Donor gamete regulation is an ongoing topic in the United States.1,2 What's so special about gametes that causes us to be concerned about their commodification? Commodification itself is not a bad thing. In free societies, supply-and-demand relationships precisely determine prices. [We’re presupposing the absence of monopolistic practices. In oil production and supply, for example, monopolistic practices skew prices considerably.]
We exchange goods and services all day long, seeing right through the transparency of their characteristics as commodities. But some services should not be commoditized. Medicine in the U.S. has severely transformed itself from a healing profession into a crass collection of commodity purveyors. We are all the worse for this change.
Should a woman be allowed to sell her ova in the same manner as she might sell other services related to her body, such as modeling or in the performing arts? Are there differences between an egg and the collection of cells and tissues that comprise her physical form?
A woman has an inherent right to dispose of her eggs as she wishes. The real issue is we must ensure that her health is not compromised by the procedures involved in egg collection. Significant harm may result, and protections and standards need to be established.
Regarding the potential for exploitation, "justice requires that the women who go through the rigors of egg retrieval be fairly compensated".3 High fees might be considered undue inducement, and insufficient fees might be considered exploitation.
A cycle of egg retrieval could be reasonably priced at $10,000. Considering the serious health risks, temporarily unpleasant side effects, and the amount of time involved, $10,000 seems fair. Such a policy would prohibit paying $50,000, for example, for “Ivy League” eggs. Such an example of "recreational genetics" is not backed by scientific evidence and its prohibition protects gullible potential buyers. An Ivy League egg may contain a gene cluster for superior intelligence (or for business acumen), but there's no guarantee those genes will be expressed.
The real issues do not relate to commodification, but rather concern protecting both buyers and sellers. We should also be worried about the interests of children, and the impact on our society of a market which explicitly places a higher price on “whiteness”, “tallness”, “Ivy League–ness”, and so on. If commodification is not an issue, why set a limit on prices?
Protections would be in place to counter the tendency toward commodification. Buyers would be protected from their own cupidity. Those who think they can purchase brains or looks are both misguided and foolish. Capping compensation at $10,000 protects the buyer from being dumb.
Likewise, a $10,000 ceiling mitigates against undue influence. A $50,000 offer for Southern California blond surfer girl eggs would be quite an undue influence on almost any UC San Diego or UC Santa Barbara undergrad. Or a lower middle-class woman needing to feed three kids could easily be induced by a $25,000 payday, even though her health might already be compromised by stress.
So the ceiling protects everyone. The ceiling also protects the children-to-be by eliminating the concern about eugenics. Buyers are prohibited from paying more in the hope of capturing specific traits, and the whole problem goes away.
1Making Laws About Making Babies, The New York Times, 9/13/2011
2Start With Some Hard Questions, The New York Times, 9/13/2011
3Steinbock B: Payment for egg donation and surrogacy. Mt Sinai J Med 71:255:265, 2004
The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.
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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.