The Case for Compensating Bone-Marrow Donors

Short dramatic film from Institute for Justice lays out the case for paying the people who give marrow, organs, and more.


What would you do to save a loved one, asks the short film "Everything."

Produced by the Institute for Justice, "Everything" dramatizes the difficulty of a family struggling to find a bone-marrow donor for a child. The movie makes a powerful case for an obvious solution that we at Reason have advanced for decades: Compensate donors who provide organs, body tissue, and other substances. Waiting lists and deaths attributable to chronic shortages would shrink overnight.

But such an obvious, common-sense solution is blocked at every turn by defenders of a status quo that serves everyone's interest but the patient's. While donors can be compensated for certain substances (blood plasma, sperm), federal law prohibits the sale of organs, body tissue, and a variety of other substances. Sometimes the argument against compensation is rooted in religious objections and sometimes it's masked in the language of "medical ethics." What never gets addressed is a death toll that will continue to climb as more and more people need transplants and are denied by a supply chain that doesn't come close to meeting demand.

Here's the original writeup about "Everything." Go here for more information about the movie and larger cause.

Every year, nearly 3,000 Americans die because they cannot find a matching bone marrow donor. Common sense suggests that offering modest incentives to attract more bone marrow donors would be worth pursuing, but federal law made that a felony punishable by up to five years in prison.

That is why in 2009, adults with deadly blood diseases, the parents of sick children, a California nonprofit and a world-renowned medical doctor who specializes in bone marrow research joined with the Institute for Justice to launch a legal fight against the U.S. Attorney General to put an end to a ban on offering compensation for bone marrow donors.

The National Organ Transplant Act (NOTA) of 1984 treats compensation for marrow donors as though it were black-market organ sales. Under NOTA, giving a college student a scholarship or a new homeowner a mortgage payment for donating marrow would land everyone—doctors, nurses, donors and patients—in federal prison for up to five years.

NOTA's criminal ban violated equal protection because it arbitrarily treats renewable bone marrow like nonrenewable solid organs instead of like other renewable or inexhaustible cells—such as blood—for which compensated donation is legal. That makes no sense because bone marrow, unlike organs such as kidneys, replenishes itself in just a few weeks after it is donated, leaving the donor whole once again.

In 2011, the 9th U.S. Circuit Court of Appeals ruled in favor of the cancer patients and their attorneys from the Institute for Justice, holding that the National Organ Transplant Act's ban on donor compensation does not apply to the most common method for donating marrow. The U.S. Attorney General sought to have that ruling overturned by the full 9th Circuit, but was unsuccessful.

The Institute for Justice's legal victory became final in June 2012, and a new tool in the fight against deadly diseases became available, when the Attorney General declined to appeal its loss to the U.S. Supreme Court.

But no sooner was that legal victory established than the U.S. Department of Health & Human Services proposed a new rule that would negate the legal victory and block model research programs designed to examine the effectiveness of compensation. Nearly 500 people—including Nobel Laureates—wrote to HHS discouraging them from adopting the rule. But for nearly 3 years now, HHS has remained silent blocking such research and costing American cancer patients their lives.

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  1. Better 1000 people die than 1 bum gets his organs scooped out by profiteers!

  2. I’d put it another way:
    The Case for Keeping the Government Out of Free Transactions

  3. I’m on the bone marrow donor list. When you’re on the list, your chances of being an actual match to somebody in need is around 1 in 1000. If someone does match me, I’ll be more than happy to donate, voluntarily, without recompense.

    But I’m not everyone. And allowing people to be paid for their time and for their efforts, or being paid just to get them to donate, would bring a hell of a lot more people into the fold, and would save thousands of lives. That the government actually makes this (criminally!) illegal is indefensible.

    1. It’s infuriating. I get the apprehension some people have that allowing people to sell organs might lead to low-time-preference folks jeopardizing their health for the sake of a few bucks, but thousands of people are dying every year. We could at least try something new, maybe a few small exceptions regarding certain components, can’t we?

  4. I don’t understand the double-standard between donating organs or tissues vs. donating gametes. If sperm donors and egg donors can get compensated for helping people create new lives, it shouldn’t be such a stretch to allow compensation for donations to save lives that already exist.


  5. Yeah, what kind of loser gives way an organ for free?

  6. Ohhhhh, no. I’m not paying for my replacement kidney. I’m owed.

    1. Damn right. The government should put together a sweeping, trillion-dollar program to register everyone’s organs and dole them out as needed.

      The people should be forced to surrender their organs to the greater good, as determined by a nameless, faceless bureaucrat. Profits are evil, and those organs don’t belong to you.

      1. “You didn’t grow that”

  7. But it’s wrong to allow people to make money off of other people’s medical need! Excluding doctors, nurses, hospitals, insurers, pharmaceutical manufacturers, organ procurers, and the government bureaucrats that regulate the industry. Oh, and lawyers, sorry Will Smith character guy.

    1. Excluding EVERY damn participant, except the ‘donor’, ’cause money is icky and medical care is a “right”!

  8. The biggest argument that most make against this is that the poor will sell organs to make ends meet and that recipients and doctors would take advantage of them. I call BS on this. If the donation is for bone marrow or some other tissue type, this could actually be something that could help the donor as well as they might get other types of medical attention they could not otherwise afford or even realize they needed.

    1. ?

      “Before we take that marrow, lets just fix that cataract”

  9. The U.S. Attorney General sought to have that ruling overturned by the full 9th Circuit, but was unsuccessful.

    Another log on the Hellfire awaiting Eric Holder.

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