
Why should it be illegal to give someone money for donating blood or marrow, but legal to pay a man to donate his seed? All three are “renewable resourses”.
If it it costs ONE MILLION DOLLARS to buy someone’s kidney, and therefore only rich people get to buy kidneys, well, at least that rich person isn’t waiting in line for a free kidney, are they? So every time a rich person buys a kidney a poor person moves up a notch in line.
If people could sell kidneys for a million dollars, there would be no more free kidneys available. Next of kin would assert rights.
On the other hand, if the supply widened, prices would drop, and it wouldn’t cost a million dollars anymore. What it would end up costing, and how that would limit availablility, would be debatable.
I also approve of the hospital-only compromise. It ensures that proper care will be taken in organ extraction.
I haven’t really heard the rationale behind treating bone marrow like an organ, and from what I’ve heard the procedure is significantly less painful and time consuming now than it was when the bill was passed in 1984. (No pelvic needles!)
Kidneys are a more problematic, but probably far less problematic than all the people dying on waiting lists and the billions wasted on semi-permanent dialysis.
My only qualm is the distant chance that changing donation from an act of good will to a detached cash transaction may be a worse solution than the current problem, but I highly doubt it applies here.
No matter what, banning kidney and bone marrow sales still makes a whole hell of a lot more sense than banning federal stem cell research, which could potentially render the whole discussion moot.
The OP and others might find this recent articleof interest. It deals with kidney donations, but I think the principle applies to other things, such as marrow.
No you can’t sell your kid for parts. :rolleyes::rolleyes::rolleyes:
You can’t chop off your kid’s hand for fun, you can’t sell him to the circus, you can’t rent him to child molestors, you can’t grind up your kid’s body and sell it for cat food, and so on.
Even if you are allowed to sell organs, no ethical doctor will remove healthy tissues or organs that will significantly disable or kill the donor. Ever heard of the Hippocratic oath?
What good would it do to remove someone’s healthy eyes, leaving them blind, to tranplant the eyes into a blind recipient? You have no net change. And since the recipient would never get full function, you’d have a net decrease in health.
Well I have a left ventricle AND a right ventricle. And I know there are two strole and four stroke engines. They ought to be able to cobble together a two chamber heart so I can sell half of mine.
On a more serious note, how about allowing insurance companies to buy organs, so they can offer it as a policy benefit if you pay a higher premium?