Showing posts with label compensation for donors. Show all posts
Showing posts with label compensation for donors. Show all posts

Friday, March 15, 2024

Plasma in Canada: payments and protests

 The local newspaper in Niagara on the Lake, a town in Ontario, Canada, covers the proposed opening next year of plasma collection centers that will pay for plasma.

Pay-for-plasma centre draws criticism from Health Coalition. The centre, which will pay residents to donate their blood plasma, is scheduled to open on Hespeler Road by early 2025, by Matt Betts

"The chair of the Waterloo Region Health Coalition is raising concerns about a pay-for-plasma centre slated to open on Hespeler Road in Cambridge by early 2025.

"Just as it sounds, residents can be compensated for donating their blood plasma.

"It's all part of an agreement between Spanish global healthcare company, Grifols, and the Canadian Blood Services.

"In September 2022, Canadian Blood Services announced our action plan in response to a global shortage of medications called immunoglobulins and plasma needed to make them," CBS said in an email to CambridgeToday.

"With funding from governments, Canadian Blood Services is opening 11 plasma donor centres in Canada and collecting more plasma ourselves. Our agreement with Grifols, a global healthcare company and leader in producing plasma medicines, is another part of that plan."

...

"paying for donations is banned in Ontario, Quebec and British Columbia. 

"However, CBS said its been in close discussions with the government and has an exemption.

...

"The agreement also complies with Ontario’s Voluntary Blood Donations Act, which has always contained an exemption for Canadian Blood Services, with implicit consideration of our agents, given our role as the national blood operator and supplier of blood products in Canada. Through our agreement, Grifols will operate under the Act as an agent of Canadian Blood Services."

"Per the agreement, Grifols must use plasma they collect in Canada to make immunoglobulins exclusively for patients in Canada, which reduces reliance on the global market, CBS said.

"But the whole operation doesn't sit right with Waterloo Region Health Coalition chair, Jim Stewart.

"It's a repugnant example of profit driven healthcare," Stewart said, questioning who's profiting in the end.

"What's next, paying people for their organs or embryos? This is just another example of Premier Doug Ford’s drive to privatize our healthcare system."

...

""These pay-for-donations centres really impact the homeless, people with low incomes and those with high levels of unemployment. This is going to dismantle the voluntary donor base and the sustainability of blood supply could be in jeopardy."

...

"While not confirmed by Grifols, Canadian Blood Resources and giveplasma.ca states qualified donors can earn up to $70 per donation and can donate twice in a seven day period."

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HT: Frank McCormick


Earlier:

Sunday, September 18, 2022

Sunday, March 10, 2024

Does high pay equal "undue inducement"? An experiment by Sandro Ambuehl

 Here's an experiment about repugnant transactions, by Sandro Ambuehl.

Ambuehl, Sandro, "An experimental test of whether financial incentives constitute undue inducement in decision-making." Nature Human Behavior (2024). https://doi.org/10.1038/s41562-024-01817-8

Abstract: Around the world, laws limit the incentives that can be paid for transactions such as human research participation, egg donation or gestational surrogacy. A key reason is concerns about ‘undue inducement’—the influential but empirically untested hypothesis that incentives can cause harm by distorting individual decision-making. Here I present two experiments (n = 671 and n = 406), including one based on a highly visceral transaction (eating insects). Incentives caused biased information search—participants offered a higher incentive to comply more often sought encouragement to do so. However, I demonstrate theoretically that such behaviour does not prove that incentives have harmful effects; it is consistent with Bayesian rationality. Empirically, although a substantial minority of participants made bad decisions, incentives did not magnify them in a way that would suggest allowing a transaction but capping incentives. Under the conditions of this experiment, there was no evidence that higher incentives could undermine welfare for transactions that are permissible at low incentives.


From the conclusions:

"Given the potentially high costs of preventing voluntary transactions, experiments paralleling those reported here should be conducted in the field. Unless their results differ drastically from the current ones, the rules and guidelines restricting incentives due to undue inducement concerns should be reconsidered."

Saturday, February 24, 2024

Foreign surrogacy in Denmark is becoming less restrictive

 Above the Law has the story:

Denmark Passes New Pro-Surrogacy Regulations. The new rules in Denmark focus on two areas of surrogacy.  By ELLEN TRACHMAN  February 14, 2024

 "On February 5, 2024, the Danish government announced new surrogacy-supportive rules scheduled to come into effect on January 1, 2025. The rules address parentage for families formed by surrogacy — including commercial (compensated) surrogacy outside of Denmark — as well as for families formed by altruistic (noncompensated) surrogacy within Denmark.

...

"In Denmark, compensated surrogacy is illegal, and altruistic surrogacy has traditionally fallen into a legal gray area, pushing most hopeful parents who want to have a genetic connection to their child, but who are unable to carry a pregnancy themselves, to go abroad. The Danish government estimates that about 100 children are born to Danish parents each year by surrogacy outside of Denmark, while about five children each year are born within Denmark in altruistic surrogacy arrangements.

...

"Denmark has a history of denying parental rights to the intended parents of children born by surrogacy abroad. But on December 6, 2022, the European Court of Human Rights ruled against Denmark in K.K. and Others v. Denmark. In that case, a married heterosexual couple had twins with the assistance of a Ukrainian surrogate. Under Ukrainian law, both Danish intended parents were recognized as parents of the child, and the surrogate was not a parent of the child.

...

"The ECHR found that Denmark’s refusal to recognize the parent-child relationship between the mother and child was a human rights violation — not a violation of the mother’s human rights, but of the two children, to have a recognized legal relationship with their mother.


To its credit, Denmark is reacting to the ECHR’s definitive ruling. In the announcement by the Danish government last week, the government made it clear that the country’s new rules are intended to go beyond the minimum requirements of the ECHR to merely not violate the human rights of Danish children.  (The bare minimum requirement would be to just allow stepparent adoptions.) Instead, the Danish government’s new rules go farther to protect children and their parents.

...

"The new rules permit Danish family courts to quickly make a decision on parenthood in the case of a foreign surrogacy agreement, even permitting a court ruling to be made prior to the family’s return to Denmark. The rules also require that the court assess the best interest of the child, but with a presumption that it is, of course, in the child’s best interest to have a timely recognition of their parents.

"Moreover, the court decisions are permitted to be retroactive to the birth of the child, permitting parents to have access to parental leave work benefits, inheritance rights, and all other benefits of that legal relationship. And, in contrast to a stepparent adoption, the new rules will allow recognition of the parent-child relationship with the mother or nongenetic parent even if parents have separated, or if one parent died before they had a chance to apply for parenthood.

...

"In a stated attempt to address the risk of child trafficking, the rules require that at least one intended parent be genetically related to the child. Additionally, the surrogate is required to confirm in a notarized declaration after the birth that she wishes to transfer parenthood of the child to the intended parents."

Friday, February 23, 2024

Directed and semi-directed living donation of kidneys: a current debate in Israel and elsewhere

 Israel leads the world in per capita living kidney donation. A good part of that comes from the work of Matnat Chaim (gift of life), an organization of religious Jews, who donate kidneys to people they don't know.  They are "semi-directed" rather than non-directed donors, in that the organization allows them to indicate some criteria they would like their recipients to have.  Sometimes they want their recipients to be fellow Jews, and this has generated some controversy in Israel.

Below is a study of this phenomenon, and in an accompanying editorial, a criticism of it.

Nesher, Eviatar, Rachel Michowiz, and Hagai Boas. "Semidirected Living Donors in Israel: Sociodemographic Profile, Religiosity, and Social Tolerance." American Journal of Transplantation (in press).

