Altruism versus commercialism

Two recent announcements have again triggered the perennial debate about altruism versus commercialism. In Israel, the health minister has reversed a ban on the import of ova, which will allow people to pay for human eggs, imported primarily from Romania. This is the first time the Israeli government has allowed the purchase of body tissue or parts for medical use. The decision was taken in response to a High Court challenge to the 6 month old prohibition, by women who were unable to receive fertility treatment because of the shortage of donated eggs.¹ In the United States, where payment for donated eggs is now fairly routine, attention has shifted to the possibility of paying for human organs for transplantation. The ethics committee of the American Society of Transplant Surgeons is reported to have recommended a pilot programme to pay the funeral expenses incurred by donating families.² At the same time, a committee of the American Medical Association (AMA) had recommended that pilot studies be conducted to determine the effect of financial incentives for cadaveric organ donation on donation rate and on the values thought to be central to donation.³ It is expected that this issue will be revisited at the AMA's annual meeting in Chicago in June when the AMA's House of Delegates will vote on a revised Report to decide whether the proposal should become AMA policy. Those promoting this type of commercialism often acknowledge that principles are giving way to pragmatism, and that the weight of moral argument lies on the side of altruism. Interestingly, however, the AMA Report would have proposed a slightly different approach arguing that: “If policymakers, ethicists, or legislators prohibit the implementation of programs that could be shown to increase the number of available organs and reduce the number of deaths, …