Incentives for Donation of Human Bodily Material?

Posted by Pete Shanks May 10, 2010
Biopolitical Times

The British-based Nuffield Council on Bioethics has launched a public consultation about donating human bodily material, including but not limited to eggs, sperm, embryos, whole organs, blood, skin, and corneas. Included in the scope of inquiry are both living and dead donors, and also healthy people "who 'donate' their bodies by taking part in clinical trials to test new medicines."

The Working Party has very general terms of reference, but the key one seems to be to consider "the role of payment and any other form of remuneration or exchange," [in this pdf] including asking, "Is there a point at which it must be accepted that supply cannot meet demand?" An email the Council sent out this week put it bluntly:

Should more people be expected to donate human bodily material and, if so, how far can we ethically go in encouraging them to donate?

The UK, like many other countries, currently forbids payment for gametes, embryos, blood, organs and tissue for transplantation (except some expenses). Is this consultation a preparatory step to recommending payment? British commentator Max Pemberton thinks it may be, and disapproves, in particular insisting that:

Egg donation must remain voluntary: the shortage of donors needs to be addressed but is money and bribery the answer?

The consultation is certainly timely. There is current discussion in the U.S. about payment for organ donors. In addition, a bill in New York would presume that organs may be taken from corpses unless the deceased (not the next of kin) had specifically expressed a contrary preference. This was the subject of a recent feature in the New York Times, with opinions from five experts, mostly supporting the concept.

A remarkable step further has been proposed by Oxford's Dominic Wilkinson and Julian Savulescu in Bioethics:

We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support.

Michael Cook at BioEdge notes that this would be "a revolution in medical ethics" (as the authors acknowledge) and also that the same authors have previously argued in favor of taking organs from living patients on life support who have no prospect of revival.

The Nuffield Council has prepared background material for the consultation, and encourages electronic submissions. As a UK-based institution, its focus is naturally on the British experience but the Working Party is explicitly directed to consider "the cultural and international perspectives, including regulatory differences."

The closing date for responses is July 13, 2010. A report, including policy recommendations, will follow in autumn 2011.

Previously on Biopolitical Times: