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Reasonable Compensation?

The New York Times ran an editorial today endorsing the plan to use state money to pay women for eggs that will be fertilized with the goal of deriving embryonic stem cells. It reads, in part: Women already get paid comparable sums to donate their eggs to help infertile women have a child through in vitro fertilization. It is hard to see why they should not be paid for contributing their eggs for research. The money is meant as reimbursement for travel, housing, child care or medical expenses. It would also compensate the women for the considerable time, burden and inconvenience of harvesting their eggs, a process that can take 56 hours spread out over many weeks.Apart from the absurdity of saying that women should be paid to donate, the problem with the Times position is that it ignores that fact that such a policy promotes the commodification of human bodies. That is never a good idea, but it is an especially bad idea in our current economic situation, where desperate times may call for desperate measures.The Empire State Stem Cell Board acknowledged this potential danger, but endorsed the payment policy anyway. Their statement endorsing the payment policy can be found here.

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What are the other questions. There has not been a real objection to artificial insemination nor has anyone objected to people selling blood for economic reasons. So the first question may be: are the other practices just as questionable?

Although I support embryonic stem-cell research, I do believe this is going to far. The Times notes that the "decision has provoked criticism from some ethicists and runs counter to guidelines issued by the National Institutes of Health and the National Academy of Sciences." But then the do not address the ethics issues or say anything about the NIH and NAS guidelines. There has been much criticism of the Obama administration over the issue of embryonic stem-cell research, but it seems to me the NIH guidelines under his administration draw the line at exactly the right place. In a society where virtually no one is attempting to prohibit or even regulate fertility clinics that create embryos for in vitro fertilization, I suppose some who oppose stem-cell research may feel it is more objectionable to use "leftover" embryos, created specifically for in vitro fertilization, for stem-cell research rather than simply destroy them. But it seems to me that since federally funded stem-cell research can only use stem cells derived from embryos created only for in vitro fertilization and then not needed, to be at all consistent, opponents of federal funding for stem-cell research must attempt not only to roll back Obama's decision about federal funding, but also to try and halt in vitro fertilization.

Good question, Bill. Didn't Jo sell her hair in Little Women?You can sell hair but not kidneys. Ought you to be able to sell sperm but not eggs?The best book I've seen for thinking through this is Margaret Jane Radin's Contested commodities.

It's not the selling-as-such, but the selling-for-which that seems to highlight the problem areas. Or would no one else argue that selling blood is manifestly different from selling sex cells? For that matter, those who would make such a distinction: how should we characterize the difference in intent?

I would second Cathy's endorsement of the Radin volume; it's really good. And I don't think selling blood is a good idea either.

Last I knew, the American Society for Reproductive Medicine wanted compensation for donated eggs to be capped at $10,000. (Egg brokers publish ads with much higher "teaser" offers, like the oft commented-upon offers like $100,000 for eggs from athletic, bright, blonde, tall Ivy-leaguers, but it's not clear how often such exorbitant fees are actually paid.) Compensation at most IVF clinics runs in the $5000-8000 range. Semen donations to a local sperm bank net only $100, but screened donors can give twice a week.So three more questions: isn't this sum for eggs high enough that it counts as pretty strongly coercive? Heck, what undergraduate couldn't find a use for 5-8 grand? This sum is for eggs for IVF clinics, but would you like to be the person being paid $10 an hour for lost time while the woman next to you gets the big bucks for enduring the same procedure? Second-rarely, there are severe after effects of donating eggs. Ovarian Hyper-Stimulation is a rare but sometimes fatal reaction to the hormonal procedure used to cause the donor to produce dozens of eggs rather than the usual one or two. Does this risk--for which there is no analogue for sperm or blood donation--change the question of whether women should be paid substantial sums for eggs? Third--some propose that only women undergoing IVF treatments themselves be allowed to donate eggs. Thus they undergo a risk they were already prepared to take for their own treatment. Of course, this will result in far too few eggs available for research purposes. One after-effect of the Bush restriction on stem cell research was that other countries dove into the process, inviting American scientists to come do their work there. Where there are substantial numbers of poor women, what's to stop the large-scale harvesting of eggs from a population in which severe after-effects are not tracked, much less actionable in courts?

Excuse me--Ovarian Hyper-Stimuation Syndrome.

DavidWish I had more time to discuss - but some of these observations are spot on. If This is just tissue, as you so frequently argue, what possible reason is there to treat it specially? This is a logical consequence of your own position.

If This is just tissue, as you so frequently argue, what possible reason is there to treat it specially? Sean,I am glad we found some "common ground."However, I don't think I have ever argued that anything is "just tissue." I have said that obviously a fertilized egg or an embryo is human in the same way that a [human] kidney is human, and that does not necessarily make it a person. But a living, adult human being is human in the same way a [human] kidney is human.I think you exhibit a kind of all-or-nothing attitude toward fertilized eggs and embryos. If they are not persons, they are lumps of tissue. As I repeatedly point out, that is not the view of Orthodox Judaism, which holds that personhood begins at birth, but that a fetus is sacred because it is human life and a potential person.

