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, 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 may have reached a critical point where the hazards and risks of some new technologies outweigh the benefits. We are indeed on the slippery moral precipice or slope we have discussed previously. (See Medicin 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.
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Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.
Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons.
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