Abstract: Living kidney donations in Israel come from 2 sources: family members and individuals who volunteer to donate their kidney to patients with whom they do not have personal acquaintance. We refer to the first group as directed living donors (DLDs) and the second as semidirected living donors (SDLDs). The incidence of SDLD in Israel is ∼60%, the highest in the world. We introduce results of a survey among 749 living donors (349 SDLDs and 400 DLDs). Our data illustrate the sociodemographic profile of the 2 groups and their answers to a series of questions regarding spirituality and social tolerance. We find SDLDs to be sectorial: they are mainly married middle-class religious men who reside in small communities. However, we found no significant difference between SDLDs and DLDs in their social tolerance. Both groups ranked high and expressed tolerance toward different social groups. Semidirected living donation enables donors to express general preferences as to the sociodemographic features of their respected recipients. This stirs a heated debate on the ethics of semidirected living donation. Our study discloses a comprehensive picture of the profile and attitudes of SDLDs in Israel, which adds valuable data to the ongoing debate on the legitimacy of semidirected living donation.


Danovitch, Gabriel. "Living organ donation in polarized societies." American Journal of Transplantation, (Editorial, in press).

"Nesher et al are to be congratulated for reporting on a unique, effective, yet ethically problematic manifestation of living kidney donation in Israel. To summarize, living kidney donation has become “de riguer,” a “mitzvah” (a religiously motivated good deed) among a population of mainly orthodox Jewish men living in religiously homogenous settlements. According to the authors, the donors view themselves as donating altruistically within a larger family. The donations, over 1300 of them, 60% of all living donations in the country, have changed the face of Israeli transplantation, reduced the waiting time for all transplant candidates on the deceased donor waiting list,2 and minimized the temptation of Israeli transplant candidates to engage in “transplant tourism,” a phenomenon that was an unfortunate feature of Israeli transplantation before the passage of the Israeli Transplant Act of 2008 that criminalized organ trading.3

So, what’s the problem? Matnat Chaim (“life-giving”), the organization that facilitates the donations, permits the donors to pick and choose among a list of potential recipients using criteria that according to its own website,4 and as Nesher et al note,1 are not transparent. ... frequently the donors elect to donate to other Jews.  ... " Israel is a country with an 80% Jewish majority; a decision to only donate to other Jews, thereby excluding non-Jews, is a practice that, were it reversed in a Jewish minority country, would likely be labeled antisemitic. Concern that the process encourages racist and nationalistic ideation has been raised in the past6 and only emphasized by the public pronouncement of some media-savvy kidney donors.7

"What lessons does the Israeli experience hold for the US and other countries, faced as all are, with a shortage of organs for transplant? Conditional living donation exists to a limited extent in the US: DOVE is an organization that works to direct living kidney donation to US army veterans9; Renewal is an organization that encourages and facilitates living donation from Jews to other Jews but also to non-Jews10; in the 1990s an organization called “Jesus Christians” made organ donation one of its precepts.11 But in each of these cases, it is a minority group whose interests are being promoted.

...

"What now for Matnat Chaim? Given its prominent impact on Israeli transplantation, its allocation policies must be transparent and subject to public comment. Criteria must be medical in nature and religious or political considerations excluded. Fears that as a result living kidney donation rates will plummet are likely exaggerated. "

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I can't help reading this discussion while being very aware that Dr. Danovitch is an ardent opponent of compensating kidney donors, for fear that inappropriate transplants would take place if that were allowed.  In much of that discussion, inappropriateness of transplants focuses on possible harm to the (paid) donors, but the donors in the Israeli case are unpaid. Here his concern is that donor autonomy about to whom to give a kidney comes at the expense of physician autonomy in choosing who should receive a transplant, by "medical" criteria. But frequently those criteria have a big component based on waiting time, rather than any special medical considerations. So maybe in general he thinks that privileging the physician's role in this way is worth having fewer organs and consequently more deaths.

Still, I think he has a point about how we perceive what is repugnant. Having minority donors donate to fellow minority recipients seems much less repugnant than having majority donors specify that they aren't interested in donating to minority recipients.

But, speaking of donor autonomy, I'm not sure that there are practical ways around it, since semi-directed donors could always present as fully directed donors to a particular person that some organization had helped them find. So, we may just have to live with the increase in donations and lives saved that donor autonomy can support.