DavidIt's nice that that is the traditional view of Orthodox Judaism, but it is not the Cathiolic view. Just because there are other views - indeed dozens upon dozens of other views - doesn't make them right, or the fact that there are other views make the Catholic view wrong.Getting back to the point - if, as you have stated, a woman may unilaterally destroy an embryo without any reason at all (at least in the first three months, if I am correct) what possible reason can we have for not allowing her to sell her eggs? Besides, it's good science - at least you know all about what what into these experimental embryo's instead of the catch as catch can you get with discarded embryos.And they are not like kidneys - you can't make a new kidney, and a woman has hundreds and hundreds of "spare" eggs. As you so reasonably and frequently point out - what do people do about the millions of spontaneously aborted embryos - how much less the trillions of naturally discharged eggs.

Just because there are other views indeed dozens upon dozens of other views doesnt make them right, or the fact that there are other views make the Catholic view wrong.Sean,No argument there. However, the Catholic view is one among many, and this being the United States, and our government being secular, Catholic doctrine is not a basis for writing our laws.Getting back to the point if, as you have stated, a woman may unilaterally destroy an embryo without any reason at all (at least in the first three months, if I am correct) what possible reason can we have for not allowing her to sell her eggs?I don't believe I have made any moral pronouncements from on high. I have said that I think a reasonable compromise in the United States would be to allow abortion in the first trimester and limit it strictly in later pregnancy, with allowances for the life and health of the mother and fetal abnormalities. I have not given my personal approval to women who want to have abortions at any stage. I would be in favor of limiting the reasons for abortion in the first trimester to exclude things like sex selection, although I don't really see how that could be enforced. My comments were not attended to address wither women ought to be allowed to sell their eggs. That is a different issue. They were directed at the proposal to use state funds to buy eggs. As the the Times pointed out, the state's proposal is not consistent with the NIH guidelines. I think the NIH guidelines are reasonable, and I don't see why the state of New York feels they need to go beyond them.

Sean,Please! you write "if, as you have stated, a woman may unilaterally destroy an embryo without any reason at all (at least in the first three months, if I am correct) what possible reason can we have for not allowing her to sell her eggs?" There are several: first the compensation offered might amount to financial coercion. Second, the process may be disproportionately risky for women who will not benefit medically themselves from the process. Third, women, especially poor women, may be disproportionately exposed to the risks that exist, both minor and major. I would suggest that in both cases (abortion and selling eggs,) there is a tendency in the public debate (though I am not accusing you of holding this stance,) to ignore the good of the woman involved. Easy example: how many anti-abortion posters show photos of fetuses suspended in space, as though any such thing as an independent fetus exists at all? Some extreme positions on abortion discount the health, or even the life, of the woman as morally relevant. Likewise, in egg selling proposals, there is an unjustified confidence that signing "informed consent" to the procedure eliminates the moral responsibility to the donor of the organization buying the eggs. I assume that most people who are desperate enough to sell a kidney for cash wouldn't blink at signing a "consent" form. Less starkly, the same is true when thousands of dollars are offered to penurious undergraduates--or when lesser sums are offered to seriously impoverished women--for eggs.

LisaEconomic coercion - this idea only works if the underlying conduct is in and of itself objectionable. You can't bootstrap it. You wouldn't say, for example, that a penniless coed was coerced into working at Arby's even if you paid her $1000 an hour. You say - second, the process may be disproportionately risky for women who will not benefit medically themselves from the process. Certainly, in most cases you could say the same thing about abortion - while the risk is small there is no concomitant medical benefit. You could say this about hundreds of procedures that are not medically necessary. You say - third, women, especially poor women, may be disproportionately exposed to the risks that exist, both minor and major. Again, you could say this about a lot of things - including abortion. Some studies show that as many as 40% of abortions involve some level of coercion by husbands, boyfriends, or parents. that doesn't seem to be enough reason to say, impose waiting periods.BTW - I actually agree with you, but my point was that all the same arguments for opposing this practice apply as much, if not more, to abortion yet we don't.

BTW I actually agree with you, but my point was that all the same arguments for opposing this practice apply as much, if not more, to abortion yet we dont.Sean,Don't you usually object to arguments based on consistency/inconsistency (at least when I make them)? If Lisa is making a good case against paying women for eggs, why are you arguing against her? And unless she supports abortion and opposes paying women for eggs, she's not even the one who is inconsistent. Who is the "we" you are talking about? It seems like every discussion has to be about abortion.