Why Giving Life a Price Devalues It
Civitas, 28 July 2009
‘If it gives a couple like us the chance to start a family, then surely it is good thing.’ So was an infertile woman quoted as arguing in yesterday’s Times for infertile couples like her and her husband to be allowed to buy eggs from fertile women. At present, donor payment is illegal here and, since the end of donor anonymity in 2005, the number of eggs donated has plummeted.
So drastic has been the decline in their number relative to demand for them that Lisa Jardine, the newly appointed Head of the Human Fertilisation and Embryology Authority (HFEA), has just indicated she wishes HFEA to revisit the whole issue of assisted reproduction.
In an interview with the Times also reported yesterday, Professor Jardine made it plain that she favours legalising donor payment, but for a seemingly somewhat different reason than that of the infertile woman quoted above.
Professor Jardine’s apparent reason for wanting donor payment legalised is concern for the health of recipients of donated eggs. She argues that, as long as the practice of payment remains illegal here, infertile couples in quest of eggs will simply travel abroad to where they can be bought legally with possible attendant health risks for purchasers. Professor Jardine said: ‘My agenda is to try to keep assisted reproduction within our regulated area, not because I’m bossy but out of concern for patient welfare.’
Asked whether such a practice might not risk exploiting women, since the prospect of payment might tempt some women in debt to risk their health by donating eggs, Professor Jardine replied:
‘Every one of my undergraduates is £3000 in debt in their first year, up to £15,000 by their third year. I can well imagine some of them doing egg donation, in fact I know some of them who have in the United States. They go to the States to give their eggs for money… When [infertile couples] go abroad, there is undoubtedly exploitation. Although is it exploitation if you can’t feed your family? We’re very ready to say it’s exploitation, but if you discover you can make a year’s food money… I’d rather we had control over it here.’
Whilst feeling nothing but sympathy for the infertile woman quoted as voicing her support for the legalisation of donor payment, I am not persuaded by her reasoning. As for the line of argument advanced by Professor Jardine, I find it positively hair-raising in its apparent amoralism.
No one blessed with children can possibly fail but to feel deep sympathy for the infertile woman who seeks a child by means of IVF using a donated egg. One wishes her and her husband every success in their ambition. Yet the mere fact such infertile couples might benefit were donor payment legalised, and that all such donations would still remain fully voluntary and informed, does not satisfy me the practice should be legally sanctioned.
As a medical ethicist who favours legalising donor payment was also quoted as saying: ‘Egg donation is an invasive and unpleasant process. Even the best scientific efforts will never make it risk-free.’
Consequently, however much donor payment might potentially benefit recipients, it potentially harms donors. Even though the latter might be willing to incur the risk of such harm in return for payment, it does not follow that the state should allow them to incur that risk for a purely mercenary reason.
Would the infertile woman and Professor Jardine approve of the legalisation of kidney donation in return for payment? Or, at the extreme, heart donation from a healthy person desperate to raise cash for his or loved ones? If not, why do they think that the law should allow women to be invited to incur risk for the sake of payment that they would not otherwise be willing to incur?
Surely, it is not a good enough reason in favour of legalising donor payment to argue that otherwise couples in quest of an egg will simply go to countries where it is legal to buy one. If in some countries the sale of body parts was legal and some people went abroad to buy one that they needed, would that justify its legalisation here? I don’t think so.
This is not a mere academic argument. A survey of nearly 1,000 university students conducted in 2002 found over a quarter prepared to sell one of their kidneys on the black market for £13,000, and nearly a third of the female students surveyed willing to sell some of their ovarian eggs for £5,000. If that’s how many young people would be willing to incur these risks for money when such practices are illegal, how many more might be willing were they given the imprimatur of the state by being made legal?
It is deeply disconcerting to discover how willing the new head of the Human Fertilisation and Embryology Authority seems to take the country to the edge of what threatens to be a very hazardous slippery slope. However, given some of the deeply wrong-headed decisions of that authority under her predecessors, I suppose we should not really expect very much different.
Thus, after initially sanctioning egg and sperm donation under conditions of donor anonymity, HFEA finally woke up to the fact that such anonymity entirely discounts the legitimate vital interest children have in knowing the identity of their biological parents. Donor anonymity was removed as a result, causing potential donors, less than happy about being confronted later in life by a biological child whom they had not known, to stop donating eggs and sperm. By then, expectations had been raised among infertile couples who might never otherwise have thought about having a child using someone else’s donated egg or sperm.
The unsatisfied demand for donated eggs is now preparing the new head of HFEA to sanction a practice whereby, in return for payment, women are to be encouraged to incur significant medical risk, not to mention possible future psychological trauma, just to satisfy expectations HFEA created, and because women can be found hard pressed enough to be willing to incur those risks for cash.
What a source of moral insight HFEA has turned out to provide, I don’t think.