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Earlier posts:

Thursday, July 27, 2023

Kidney brouhaha in Israel: is a good deed still good when performed by a shmuck?


I ended that post with this:

"I'll give the last word to a Haaretz op-ed, also in English:


Monday, July 31, 2023

Altruistic kidney donors in Israel


...
and, here in the U.S.:

Friday, March 12, 2021

Kidneys for Communities

" A new organization, Kidneys for Communities, plans to advocate for living kidney donation by seeking donors who identify with a particular community.  Their come-on is "Put your kidney where your heart is.  Share your spare with someone in your community"

Thursday, February 8, 2024

Morally contested markets on NPR's Planet Money (including kidneys, revenge and insider trading)

 The NPR show Planet Money discusses kidney sales, revenge, and insider trading. The hosts are enthusiastic about at least thinking about all of these.* 

They start with a discussion of organ transplants, and in the first 9 minutes of the show you can hear some parts of an interview with me, discussing tradeoffs (and possible titles for a book I'm working on).  Then they talk to Siri Isaksson about retaliation, and after that to Chester Spatt about insider trading.

 

They write:

"There are tons of markets that don't exist because people just don't want to allow a market — for whatever reason, people feel icky about putting a price on something. For example: Surrogacy is a legal industry in parts of the United States, but not in much of the rest of the world. Assisted end-of-life is a legal medical transaction in some states, but is illegal in others.

"When we have those knee-jerk reactions and our gut repels us from considering something apparently icky, economics asks us to look a little more closely.

"Today on the show, we have three recommendations of things that may feel kinda wrong but economics suggests may actually be the better way. First: Could the matching process of organ donation be more efficient if people could buy and sell organs? Then: should women seek revenge more often in the workplace? And finally, what if insider trading is actually useful?"

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*In their enthusiasm, they mis-state how few kidney exchanges were done before my colleagues and I got involved. (There weren't many, but more than two...)

As it happens, earlier this week I blogged about another interview, in the NYT, by Peter Coy (in print, not audio) that focused on kidney exchange:

Tuesday, February 6, 2024

Update (5pm): now I see that on the Planet Money site there's a transcript.  Here's the part that I participated in:

SYLVIE DOUGLIS, BYLINE: This is PLANET MONEY from NPR.

(SOUNDBITE OF COIN SPINNING)

MARY CHILDS, HOST:

A couple decades ago, Al Roth was working on solving this problem - people who needed kidneys weren't getting matched effectively with people who had kidneys to donate.

AL ROTH: Part of the kind of work I do is called matching theory.

GREG ROSALSKY, HOST:

Al helped create this, like, beautiful, elegant algorithm that would match kidney donors with recipients.

CHILDS: You obviously won a pretty big prize for this work.

ROTH: I did. I recommend it.

CHILDS: OK. Yeah (laughter). You like the prize. It's a good prize.

ROTH: Yeah.

CHILDS: That's good to know.

ROTH: A week long of parties.

CHILDS: The prize he won? - it was the Nobel Prize in economics.

ROSALSKY: As you might know, Al's matching work vastly improved the way people get kidneys and saved literally thousands of lives. Like, in the year 2000, before Al's work, there were only two paired kidney transplants - two. Thanks to Al's algorithm, there are now about a thousand per year.

CHILDS: But, Al says, his Nobel Prize-winning algorithm - it isn't even the best way to get people kidneys. Technically, he says, the best way is to grow kidneys in a lab, so it's not even the second-best way.

I'm just envisioning you doing all this matching work knowing that this is, like, a little goofy. Like...

ROTH: Oh.

CHILDS: ...There's a easier way.

ROTH: I hope it's a lot goofy...

CHILDS: (Laughter).

ROTH: ...The work I'm doing, anyway.

CHILDS: (Laughter).

ROTH: No, no. That's right. So could we figure out a way to have more donors to have fewer deaths? I bet we could.

ROSALSKY: OK, so there is a much easier, more efficient way to get people kidneys. It's the way people get most things - with money. Like, what if we could just buy and sell organs?

