Today WBUR, one of the NPR radio stations in Boston, played an in depth piece by Alan Coukel called “Donor Payments and Stem Cell Research” about the ethical debate surrounding the prohibition of payment to women for ova for stem cell research in Massachusetts.(Note the similar policy in California and the in the recommendations of the National Academies in their"Guidelines for Human Embryonic Stem Cell Research".) This week, Robert Steinbock has an article in the New England Journal of Medicine that addresses the ethical issues of ova donation/sales for research purposes. Neither of these reports addresses the worry that I and others have about the potential exploitation of women in this exchange. And this exploitation appears not because women will be paid, but because they will not.
What seems to be at issue in this debate is commodification. "Commodification" refers to the association of a thing or a practice with attitudes and behaviors that accompany typical market transactions. Today there are commercial and non-commercial markets for human blood, sperm, organs, and other body parts. But for the idea of there being a market for ova, human embryos and fetal material is repugnant to many. This reaction is supported by a belief that there are certain kinds of things that should never be commodities or treated like commodities.
The issue is not a quibble about price. If we put a price, any price, on bits of the human body, the worry is that in so doing we are saying that it is acceptable to treat some persons (the donors/vendors) in the same manner that all manufactured objects are treated. So fertile women who exchange ova for money would be treated like toasters and laundry detergent.
Human tissue, like ova, is needed to continue stem cell research. And stem cell research promises to be a therapy to treat for all sorts of horrible diseases. So ova have more than intrinsic value. They have the potential to be really good for other things, like helping people. Because of this, and the toaster concern, people claim that exchange of human tissue should be motivated by altruism and given in the form of a gift. Thus, embryos and fetal tissue, ova and sperm, (as well sex and surrogacy) may be given to others, for others, but only if the giver does not get paid for it. The exchange is this: a woman gives her ova freely and in exchange she get the satisfaction that she is helping the greater good.
But these tissues are extremely valuable for other reasons besides the greater good. They are market commodities. Their value derives from what researchers and companies are willing to pay for the development of therapies, the potential profit to be made from the products derived from the tissue, and from the patents that that biotechnology companies and universities can obtain on these tissues.
According to Curtis Naser and Sheri Albert, “[t]he use of human tissues and cells is …the foundation upon which much of the current biotechnological revolution has been based.” The interests of the person supplying the tissue and of researchers or firms may conflict. This potential conflict is usually put forward as conflict between the interests of the individual tissue supplier and those of scientific progress, of “researchers in freely pursuing scientific knowledge.” To be sure, new breakthroughs have the potential in principle to benefit all humankind, but it is not outrageous to point out that the medical biotechnological industry has a great financial incentive for developing therapies and products.
And here is my concern for the exploitation of women if they are not paid for ova: To be forced to give something away for free and not even to have a say as to where it goes when others make significant profit from it is to grossly exploit the giver. This for-profit part of the picture is missing from the current debate over ova donation.
Curtis Naser and Sheri Albert, “Genetic Information, Ethics, Ethical Issues in Tissue Banking and Human Subject research in Stored Tissues,” Encyclopedia of Biotechnology, Volume 1 Thomas H. Murray and Maxwell J. Mehlman, eds. (New York: Thomas Wiley, 1999): 363-389.