What is a human life worth?
For centuries, this question has centered on the cost of keeping people
alive. The question cannot be answered in purely economic terms since a
terminally ill or injured patient has no economically productive value. In
recent years, however, the question has expanded to include the value of
creating people in other than the natural manner: the "businesses" of sperm
donation, artificial insemination, in-vitro fertilization and cloning.
Now the issue has broadened yet again. What about the "business," ‹ now a $3
billion per year business ‹ of women selling their eggs?
It's an issue that involves two other questions. First, what are the
long-term effects on the woman who sells her eggs? Let's face it ‹ donating
sperm is, as a matter of physiology, a transient thing. Harvesting eggs is
not.
And second, should a woman be able to sell her eggs in the same way other
people sell their organs, such as kidneys(in other countries), as part of a
body they're free to do with as they choose? Eggs aren't kidneys. But
neither are they sperm.
Notes Jane Orient, M.D., executive director of the Association of American
Physicians and Surgeons, "We're not going to know all the effects of women
selling their eggs for at least 10 years or more. We don't know the
long-term consequences of the powerful drugs and surgery to obtain the eggs.
How many women are selling their chances of motherhood for a few thousand
dollars?"
Still, it's one thing to sell eggs to women or couples who can't have
children of their own. It's quite another to "design" babies.
As science marches on, mankind has reached a critical point where the
hazards and risks of some new technologies may outweigh the benefits. We are
indeed on the slippery moral precipice or slope we have discussed
previously. (See JWR Medicine Men archives.)
But new life is for sale and a $3 billion human egg industry booms according
to an AAPS release in early January 2008.
There's a new kind of brokerage firm in our new world. These are agencies
that assemble databases of young women and market their eggs to customers
who want a baby and can't produce one.
Some offer photographs and information about hobbies, education, and
religion, along with health screening, so customers can pick the "donor."
Some do consider "donor shopping" for "designer babies" unethical, and match
the donor on the basis of a few genetic traits.
The egg broker charges around $16,500, which includes the donor's fee of
$4,000 or more. A woman who has successfully produced eggs three or four
times can receive up to $8,000.
A donor must inject herself with fertility drugs every day for six weeks.
One donor, donor No. 8447 produced 16 eggs during one cycle. Some of the
embryos that were created were implanted, and some frozen. "I think it's
great," she said. "Men have always been able to spread their genes. Now I
can spread my genes" (Minneapolis Star-Tribune Oct. 22, 2007). (As a
liberated aside when will men demand equality in pay for their DNA?)
The outcome of these "miracles for sale" is not always happy. Some clients
have held a newborn in their arms and said "I don't feel attached to my
child," reported University of Minnesota psychologist Linda Hammer Burns. Or
years after children are born, divorcing parents use the means of their
conception as emotional weapons in bitter legal fights, according to the
Star-Tribune.
An unasked question is how many years of her potential fertility has donor
8447 sold? There is apparently no limit. Tests for infectious diseases that
could be transmitted to surrogate or baby are among the few requirements
governing egg and sperm donation in the U.S.
Infertile women who create frozen embryos tend to have a view of them that
differs from that of donor 8447.
Anne Drapkin Lyerly of Duke University Medical Center and Ruth R. Faden of
the Johns Hopkins Berman Institute of Bioethics (Science 2007; 317: 46-47)
write, "Our data suggest that for most of the individuals who create embryos
in hopes of having a baby, the preference is not that their remaining
embryos have a chance at life, but rather that they be used in a way
(research, and if not, simply destruction) that ensures that they do not."
More than half would donate their embryos for research, apparently believing
that "scientific progress justifies the instrumental use of early human
life." Only around 20 percent would donate to another couple, suggesting
that "there are deep responsibilities to one's own embryos" that preclude
allowing them to develop into children without the knowledge, participation,
or love of those who created them."
About 400,000 human embryos are currently cryo-preserved. We expect that
this number will increase rapidly as news of egg brokerage houses becomes
more wide spread. Eventually someone will question whether frozen embryos
have "rights" even though they are not presently in a woman's body.
In sum, medicine has continued to create more and more ethical and moral
dilemmas in the name of scientific advancement. Genetic DNA roulette is not
something to be taken casually. The odds of eventually losing to the
monstrous powers of DNA seem overwhelming to us at this time.
Editor's Note: Michael Arnold Glueck, M.D. wrote this week's commentary
