Bone marrow transplants save lives. Bone marrow, unlike a kidney, regenerates. Kudos to the Dept. of HHS for removing restrictions on the sale and purchase of bone marrow.
Bone marrow is not like a kidney. A kidney does not regenerate. Bone marrow does. This might be a primary point for skeptics who see the commercialization of kidney transplants as unethical.
If the highest ethic is to save human lives, then the right to buy and sell bone marrow trumps whatever ethical ambiguities might attend to the controlled commercialization of bone marrow purchase and sale. Not, truth to tell, that we see any ambiguities.
First, as we say, bone marrow regenerates. There is no permanent loss to a healthy bone marrow donor.
Second, why must a person be a bone-marrow “donor?” Why must people die waiting for a bone-marrow transplant? Money is a motivator, especially for the poor; and as reality would have it, it is the poor who include some of those most in need of life-saving bone marrow transplants. This is because the potential donor pool is smallest among, for example, Hispanics. Which means that if you are Hispanic and you need a bone marrow transplant in order to stay alive, you are less likely to find the required match. Public policy that supports this lethal limitation is wrong.
Public policy, blessedly, is changing. Current law lumps organ donors and bone-marrow donors together, forbidding their sale for commercial gain. The Trump administration is doing the humane thing in reversing a proposed Obama regulation that would prohibit compensation for bone-marrow donors.
It is not difficult to conceive or to enforce rules that protect from exploitation those who wish to sell their bone marrow, though nothing can protect the donor from the discomfort involved. If a person wishes to subject himself to that discomfort in the name of saving lives, and receive a bit of compensation along the way, we say: Bless him. Bless her. Even for money, people who volunteer to go through what it takes to provide bone marrow display real, albeit not pure, idealism,
We all know the extraordinary odds of a person who needs a bone-marrow transplant of finding an exact match. If the pool of potential bone-marrow donors were larger, the odds of matches would be greater.
It has long mystified us why it is deemed ethical only if one donates a body organ or bone marrow, but not if one sells it. Every other person and entity involved in the transplant of an organ profits from the procedure. Doctors, nurses, orderlies, hospitals, middle men, insurance companies — no one works for free in an organ transplant. But somehow, it is considered wrong if the donor profits, too. The consideration should be the other way around: It is unethical to expect total altruism exclusively of the organ donor, provided only that a donor is not exploited. Appropriate, rigorous guidelines would not be difficult to enforce. Perhaps they will become reality as the less controversial commercialization of bone marrow has been given the green light by the current administration.
We hope that this will dramatically increase the potential donor pool of bone marrow so that no longer must people watch their children — or themselves — die needlessly.
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