To resolve the conflict on ethical argument, United States and United Kingdom have imposed their heath care policies that shall justify the appropriateness and applications of bone marrow transplant. Policies can greatly affect the (1) availability and willingness of donors (stricter policies commonly reduce the likelihood of donor volunteers; Powell, 1999 p.
309), (2) the safety and security of both patient and recipient during the procedure, and (3) the market demand availing the country’s medical specialization on bone marrow transplant. According to Buchsel and Whedon (1995), bone marrow transplant patients are likely to avail services on medically reputed countries, such as United States of America, United Kingdom, Japan and others with developed medical technology and wide history of successful transplant (p. 304-305).
United States is the most common destinations of bone marrow transplant patient due to its appropriate and donor-friendly health care policies, which is oriented in a decentralized system providing every health care institution to freely establish their own systems of bone marrow therapy standards and procedural protocols (Buchsel and Whedon, 1995 p. 305). In United States, the Public Health Service Act on National Bone Marrow Donor Registry (NBMDR; 101 to 102) establishes seven registry functions that shall govern the bone marrow transplant procedure, specifically:
(1) establish a system for matching both donor’s and recipient’s bone marrow type, (2) establish a system for patient advocacy, (3) increase representation of individuals from racial and ethnic minority groups in pool of potential donors, (4) provide information regarding the procedure, (5) recruit potential donors, (6) collect, analyze and publish data concerning bone marrow transplantation, and (7) support studies and demonstration projects to increase the willing donors (Title III of PHSA sec.
379; cited in WHO, 1994 p. 413). United States’ NBMDR centers in establishing bone marrow donors and increasing the studies, programs and campaigns that can foster donors’ willingness to participate in the procedure. Meanwhile, in United Kingdom’s British Society of Blood and Marrow Transplantation (BSBMT), the extensive health policies (sec. 3 to 4.
37) on bone marrow transplantation have emphasized similar policies with United States except for their centralized and organization-oriented management of bone marrow donor requirements, which implies stricter rules for qualifying as donors (BSMBT, 1997). Unlike in the British policy, United States is implementing free and self-directed qualification fostered by education and appropriate information dissemination.