Strapped for cash? Sell your cells!

sperm maze

 In these difficult economic times, it is not surprising that many people are scavenging the basement for goods to sell on E-bay. Most people don’t realize that there are valuable (and renewable) personal possessions available for sale closer to hand: their own cells.

A market for blood components, such as plasma, has long existed because the need is so high. Recently, however, new cellular products have become far more lucrative. These are sperm, and, especially, eggs (ova).  An article on MSNBC highlights the rise in inquiries about paid donation:

…Seeking quick cash in a tanking financial market, would-be sellers of a variety of body products — sperm, eggs, blood plasma, even human hair — are filling waiting rooms and swamping agencies with inquiries.

Increasingly, industry officials say people are hoping to trade spare body fluids, tissues and other parts for payments that can range from $20 to $50 a pop for blood plasma to $60 to $100 for a shot of sperm, $200 for a shiny ponytail and up to $7,000 for a fertile egg.

At the Seattle Sperm Bank alone, donor applications have tripled from 50 to 150 a month during this financially precarious autumn, staff members said, while officials at egg donation agencies from Chicago to Houston estimate that calls are up at least 30 percent over last year.

Organizations that pay for donations insist that donors aren’t motivated by money, or at least not motivated solely by money:

…Christine Kuhinka, a spokeswoman for ZLB Plasma, which operates 66 centers across the country, said she believes more donors are being motivated by altruism.

“There are many reasons to donate plasma,” she said. “At the end of the day, most people recognize that they’re saving lives.”

But blood industry experts said it’s disingenuous to claim that compensated plasma isn’t tied to a faltering economy.

“I am confident that paid plasma increases in tough economic times as a direct result of the economy, and would love to see the data used by plasma companies that says it is not,” said Dr. Louis M. Katz, executive vice president of the Mississippi Valley Regional Blood Center in Davenport, Iowa.

The opportunity to donate plasma, sperm and eggs in exchange for financial compensation highlights an ethical paradox in US healthcare. While sale of cells for money is allowed, sale of organs is strictly prohibited. According to Payment for donor kidneys: Pros and cons by Friedman and Friedman:

…The National Organ Transplant Act states: ‘It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.’ Punishment includes fines up to $50,000 and/or 5 years in prison, but has not been meted out. A year after enactment of National Organ Transplant Act, the Ethics Committee of the Transplantation Society issued a supporting Policy Statement: ‘No transplant surgeon/team shall be involved directly or indirectly in the buying or selling of organs/tissues or in any transplant activity aimed at commercial gain to himself/herself or an associated hospital or institute.’

A variety of ethical principles are invoked to justify this ban, even though it may inadvertently sentence to death many people in need of replacement organs. Thousands die each year for lack of people who donate for altruistic reasons during life or after death. Opponents of paid organ donation argue that compensating people for their own organs violates the principle, articulated by the philosopher Immanuel Kant, of intrinsic human dignity. More prosaically, opponents point out that the need to donate for cash will not fall equally on all members of society. The poor and the socially marginized will be under much greater pressure to donate for financial reasons than other members of society.

Other countries do not share the illogical combination of policies favored by the United States. Canada bans financial compensation for all donations, organs and cells. At the opposite end of the spectrum, many countries pay only lip service to legal bans on organ donation. India, China and Russia, among others, have thriving trades in replacement organs.

In the US, we are even inconsistent about our inconsistency. While donation of eggs (ova) for use by infertile couples is generously compensated, donation of eggs for stem cell research is typically not compensated at all. Partly this is the result of the controversial nature of stem cell research under the Bush administration. However, it also reflects our ambivalence about the various uses of donor cells. The creation of human embryos to treat infertility is viewed very differently than the creation of human embryos for use in research.

Can selling cells be ethically justified within a system that bans selling of organs? Without financial compensation, the supply of donor sperm will drop precipitously, and the supply of donor eggs will likely disappear altogether. Yet that is hardly as disastrous an outcome and the thousands of deaths resulting from a ban on selling organs.

Art Caplan, director of the Center for Bioethics at the University of Pennsylvania, knows where he stands:

“The uptick [in donation for money] gives lie to the system that invokes ‘donors’ when it’s really a system of ‘sellers,’”…

“Altruistic motivation isn’t going up,” he added. “The drive to get paid is going up.”

Caplan worries most about donation of genetic material such as sperm and eggs. People who need cash may not be truthful about their medical background, for instance. Or they might be so desperate for money, they don’t think through the potential for physical and emotional complications.

“In economic hard times, if somebody went out to sell a baby, there would be moral contempt,” he said. “But if you sell the ingredients for a baby — and the oven — we don’t pay attention.”