How much do you think your bone marrow is worth? Or more accurately, how much would it take for you to consider selling it?
According to a U.S. federal court, that price is about $3,000. In a landmark decision in a lawsuit brought by patients, parents and a donor-advocacy group, the court ruled it's now legal to buy bone-marrow cells--provided that the payment is made in the form of scholarship vouchers or donations to charity and that the bone marrow, or blood stem cells, is obtained from the bloodstream, not the bone. (If extracted from the bone, it would be considered an organ under the National Organ Transplant Act, and selling it would be illegal in any form.)
Although the ruling affects a limited number of patients--there are roughly 15,000 bone-marrow transplants in the U.S. each year, primarily to treat cancers--the case could be used as a precedent to argue for compensation for other organs, like kidneys. That would reopen a long-standing debate over the ethics of paying for body parts. More incentives would inevitably equal more available tissues and organs--a huge boon for people in desperate need of transplants. But morally, it's a slippery slope. "We don't allow people to buy and sell human beings. That's slavery," says Dr. Robert Klitzman, director of the bioethics program at Columbia University. "Should we allow people to buy and sell human body parts?"
For now, the legally sellable human body parts (see sidebar) aren't ones that could be used to cure fatal diseases, which prevents a market frenzy. But if the bone-marrow case starts changing that--and experts say it could--it might jump-start a dangerous trend in which lower-income groups are disproportionately targeted or incentivized to give up their marrow and people with rarer blood types demand more money for their valuable cells.
There are other solutions, though. Making people donors by default, as is the policy in Spain--instead of having them opt in--might help, says Klitzman. And giving donors other perks, like allowing their family members to move up the organ-transplant list, as is the case in Israel, could also encourage more people to give--all without a cent changing hands.
Sources: Flynn v. Holder; BuyandSellHair.com Sperm Bank of Calif.; Center for Human Reproduction--NY; Interstate Co.