Past Agenda guest Sally Satel, resident scholar at the American Enterprise Institute and author of "When Altruism Isn't Enough: The Case for Compensating Organ Donors," has an op-ed in the Wall Street Journal today on what she sees as a small, but profound first victory in the quest to legally compensate organ donors.
Last week, in a unanimous ruling, the U.S. Court of Appeals for the Ninth Circuit rejected the government's position that collecting bone-marrow stem cells via a needle in a donor's arm -- the same way blood is donated -- violates the ban on paying for organs established by the National Organ Transplant Act (NOTA). It is legal and common to pay blood donors and therefore, the court said, bone marrow donors can be paid as well and are exempt from the law making it a felony to sell human organs. The ruling, she writes, will not only impact policy, but spur further discussion about commodifying body parts:
At one level, the Ninth Circuit ruling is narrow: Only cells collected in a certain way are deemed exempt from NOTA, making their donors eligible for compensation. But the decision has broad implications for transplant policy in general because it underscores the profound weakness in our altruism-only transplant policy—not only relating to bone marrow, no matter how it is collected, but also for the thousands who die each year awaiting a kidney, liver, heart or lung.
As the judges pointed out, there is no logical basis for allowing compensation for blood, sperm and eggs while disallowing bone-marrow cells obtained through apheresis. Nor is it a novel cause for alarm that the better-off will be at an advantage in purchasing. This is already true for egg donation and maternal surrogacy. In contrast, all serious proposals for revising NOTA have advanced a system in which a third party would provide in-kind incentives for bone marrow and other organs as well.
The Ninth Circuit decision should also spur a moral dialogue about the idea of "commodification." Giving a body part "free" is noble, some say, but accepting compensation is illegitimate, a sordid affront to human dignity.
How absurd. Dignity is affirmed when we respect the capacity of individuals to make decisions in their own best interest, protect their health, and express gratitude for their sacrifice. The true indignity is to stand by while thousands of people die each year.
Satel is a passionate advocate of compensation for organ donors having been in need of a kidney transplant herself. She was fortunate enough to receive an altruistic kidney donation from a friend -- and another Agenda guest -- Virginia Postrel, but she believes that depending on altruistic donations alone means a long waiting list for those in need of a life-saving transplant. If we compensated organ donors for their life-saving gift, she argues it will provide an incentive for others to do the same and increase the supply of organs. Watch her make the case for a government-regulated, compensation-based system for living donors in the video window above.
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