ROTH: Oh, we'd have a lot more organs. That's how we get most of our stuff. There's a famous passage quoted from Adam Smith, which I'm going to paraphrase, but it says something like, it's not through the generosity of the butcher and the baker that you get your food. You buy it from them. It's how they - that's how they sustain their families - is by selling you food. And that's how you get food, and that's why there's enough food.

CHILDS: Right. The kidney market already has supply and demand. It just doesn't have prices to balance them because buying and selling kidneys is illegal in basically the entire world. So here we are. We don't have enough kidneys. We desperately need more, and yet, we refuse to pay more than $0 for them.

ROSALSKY: And as Al saw while working on kidneys, people had moral objections to the idea of paying for organs. They had concerns that just didn't really make sense to him as an economist.

ROTH: But when I started to look, it turns out there are lots of markets like that.

CHILDS: Lots of markets where people just don't want to allow a market. They feel icky about putting a price on something. Al has a list - for example, surrogacy - a legal and flourishing industry in much of the U.S., not in much of the rest of the world; assisted end of life - perfectly fine medical transaction in Oregon, illegal where I am in Virginia.

ROSALSKY: Al is actually working on a book about all of this.

ROTH: Its working title is "Repugnant Transactions And Controversial Markets." And the idea is that sometimes economists have perfectly good ideas that other people don't think are perfectly good.

ROSALSKY: Al has sort of made his own little subdiscipline in economics about this.

ROTH: "Ickonomics" (ph), "Yuckonomics" (ph) - you know, I trade in book titles. I'm open to suggestions.

CHILDS: You can email Al with your book title suggestions, though honestly, that's kind of hard to beat. In the meantime, when we have those knee-jerk reactions and our gut repels us from considering the icky thing, economics would like to humbly submit that maybe we should.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: Hello, and welcome to PLANET MONEY. I'm Mary Childs.

ROSALSKY: And I'm Greg Rosalsky. Today on the show, we apply an elegant economic framework to Al's market, the trading of human organs, to whether or not we should exact revenge on our enemies, and to whether or not we should trade on inside information.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: When we face difficult situations that don't have an absolutely clear right answer, economist Al Roth says borrowing tools from economics can be useful.

ROTH: Economists deal in trade-offs, and one of the things about trade-offs is you have to say to yourself, supposing there's something we really don't like, what will happen if we ban it? And if the answer is it won't go away, but it'll go underground or become criminalized or become very irregular, then you might prefer to regulate it rather than ban it.

ROSALSKY: And there are real problems with banning things. For example, remember that time we tried to ban alcohol, like, in the 1920s and 1930s?

ROTH: We discovered that it gave rise to a big criminal economy and didn't completely wipe out alcohol at all. So we legalized it. And the legal market for alcohol, with all its problems, is a lot nicer in many ways, a lot more socially useful than the criminal market - you know, Al Capone and the Saint Valentine's Day massacre and, you know, Eliot Ness.

CHILDS: Alcohol, as you may know, is legal today. Selling kidneys - no, not legal - with kidneys, we are in our Prohibition era.

ROTH: There is a black market for kidneys. And often it's pretty terrible because the almost-universal laws against compensating kidney donors have driven that market underground. And what underground often means is out of the hospitals and into hotel suites and apartments...

CHILDS: Eugh (ph).

ROTH: ...And - yes, so medically very bad, as well as, you know, not just illegal but dealing with criminals - medically very bad, bad for the donors, bad for the recipients.

CHILDS: And that's what we have today. That's the market we have chosen. We have the black market with money and the legal market with no money.

ROSALSKY: So Al has been thinking about solutions to this. Like, what can we do realistically to incentivize more kidney donations? How else could we go about creating a market for kidneys to be, as Al likes to put it, more generous to kidney donors?

CHILDS: And when Al thinks about how to design a market, he prioritizes investigating what exactly it is that we're objecting to so he can build a market that fixes or avoids those problems. And in the case of kidneys...

