Can we ethically increase organ, egg and sperm donation?
Should more people be expected to donate organs, eggs and sperm and, if so, how far can we ethically go in encouraging them to donate, asks the Nuffield Council on Bioethics in a consultation launched today. The Council is calling for the public’s views on how we should respond to the current demand for organs, sperm, eggs and other human material for use in medical treatment and research. Professor Dame Marilyn Strathern, the Chair of the inquiry, said: “We could try to increase the number of organ donors by providing stronger incentives, such as cash, paying funeral costs or priority for an organ in future, but would this be ethical? Women can already get free IVF treatment from private clinics to encourage them to donate eggs, and healthy volunteers may be paid significant sums of money to ‘donate’ their bodies to test new medicines for the first time in humans. We want to explore why the rules are different for different kinds of donation.” Paying people, beyond covering expenses, to donate most kinds of organs and tissue for use in medical treatment is currently illegal in the UK. However, some people are travelling abroad to get organ transplants and fertility treatment in countries where this is more widely available, either because of different laws or because of illegal markets. The extent of ‘transplant tourism’ is not fully known. “Perhaps we should accept that we can only do so much to meet the ever increasing demand,” said Professor Strathern. “We also need to think about the morality of pressing people to donate their bodily material. Offering payment or other incentives may encourage people to take risks or go against their beliefs in a way they would not have otherwise done.” The current system of organ donation relies on people donating to help a loved one or society as a whole. The NHS has been working to increase organ donation by improving transplant infrastructure and encouraging people to sign the organ donor register. The demand for organ donors has increased in recent years, due to an ageing population and improvements in medicine that mean more people are able to benefit. This rise is likely to continue into the future. Around 8000 people are waiting for an organ transplant in the UK, and there is currently a demand for roughly 1200 more egg donors and 500 more sperm donors. Scientists also need people to donate human tissue for research. “We ourselves or one of our relatives may one day need donated organs or tissue, and most of us are likely at some point to use NHS medicines that have been tested on healthy volunteers or human tissue. Given this, perhaps donating parts of our bodies should been seen as a moral obligation for all of us,” said Professor Strathern. The Council is considering all kinds of donation, both in life and after death, including whole organs, blood, skin, corneas, bone, sperm, eggs and embryos, as well as clinical trials that test the safety of new medicines for the first time in humans. The Council is seeking views from professionals, groups and individual members of the public on a number of questions. It has today published a consultation paper, Give and take? Human bodies in medicine and research. The closing date for responses is 13th July 2010. The Council set up a Working Party in January 2010 to consider the ethical issues raised by the use of human bodies on medicine and research. The group is chaired by Professor Dame Marilyn Strathern, Professor of Social Anthropology at Cambridge University, and includes members with expertise in organ transplantation, fertility treatment, clinical trials, tissue research, ethics, health psychology, law, and anthropology. A report outlining the group’s findings, including recommendations for policy, will be published in autumn 2011.