Should Monetary Incentives Be Used To Expand Donor Pools?

By Sharita Thomas, Staff Editor

On December 1st, the 9th U.S. Circuit Court of Appeals ruled that bone marrow donors can receive compensation for marrow acquired through blood donations. Title III of the 1984 National Organ Transplant Act (pdf) prohibits the transfer of organs for “valuable consideration” apart from the reasonable compensation associated with the donation process, such as transportation or lost wages. The act included bone marrow as an organ due to the extensive nature of the traditional extraction process, which involved cells from the hip bone. The appellate court ruled that the filtration of bone marrow stem cells from the blood, a process commonly known as peripheral blood stem cell (PBSC), is a process dealing with “blood parts” rather than “organ parts.” Members of the medical community are hopeful that a removal of the compensation ban on bone marrow donations by way of PBSC will significantly expand the donor pool.

Monetary compensation for the donation of naturally replenishable human components, like sperm and plasma, account for a large part of the motivation driving donors. The ban associated with the National Organ Transplant Act was implemented partly to protect the vulnerable poor from choosing painful and tolling procedures in order to earn cash. According to the National Marrow Donor Program, 10,000 patients need a marrow transplant but only half will receive one. The organ donor list in the U.S. is not as large as donation advocates wish, with estimates that 18 people will die each day waiting for an organ. This recent ruling has me once again thinking about whether it has come to a point where implementation of a death benefit (in which living relatives are paid for donating the organs of deceased family members) should be considered as a policy alternative to revitalize the supply of organ donations


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