In a recent thread I argued that renewable is not a sufficient criterion (and perhaps not necessary, either). Risk to the donor is much more important. Money in medicine is coercive, but if you are coercing someone into doing something nearly never harmful (blood or sperm donation), it's not a problem. If you're coercing them into doing something with high risk, even if the tissue is renewable, then I believe we have a problem (liver donation).
Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
Risk matters, but the only impact is has on anything is on price. If something has a 0.1% chance of killing me, I'll expect far, far less money for it than something with a 5% chance of killing me. I might still do it, but the payoff has to be proportional to the risk I'm taking. I ride in cars knowing that I'm taking a risk, but I do it because I want the value that riding in a car gives me.
In the abstract, I agree. One could create a utility function expressing the necessary compensation (for them) in exchange for taking on a certain amount of risk. In the concrete, I'm not so comfortable with this on a population scale. People in general are not good at understanding risk, and they are not good at understanding medicine.
Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk.
We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.
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In a recent thread I argued that renewable is not a sufficient criterion (and perhaps not necessary, either). Risk to the donor is much more important. Money in medicine is coercive, but if you are coercing someone into doing something nearly never harmful (blood or sperm donation), it's not a problem. If you're coercing them into doing something with high risk, even if the tissue is renewable, then I believe we have a problem (liver donation).
Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
Risk matters, but the only impact is has on anything is on price. If something has a 0.1% chance of killing me, I'll expect far, far less money for it than something with a 5% chance of killing me. I might still do it, but the payoff has to be proportional to the risk I'm taking. I ride in cars knowing that I'm taking a risk, but I do it because I want the value that riding in a car gives me.
In the abstract, I agree. One could create a utility function expressing the necessary compensation (for them) in exchange for taking on a certain amount of risk. In the concrete, I'm not so comfortable with this on a population scale. People in general are not good at understanding risk, and they are not good at understanding medicine.
Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk.
We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.