New ethical guidance on egg donation, following an antitrust settlement regarding price fixing.
Financial compensation of oocyte donors: an Ethics Committee opinion. by The Ethics Committee of the American Society for Reproductive Medicine, American Society for Reproductive Medicine, Birmingham, Alabama, Fertility and Sterility® Vol. 116, No. 2, August 2021
"Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. This document replaces the document of the same name published in 2016. (Fertil Steril 2021;116:319-25. 2021 by American Society for Reproductive Medicine.)
"ESSENTIAL POINTS:
Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds.
Compensation is in accord with principles of fairness, occurring within the framework of a professional relationship.
Compensation should acknowledge the donor’s time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery. Compensation should not vary according to the planned use of the oocytes (reproductive or research) or the number or quality of oocytes retrieved.
Compensation should be fair and should not be an undue enticement that negatively impacts a donor’s ability to make an informed decision about the donation process and the risks involved with donation.
All oocyte-donor recruitment programs, including agencies, egg banks, and fertility clinics, should individually adopt and implement effective processes for information disclosure and counseling in order to promote informed decision-making by prospective donors.
Treating physicians owe the same professional duties to oocyte donors as to all other patients.
Programs should ensure equitable and fair provision of services to oocyte donors.
Programs should individually adopt and disclose policies regarding coverage of an oocyte-donor’s medical costs should she experience complications associated with the oocyte retrieval process."
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" Because the burdens of donation are similar regardless of the ultimate use of the oocytes, compensating donors of oocytes for research is also ethically justified. There has been some movement at the state level to permit compensation to research donors, which stands in contrast to the approach articulated by the National Academy of Sciences with respect to compensation for oocyte donation for stem-cell research (21). In 2009, New York became the first US state to implement a policy permitting researchers to use public funds to reimburse women who donate oocytes directly and solely for stem-cell research, not only for the woman’s outof-pocket expenses, but also for the time, burden, and discomfort associated with the donation process (22). A law enacted in California in 2019 likewise requires women who provide human oocytes for research to be compensated for their time, discomfort, and inconvenience in the same manner as other research subjects, removing a previous prohibition of compensation of research donors (11).
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"It is ethically permissible for a program to refuse to accept a prospective oocyte donor if they become aware that a prospective oocyte recipient or recruiting agency has offered gifts or payments that the program, in the exercise of its own ethical judgment, believes compromise the donor’s free choice or are otherwise ethically inappropriate. Programs should not assume that known donors, such as family or friends, are not being financially compensated. In one study of recipients using both known and anonymous donors, 19 of 20 of the known donors had been compensated, and there were no differences in the amounts provided to known and anonymous donors (27).
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"This report was developed under the direction of the Ethics Committee of the American Society for Reproductive Medicine (ASRM) as a service to its members and other practicing clinicians. Although it reflects appropriate management of a problem encountered in the practice of reproductive medicine, it is not intended to be the only approved standard of practice or to dictate an exclusive course of treatment. Other plans of management may be appropriate, taking into account the needs of the individual patient, available resources, and institutional or clinical practice limitations.
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That last paragraph may be a bow to the antitrust settlement discussed in the post below:
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