ROTH: There are metaphysical objections. You know, it's just wrong. But the objections that seem to touch on the world seem to say that you can't do this without exploiting poor people because poor people are so vulnerable that just offering them money takes away their agency.

CHILDS: The first reaction is just a gut reaction, which doesn't help inform Al on design. The second reaction is that money can be coercive, that if people have no money and you offer them money to participate in a study, they might have to do the study, especially if you offer a huge amount, like a life-changing amount of money. It's just too compelling. They wouldn't have a choice.

ROSALSKY: This argument does strike Al as unreasonable.

ROTH: There's lots of jobs that we pay people to do because otherwise no one would do them. And you can earn a decent living being a meatpacker. But that's one of the things that bothers people. They say, why should we allow a market that will be mostly - most of the participants will be in the lower parts of the income range? And of course, that isn't very sympathetic to people who are lower income, right? In other words...

CHILDS: Right.

ROTH: ...We need jobs that people with lower income can get. That's why they have some income - is that there are jobs.

CHILDS: Luckily, there is a really obvious, easy solution to this objection - just solve poverty.

ROTH: There'd be a lot less repugnance to monetary transactions if there was no income inequality.

CHILDS: (Laughter).

ROTH: If you wanted to sell me your kidney, but we all had the same income and the same prospects, it just might not be a big thing.

CHILDS: OK, failing that, Al mentioned another way to create a kidney market, a way to get kidneys only from people who aren't that poor - a tax break.

ROTH: People who are wealthy enough to benefit from tax credits on income tax aren't the poorest of the poor. So it might be that the way to start paying kidney donors is to say, we will give you a tax break on everything after the first $10 million of income in the year that you - you know, and then only hedge fund managers would donate kidneys, and that would be repugnant.

CHILDS: But there's a twisted logic to it because at least they could - like, should something go awry in the surgery or in the...

ROTH: Yeah, they'd be fine. They'd be fine. Yeah.

ROSALSKY: Perfect. Like, now we have a few ideas of how to make this happen without paying people for kidneys. We could resolve income inequality, or we could just, you know, do a tax credit and receive only hedge fund manager kidneys. And - right? - there's something a little goofy about all this because these solutions are trying to account for objections that are just hard to design around 'cause those objections are at least partly stemming from some messy human feeling or intuition that just won't let us exchange things in the normal way.

CHILDS: So do you think there'll ever be a U.S. market for kidneys?

ROTH: Well, I think we're not doing a good job yet and that we ought to find a way to be more generous to donors so that we have more of them.

CHILDS: And what that looks like - you're open to suggestion?

ROTH: I'm open to suggestions.

Sunday, January 21, 2024

Legislative proposals to help living kidney donors

 Martha Gershun brings us up to date on various proposed pieces of legislation to help organ donors and increase access to transplants.

Legislative Efforts to Support Living Kidney Donors,  by Martha Gershun, Guest Blogger

"As a member of the Expert Advisory Panel to the Kidney Transplant Collaborative, I have been honored to provide input during the development of the organization’s priority legislation, the Living Organ Volunteer Engagement (LOVE) Act.  This legislation would help build a comprehensive national living organ donor infrastructure that would support a national donor education program, create a donor navigator system, ensure appropriate donor cost reimbursement, collect essential data, and improve all aspects of living organ donation across the country, substantially reducing barriers that limit participation today.

Key provisions of the LOVE Act would:

  • Provide reimbursement for all direct and indirect costs for living donation, including lost wages up to $2,500 per week.
  • Provide life and disability insurance for any necessary care directly caused by donation.
  • Modify NLDAC rules so neither the recipient’s income nor the donor’s income would be considered for eligibility.
  • Provide for new public education program on the importance and safety of living organ donation.
  • Provide for new mechanisms to collect and analyze data about living organ donation to enable evidence-based continuous process improvement.

