December 12, 2017

Eggs, sperm and kidneys for sale

In the US, it is against the law for somebody to sell their kidney or other organ. This is clear, even if getting a kidney could well be the difference between life or death. It’s true even if the recipient is eager to pay and even if the potential kidney donor is rational, intelligent and voluntarily willing to make the exchange with no coercion.

This is certainly one of the most complex ethical dilemmas in medicine and although the law is simple and clear-cut, the overall ethical answers are not so clear cut.

Two recent news stories bring this issue up for discussion. One reporting an increase in egg and sperm donor applicants and one reporting about people turning to internet sites such as Craigslist to solicit organ donation.

In contrast to kidneys and other organs, when it comes to the donation of sperm and eggs, the law in the US is different. Egg and sperm donors are regularly paid for their participation. Technically, an egg donor does not sell her eggs. At least that’s the official spin. She undergoes injections and a medical procedure to enable her eggs from that month to be removed. This is what she officially gets paid for, not for her eggs per se. But no matter how you label it, the fact is the recipient couples pay her with the intention of using her eggs to help themselves have a baby.

So for kidneys and other organs, it is illegal in the US for there to be any financial compensation given to the donor. For eggs, it is legal in the US, but it is illegal in other countries, such as in the United Kingdom.

Kidney donation and egg donation have some key fundamental differences. Kidney donation is done to save a life. Egg donation is done to voluntarily conceive a baby. A kidney donor loses half of his/her potential kidney function. An egg donor loses only surplus eggs from THAT month, which were going to be wasted forever anyway. The same goes for a sperm donor. However, the sperm and egg donation have social repercussions in that afterwards, there could be a child walking around with the donor’s genes that he/she will never know. So keeping those in mind, let’s look at the different arguments.

PAYMENT SHOULD BE ALLOWED TO GIVE INCENTIVE FOR PEOPLE TO DONATE:
– “It is sheer agony to watch my wife waste away day by day. The dialysis is barely keeping her alive. I’ve read stories of how life greatly improves after a successful transplant and I wish for her to have her once-happy life back again. We have been on the waiting list for over a year and we’ve already pleaded with all our family and friends. Of the few that offer, none have been a match. Yesterday, I saw someone on Craigslist offering to donate a kidney in exchange for money. The money in my retirement account is worthless to me in the future in comparison to what it could do now to save my wife. Yet, I am afraid I will have to risk breaking the law if we make an under-the-table arrangement.”

ALLOWING PAYMENT FOR ORGANS IS UNFAIR TO THOSE WHO DON’T HAVE THE MEANS TO PAY:
– “My wife has been on the waiting list for a kidney for a year now. We are on welfare, because neither of us work and we just don’t have the financial means to purchase a kidney. We are so thankful that kidneys can not be bought, because otherwise, it would be unfair for the rich people to jump ahead of us in line. By making it not about money, then it is fair for everyone, rich or poor. The decision of who gets to live should not be based on ability to pay”

– “My cousin was ready to donate his kidney to me. Then he heard that other people were getting thousands for their kidney and he decided he longer wanted to give me his kidney. Instead, he wanted to shop for the best offer instead. I don’t make enough money to pay him and therefore, I am losing the kidney that I was entitled to. It should be illegal for someone to offer money.”

PAYMENT WILL RESULT IN MORE OVERALL DONATIONS, THEREBY BENEFITTING THOSE WHO ARE WAITING FOR ORGANS:
– “There is no doubt that money talks. Look what’s happened to the number of sperm and egg donor applications with the current drop in economy. There are not many people lining up to volunteer their kidneys today. If there were financial compensation, the number of willing donors would skyrocket. So let’s say there are 10 rich people and 10 poor people waiting for kidneys and at the current rate of new donors, 1 rich person and 1 poor person would be saved by getting a kidney. Now let’s say that the rich people are allowed to offer a reward for donated kidneys as long as they help subsidize kidneys for the poor. As a result of this policy, all 10 rich people get kidneys as well as 5 of the poor people. While this is still biased in favor of the rich, the overall number of people saved is much higher.

OFFERING TO PAY FOR ONES BODY PARTS EXPLOITS THE POOR:
– “Can you imagine all the people who are so desperate for money that they will be forced to donate a kidney just to survive? It is cruel and inhumane to turn our bodies into replacement parts”

IT’S MY RIGHT TO DO WITH MY BODY AS I WISH:
– “I work a minimum wage job. I have always dreamed of of going to Hawaii, but there’s no stinking way I can ever afford it. I’m more than willing to give up a kidney in exchange for a chance to realize my dreams. I know that there’s a 5% chance that I will have problems and regret it, but I’m willing to take a little hope for my life in exchange for no hope at all. With the money, not only could I go to Hawaii, but I could also go to Europe and do many other things I could never have done otherwise. I would also have something leftover to give to my children to help brighten their future.”

COUNTRIES WITH MORE RESTRICTIONS HARM THOSE WHO NEED THE DONATIONS:
– “In England, there is a severe shortage of egg and sperm donors. Couples are resorting to drastic measures in order to find the help they need in order to have babies. More and more, couples are coming to the US and to other less-restricted countries in order to do their cycles that require donor eggs or donor sperm.

DONORS ARE TAKING A RISK AND SOCIETY COULD END UP BAILING THEM OUT:
– “Look. If somebody donates a kidney and is left with just one remaining. Then, they go spend all the money they got. What if something happens to their remaining kidney and now, my tax money or my insurance premiums will go to pay for their needed medical care. That’s certainly not fair to burden society just so that those people can have more spending money.”
– “Then what about someone who donates altruistically for no money compensation. If something happens to their remaining kidney, doesn’t society face the same burden?

Where do I stand? I see the arguments of both sides because, well there are some good and bad things associated with either a free policy to accept payment for donating or a restricted policy banning financial compensation. Because there are good arguments in favor of and against the restriction of paying donors, I don’t agree with the government’s black-and-white policy of just saying NO to every case. There needs to be some flexibility with reasonable checks and balances against abuse. A blanket ban is not the best for everyone involved.

17 February update:
Here’s a story about how things are in China.

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  • Edward Bonk

    Hello

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    Best regard
    Dr Pramod
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    ..

  • Edward Bonk

    Hello

    this is to inform the general public
    that healthy Kidney donors are needed from all blood groups by Manipal
    Hospita, each donor gets 1 crore 20 lakhs. Advance payment will be paid
    first to the donor before the operation will commence after which the
    balance will be paid after the completion of the operation. hurry now
    and contact us via email pramodtransplant7@gmail.com or WhatsApp +918867413844

    Best regard
    Dr Pramod
    WhatsApp +918867413844
    .