Medical Humanities, Julius Center for Health Sciences and Primary Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.
Reproductive Medicine and Gynecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
J Med Ethics. 2019 Nov;45(11):736-741. doi: 10.1136/medethics-2019-105474. Epub 2019 Aug 2.
There is a growing consensus that the offer of a reasonable compensation for oocyte donation for reproductive treatment is acceptable if it does not compromise voluntary and altruistically motivated donation. However, how to translate this 'reasonable compensation' in practice remains unclear as compensation rates offered to oocyte donors between different European Union countries vary significantly. Clinics involved in oocyte donation, as well as those in other medical contexts, might be encouraged in calculating a more consistent and transparent compensation for donors if the elements that constitute a reasonable compensation are explicated. In doing so, lessons can be learnt from living organ donation and medical research participation. Practices in which the elements of a reasonable compensation for the individuals involved have already been more defined in the literature. By means of analogical reasoning, we will outline the different components of a reasonable compensation and subsequently apply these to the context of oocyte donation. We will argue that oocyte donors should first of all be reasonably reimbursed direct expenses related to the donation, without standard remuneration of lost wages. Second, donating oocytes requests a serious time investment, therefore donors are entitled to suitable compensation for their time spent and efforts made. Finally, we will explain that a reasonable compensation consisting of these two components allows for altruism to remain the key value of oocyte donation for reproductive treatment. However, if we acknowledge that donors' motives are more complex and often include reasons from self-interest, the reasonable compensation may be complemented with modest (non)monetary benefits.
越来越多的人认为，如果提供的报酬不会损害自愿和利他动机的捐赠，那么为生殖治疗提供合理的卵子捐赠报酬是可以接受的。然而，在实践中，如何翻译这个“合理报酬”仍然不清楚，因为不同欧盟国家的卵子捐赠者的报酬率差异很大。如果明确构成合理报酬的要素，那么涉及卵子捐赠的诊所，以及其他医疗环境中的诊所，可能会被鼓励为捐赠者计算更一致和透明的报酬。在这样做的过程中，可以从活体器官捐赠和医学研究参与中吸取经验教训。在这些实践中，文献中已经更明确地界定了涉及个人的合理报酬的要素。通过类比推理，我们将概述合理报酬的不同组成部分，然后将这些应用于卵子捐赠的背景。我们认为，卵子捐赠者首先应该得到与捐赠相关的直接费用的合理补偿，而不是标准的工资损失补偿。其次，捐赠卵子需要大量的时间投入，因此捐赠者有权获得与其时间投入和努力相匹配的报酬。最后，我们将解释说，由这两个部分组成的合理报酬可以使利他主义仍然成为生殖治疗中卵子捐赠的核心价值。然而，如果我们承认捐赠者的动机更加复杂，通常包括自利的原因，那么合理的报酬可以通过适度的（非）金钱利益来补充。
