The BBC is this week reporting that the Nuffield Council on Bioethics (an entity set up to evaluate ethical questions arising from the advance of biological and medical research) is running a public consultation to evaluate means of increasing the donation of blood, sperm and organs, to counteract the outstripping of supply by demand. Among the ideas put forward is the possibility of cash incentives and/or the payment of funeral expenses in exchange for these precious commodities.
The consultation exercise is, I believe, interesting in two philosophically-relevant respects. Firstly, and most obviously, there is the question about whether financially incentivising major organ donation is an ethically acceptable practice. This issue has already been raised once on this blog most ably by one of my estimed colleagues, so I will keep this brief. It is a fact that the demand for organs is large, and growing (due to longer-lifespans and improvements in medical technology). Furthermore, a successful donation and transplant can do a dramatic good to the life of the recipient. On the face of it, then, offering a motivation to donate seems like a good idea. However, Professor Dame Marilyn Strathern urges caution:
“We 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 could not have otherwise done.”
There are, perhaps, further concerns present here of an ethical ‘slippery slope’ towards more wide-spread ‘live’ organ donation for financial gain, an activity not sanctioned in the UK.
The second point of philosophical interest is the very fact of the consultation itself. What we are faced with is a question of moral legitimacy. The Nuffield Council’s approach is to consult not ‘experts’ on morality (trained ethicists, judges, even philosophers perhaps), but rather the general public: or, to put the point better, to treat the general public as moral experts on this matter. Without venturing a point of judgement on this practice, it is an interesting one which raises fascinating questions about whose word we should take for the moral legitimacy of certain practices.
The Nuffield Council’s consultation exercise will run for 12 weeks (until 13th July 2010), with the results published in the Autumn. You can participate in the exercise here.
Back to Basics in Bioethics: Reconciling Patient Autonomy with Physician Responsibility
By Antonio Casado da Rocha, University of the Basque Country
(Vol.3, December 2008)