Numerous other federal proposals are also currently vying for support to address barriers to living donation on a national level.  They include:

Living Donor Protection Act (H.R. 2923, S. 1384)

  • Prohibits insurance carriers from denying, canceling, or imposing conditions on policies for life insurance, disability insurance, or long-term care insurance based on an individual’s status as a living organ donor.
  • Specifies that recovery from organ donation surgery constitutes a serious health condition that entitles eligible employees to job-protected medical leave under the Family and Medical Leave Act.

Organ Donor Clarification Act (H.R. 4343)

  • Clarifies that reimbursement to living organ donation is not “valuable consideration” (I.e., payment), which is prohibited under the National Organ Transplant Act (NOTA)
  • Allows pilot programs to test non-cash compensation to living organ donors.
  • Modifies NLDAC rules so the recipient’s income would no longer be considered for eligibility.

Living Organ Donor Tax Credit Act (H.R. 6171)

  • Provides a $5,000 federal refundable tax credit to offset living donor expenses.

Honor Our Living Donor (HOLD) Act (H.R. 6020)

  • Modifies NLDAC rules so the recipient’s income would no longer be considered for eligibility.
  • Requires public release of annual NLDAC report.

Helping End the Renal Organ Shortage (HEROS) Act

  • Provides a $50,000 refundable federal tax credit over a period of five years for non-directed living kidney donors.
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And here's one more, from the Coalition to Modify NOTA



Wednesday, January 10, 2024

Pope Francis calls for a ban on surrogacy

 The Catholic Church has long opposed in-vitro fertilization (IVF), one of the technological tools that allows surrogacy, on the grounds that IVF produces more embryos than are brought to term as babies, and so is comparable to abortion.*  But this week, during his annual "state of the world" foreign policy speech, Pope Francis made clear that he thinks surrogacy should additionally be banned because of the presence of "commercial contracts." 

Here's the story from the National Catholic Register:

Pope Francis Calls Surrogacy ‘Deplorable,’ Calls for Global Ban in Speech to Ambassadors

"Pope Francis called surrogacy “deplorable” and called for a global ban on the exploitative practice of “so-called surrogate motherhood” in a speech to all of the world’s ambassadors to the Vatican on Monday.

“The path to peace calls for respect for life, for every human life, starting with the life of the unborn child in the mother’s womb, which cannot be suppressed or turned into an object of trafficking,” Pope Francis said Jan. 8.

In this regard, I deem deplorable the practice of so-called surrogate motherhood, which represents a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother’s material needs. A child is always a gift and never the basis of a commercial contract.”

"The Pope then called on the international community to prohibit the practice of surrogacy universally."

##########

The United States Conference of Catholic Bishops reiterates the main point in this quote from its spokesperson:

Statement of USCCB on Holy Father’s Remarks on Surrogacy, January 8, 2024

“As Pope Francis stated, with surrogacy, an unborn child is turned into ‘an object of trafficking’ because it exploits the birth mother’s material needs and makes the child the product of a commercial contract. This is why the Catholic Church teaches that the practice of surrogacy is not morally permissible. Instead, we should pray for, and work towards, a world that upholds the profound dignity of every person, at every stage and in every circumstance of life.”

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And here's the story in the NYT:

Francis Urges Ban on Surrogacy, Calling It ‘Despicable’  The pope said that an unborn child must not be “turned into an object of trafficking,” expanding his condemnation of a practice already illegal in Italy and some other European countries.  By Jason Horowitz

"Pope Francis on Monday called surrogate motherhood a “despicable” practice that should be universally banned for its “commercialization” of pregnancy, including the practice among wars, terrorism and other threats to peace and humanity in an annual speech to ambassadors.

...

"Surrogacy is already illegal in Italy and compensated surrogacy is also illegal or restricted in much of Europe. The United Kingdom, the Netherlands, Portugal and several other nations allow surrogacy under certain conditions. Paid surrogacy is legal in some European nations, including Ukraine, Russia and Belarus.

"Surrogate mothers in the United States and Canada are often hired by Europeans, including same-sex couples, seeking to have children..."

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Earlier:

Wednesday, April 5, 2023  Surrogacy under siege in Italy



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Update: here's the Pope's full speech (in English) from the Vatican Press Office: