Here is a longish set of excerpts from a very interesing NY Times Magazine story about surrogacy: Her Body, My Baby . It touches on a number of issues that also come up in discussions of organ transplantation, and the controversy about compensation for donors.
"Before I.V.F. became a standard fertility treatment, about 15 years ago, the only surrogacy option available to infertile couples who wanted some genetic connection to their child was what is now called traditional surrogacy. That is when the woman carrying the baby is also the biological mother; the resulting child is created from her egg and sperm from the donor father. When the surrogate mother is carrying a child genetically unrelated to her, she is gestating the child, and the process is called gestational surrogacy. Now that there are hundreds, if not thousands, of doctors in the United States who can perform I.V.F., surrogacy agencies report that the numbers have shifted markedly away from traditional surrogacies toward gestational surrogacies.
There are no national statistics documenting this shift, however, or documenting much of anything about surrogacy. Shirley Zager, director of the Organization of Parents Through Surrogacy, a national support group, told me that there have probably been about 28,000 surrogate births since 1976, a figure that includes gestational and traditional surrogacies. Sherrie Smith, the program administrator for the East Coast office of the Center for Surrogate Parenting, a surrogacy and egg-donation agency, said that of the 1,355 babies born in their program since 1980, 226 were created through artificial insemination — traditional surrogacies — and the rest were gestational surrogacies, using either a donor egg or the intended mother’s own egg."
...
"Surrogacy is unregulated, and laws vary by state. In the states where it is legal, there is no box on the birth certificate to check “surrogate birth.” In many states that don’t expressly prohibit surrogacy — like Pennsylvania, where our child was eventually born — the genetic parents’ names could be the only ones that appear on the birth certificate. If, however, our baby had been born in New York, where we live and where it is illegal to compensate someone for surrogacy, we would have had to adopt our biological child from Cathy, the woman who carried our child, and her husband. But our contracts were signed in New Jersey, and the consent form that Dr. Fateh had Cathy sign skirted any remaining legal issues."
...
Of the potential surrogate moms:
"None were living in poverty. Lawyers and surrogacy advocates will tell you that they don’t accept poor women as surrogates for a number of reasons. Shirley Zager told me that the arrangement might feel coercive for someone living in real poverty. Poor women, she also told me, are less likely to be in stable relationships, in good health and of appropriate weight. Surrogates are often required to have their own health insurance, which usually means the surrogate or her spouse is employed in the kind of secure job that provides such a benefit.
While no one volunteering to have our baby was poor, neither were they rich. The $25,000 we would pay would make a significant difference in their lives. Still, in our experience with the surrogacy industry, no one lingered on the topic of money. We encountered the wink-nod rule: Surrogates would never say they were motivated to carry a child for another couple just for money; they were all motivated by altruism. This gentle hypocrisy allows surrogacy to take place. Without it, both sides would have to acknowledge the deep cultural revulsion against attaching a dollar figure to the creation of a human life.
In fact, charges of baby selling have long tarnished the practice of traditional surrogacy, and charges of exploiting women have lingered even as more couples opt for gestational surrogacy. We were not disturbed by the commercial aspect of surrogacy. A woman going through the risks of labor for another family clearly deserves to be paid. To me, imagining someone pregnant with the embryo produced by my egg and my husband’s sperm felt more similar to organ donation, or I guess more accurately, organ rental. That was something I could live with. "
...
"THE PREVIOUS WINTER, a Catholic priest, upon hearing of our impending birth and my plans to raise the boy in the same liberal Catholic tradition in which I was raised, sniffed and said to me, “You know, the church frowns on science babies.” "
Showing posts sorted by relevance for query sperm. Sort by date Show all posts
Showing posts sorted by relevance for query sperm. Sort by date Show all posts
Friday, November 28, 2008
Monday, December 30, 2019
Some kinds of privacy may be gone forever
Lots of family secrets are revealed by DNA analysis, and it may no longer be possible to keep those secrets. That is part of the argument made by Dr. Julia Creet, in an interview published at Bill of Health under the title "The End of Privacy?"
Dr. Julia Creet: I made the statement that any idea we had about privacy is over in response to a number of troubling trends in genetic genealogy. DTC genetic tests have revealed long-held family secrets, biological parents and siblings of adoptees, and the identities of sperm and egg donors. In each case, the question of the right of the searcher trumped the rights of those who wanted their privacy protected. In a few cases, sperm donors have sued for invasion of privacy. What these cases show is that even if we think we are protected by the privacy provisions of donor agreements or closed adoptions, genetic tests can leap over those privacy barriers. Many genealogists have declared that there will be no more family secrets in the future. So, family privacy is a thing of the past, which may or may not be a good thing. On a larger scale, law enforcement use of DTC genetic testing databases has demonstrated that data uploaded for one purpose can be used in the future for a completely unanticipated purpose. Without the ability to predict future uses of this information, we cannot put a privacy policy in place that will anticipate all the unforeseen future uses. I think the most telling cases in the last few weeks are the recent warrant that allowed law enforcement access to the GEDmatch database even though most users had opted out of having their results included in searches, and the rather frightening report for Peter Ney about the ease of malware intrusions on genetic genealogy databases.
Dr. Julia Creet: I made the statement that any idea we had about privacy is over in response to a number of troubling trends in genetic genealogy. DTC genetic tests have revealed long-held family secrets, biological parents and siblings of adoptees, and the identities of sperm and egg donors. In each case, the question of the right of the searcher trumped the rights of those who wanted their privacy protected. In a few cases, sperm donors have sued for invasion of privacy. What these cases show is that even if we think we are protected by the privacy provisions of donor agreements or closed adoptions, genetic tests can leap over those privacy barriers. Many genealogists have declared that there will be no more family secrets in the future. So, family privacy is a thing of the past, which may or may not be a good thing. On a larger scale, law enforcement use of DTC genetic testing databases has demonstrated that data uploaded for one purpose can be used in the future for a completely unanticipated purpose. Without the ability to predict future uses of this information, we cannot put a privacy policy in place that will anticipate all the unforeseen future uses. I think the most telling cases in the last few weeks are the recent warrant that allowed law enforcement access to the GEDmatch database even though most users had opted out of having their results included in searches, and the rather frightening report for Peter Ney about the ease of malware intrusions on genetic genealogy databases.
Saturday, December 15, 2018
Are uterus transplants repugnant? And to whom? And why? (in the Irish Times)
Here's an article in the Irish Times on uterus transplants , that makes clear the view that the views of those not directly involved should play a large and perhaps decisive role in public discussions of transactions that some may find repugnant. The author indicates that among his concerns is that the parentage of the baby might be in doubt (i.e. that a child conceived from the eggs and sperm of his genetic parents and carried to birth by his pregnant genetic mother might have to be regarded as the child of the donor of the uterus...). I wonder if even the author thinks this is a serious reason to ban uterus transplants; rather, I get the sense that he is throwing his net widely in the hope that different objections might resonate with different parts of his audience. Maybe his goal is simply to be controversial. [Just to be clear, I am not disagreeing that child welfare is an important concern when evaluating issues related to reproduction and childbirth...but this concern strikes me as particularly far-fetched.]
Are uterus transplants ethically acceptable?
Several infertile women worldwide have given birth with wombs received from either living or dead donors by George Winter
"In September 2014, the first live birth following UTx was reported from Sweden by Prof Mats Brännström and colleagues. The recipient had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome – she was born without a viable womb – and the donor was a 61-year-old friend. Since then, there have been at least 12 successful births worldwide following UTx.
The brave new world of wombless gestation--Artificial womb technology poses many ethical questions – we need to debate them
(that article is about experimental technology about lamb embryos brought to term "in a plastic “biobag” – literally, a womb with a view ..." I was relieved to note that, in considering the implications for humans, the author didn't raise the question above about the parentage--or in this case perhaps the humanity--of the baby (so maybe he was just kidding.)
Are uterus transplants ethically acceptable?
Several infertile women worldwide have given birth with wombs received from either living or dead donors by George Winter
"In September 2014, the first live birth following UTx was reported from Sweden by Prof Mats Brännström and colleagues. The recipient had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome – she was born without a viable womb – and the donor was a 61-year-old friend. Since then, there have been at least 12 successful births worldwide following UTx.
"Recently, it was revealed that the first baby had been born following a womb transplant from a deceased donor. Ten previous attempts had been made in different countries to deliver a live baby following a uterus or womb transplant from a deceased donor, but this – performed by surgeons in Brazil – was the first with a successful outcome.
...
"The UTx procedure begins with in-vitro fertilisation, using the recipient’s egg and her partner’s sperm; the subsequent embryo is frozen; a uterus – from a living or dead donor – is transplanted; the embryo is thawed and implanted; and following pregnancy and delivery by Caesarean section, a hysterectomy is performed, obviating the need for lifelong immunosuppressive therapy."
...
"The “Ethical Considerations” section of the Womb Transplant UK website implies that any societal misgivings on the acceptability of UTx will be ignored: “Ultimately, the decision to go forward will depend on the judgment of the researchers, the participating institution, and most importantly, the patient to whom the transplant will be offered.”
"Hardly an unbiased trio.
"What ethical dilemmas might arise?
"If a transplanted uterus were to jeopardise a recipient’s life, it could be removed; but what if it contains a viable foetus? And there is debate over living versus deceased donation, with Spanish and Japanese teams favouring the Swedish “live” model, and French, Belgian and UK researchers preferring deceased donors. Writing in the journal Bioethics, Dr Nicola Williams cites the view of the International Federation of Gynaecology and Obstetrics that “the retrieval of a uterus from a living donor necessitates a relatively major surgery with its own risk of complications [and] constitutes reason enough to deem the procedure ethically inappropriate”.
"Also, how much would a child be entitled to know about the donor from whose uterus he or she issued, and – irrespective of whether the donor had been dead or alive – would the infant be the child of the donor or the recipient?"
***********
George Winter, the author of the piece, apparently writes often on ethical issues in medicine (although the above is the first article I had read by him). See e.g. his recent related articles on The ethical considerations of face transplants and The brave new world of wombless gestation--Artificial womb technology poses many ethical questions – we need to debate them
(that article is about experimental technology about lamb embryos brought to term "in a plastic “biobag” – literally, a womb with a view ..." I was relieved to note that, in considering the implications for humans, the author didn't raise the question above about the parentage--or in this case perhaps the humanity--of the baby (so maybe he was just kidding.)
**********
And see my related post from yesterday:
Friday, December 14, 2018 Successful birth in Brazil to a woman who received a uterus transplanted from a deceased donor
Friday, December 14, 2018 Successful birth in Brazil to a woman who received a uterus transplanted from a deceased donor
Monday, December 19, 2016
Crowdfunding For IVF
NPR has a story which involves a combination of very modern transactions:
Please, Baby, Please: Some Couples Turn To Crowdfunding For IVF
"They began with a less costly and less invasive option: IUI or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try.
...
"The next step they took was to try in vitro fertilization, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.
"At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. "
Please, Baby, Please: Some Couples Turn To Crowdfunding For IVF
"They began with a less costly and less invasive option: IUI or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try.
...
"The next step they took was to try in vitro fertilization, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.
"At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. "
Thursday, May 28, 2009
Miscellaneous repugnant transactions
Germany to ban paintball
"The German government is planning to ban paintball and laser shooting games in reaction to the recent school massacre in which 15 people died.
Under legislation agreed by the ruling coalition of the chancellor, Angela Merkel, using air rifles to shoot paint-filled pellets at opponents is likely to be made illegal, and would be punishable with fines of up to €5,000 " (HT Muriel Niederle)
Over at Knowledge Problem: Price gouging: Is it wrong? Should it be against the law?
At MR, Tyler Cowen reports:"Love Land, a sex theme park set to open this October in China won't have the chance to lose it's virginity. Chinese bureaucrats ordered the park destroyed after details of the park's featured attractions were leaked.
The story is here. The rest of the article relates:
The park was to have giant-sized reproductions of male and female anatomy, and offered lessons in safe sex and the proper use of condoms. There was also an exhibition about the history of sex, as well as workshops offering sex techniques.
The entrance to park featured a giant pair of women's legs clad only in a red thong. Those legs are now closed forever. Officials would only say that the concept of the park was vulgar, and deemed unnecessary. Bulldozers and wrecking ball were seen destroying the exhibits as onlookers tried to get a peak.
China considers the topic of sex taboo, even though illegal prostitution is at an all-time high in the country. "
Fertility treatments in Britain: a post actually headlined Repugnant Transactions follows a story in the Guardian, Thousands of women leaving UK for fertility treatment, • Women losing patience with NHS waiting lists • Eggs and donated sperm in short supply, study says.
"Couples here are able to exploit the fact that, in some countries, women who choose to donate eggs can be paid, said Culley, with some donors in America receiving up to $10,000. In Britain, by contrast, tight regulation of fertility means egg donors receive only expenses.
"All the evidence is that cross-border reproductive care is growing. Women here do this for all sorts of reasons," she said. "There is a serious shortage of eggs, donated sperm is in shorter supply than before, the cost can be cheaper abroad and some people want IVF which they can't get on the NHS."
...
"Isobel O'Neill, a fertility counsellor in Glasgow, said couples seeking a donated egg who visit the Glasgow Royal Infirmary are told there is a six- or seven-year wait for one on the NHS. Even those willing to pay at the private Glasgow Centre for Reproductive Medicine, where she also works, face a delay of up to a year."
California High Court Upholds Gay Marriage Ban
"The California Supreme Court upheld a ban on same-sex marriage Tuesday, ratifying a decision made by voters last year. The ruling comes at a time when several state governments have moved in the opposite direction.
"The court’s decision does, however, preserve the 18,000 same-sex marriages performed between the justices’ ruling last May that same-sex marriage was constitutionally protected and voters’ passage in November of Proposition 8, which banned it.
The court’s opinion, written by Chief Justice Ronald M. George for a 6-to-1 majority, noted that same-sex couples still had a right to civil unions. Such unions, the opinion said, gives those couples the ability to “choose one’s life partner and enter with that person into a committed, officially recognized and protected family relationship that enjoys all of the constitutionally based incidents of marriage.”
Justice George wrote that Proposition 8 did not “entirely repeal or abrogate” the right to such a protected relationship. Instead, he said, it “carves out a narrow and limited exception to these state constitutional rights, reserving the official designation of the term ‘marriage’ for the union of opposite-sex couples as a matter of state constitutional law.”
The 18,000 existing marriages can stand, he wrote, because Proposition 8 did not include language specifically saying it was retroactive."
Update, hugging: Jorge Ortiz directs my attention to a story in today's NY Times that I had overlooked, some high schools are banning hugs:
"And schools from Hillsdale, N.J., to Bend, Ore., wary in a litigious era about sexual harassment or improper touching — or citing hallway clogging and late arrivals to class — have banned hugging or imposed a three-second rule. "
An innovative early paper on repugnance: Ravi Kanbur, "On Obnoxious Markets", July 2001. Revised version published in Stephen Cullenberg and Prasanta Pattanaik (editors), Globalization, Culture and the Limits of the Market: Essays in Economics and Philosophy. Oxford University Press, 2004.
Professor Kanbur argues that extreme outcomes, and asymmetric and inadequate information, and inequality are big components in making markets obnoxious, and I agree.
I'm personally reluctant to set out a theory of what makes markets repugnant since I always find markets that don't fit into any simple framework. Same-sex marriage, for example, is a transaction that many people find repugnant (and is now once again illegal in California, see above), but it is no more extreme, or subject to asymmetric information, or unequal than heterosexual marriage, which is just about the opposite of a repugnant transaction, what we might call a "protected" transaction.
"The German government is planning to ban paintball and laser shooting games in reaction to the recent school massacre in which 15 people died.
Under legislation agreed by the ruling coalition of the chancellor, Angela Merkel, using air rifles to shoot paint-filled pellets at opponents is likely to be made illegal, and would be punishable with fines of up to €5,000 " (HT Muriel Niederle)
Over at Knowledge Problem: Price gouging: Is it wrong? Should it be against the law?
At MR, Tyler Cowen reports:"Love Land, a sex theme park set to open this October in China won't have the chance to lose it's virginity. Chinese bureaucrats ordered the park destroyed after details of the park's featured attractions were leaked.
The story is here. The rest of the article relates:
The park was to have giant-sized reproductions of male and female anatomy, and offered lessons in safe sex and the proper use of condoms. There was also an exhibition about the history of sex, as well as workshops offering sex techniques.
The entrance to park featured a giant pair of women's legs clad only in a red thong. Those legs are now closed forever. Officials would only say that the concept of the park was vulgar, and deemed unnecessary. Bulldozers and wrecking ball were seen destroying the exhibits as onlookers tried to get a peak.
China considers the topic of sex taboo, even though illegal prostitution is at an all-time high in the country. "
Fertility treatments in Britain: a post actually headlined Repugnant Transactions follows a story in the Guardian, Thousands of women leaving UK for fertility treatment, • Women losing patience with NHS waiting lists • Eggs and donated sperm in short supply, study says.
"Couples here are able to exploit the fact that, in some countries, women who choose to donate eggs can be paid, said Culley, with some donors in America receiving up to $10,000. In Britain, by contrast, tight regulation of fertility means egg donors receive only expenses.
"All the evidence is that cross-border reproductive care is growing. Women here do this for all sorts of reasons," she said. "There is a serious shortage of eggs, donated sperm is in shorter supply than before, the cost can be cheaper abroad and some people want IVF which they can't get on the NHS."
...
"Isobel O'Neill, a fertility counsellor in Glasgow, said couples seeking a donated egg who visit the Glasgow Royal Infirmary are told there is a six- or seven-year wait for one on the NHS. Even those willing to pay at the private Glasgow Centre for Reproductive Medicine, where she also works, face a delay of up to a year."
California High Court Upholds Gay Marriage Ban
"The California Supreme Court upheld a ban on same-sex marriage Tuesday, ratifying a decision made by voters last year. The ruling comes at a time when several state governments have moved in the opposite direction.
"The court’s decision does, however, preserve the 18,000 same-sex marriages performed between the justices’ ruling last May that same-sex marriage was constitutionally protected and voters’ passage in November of Proposition 8, which banned it.
The court’s opinion, written by Chief Justice Ronald M. George for a 6-to-1 majority, noted that same-sex couples still had a right to civil unions. Such unions, the opinion said, gives those couples the ability to “choose one’s life partner and enter with that person into a committed, officially recognized and protected family relationship that enjoys all of the constitutionally based incidents of marriage.”
Justice George wrote that Proposition 8 did not “entirely repeal or abrogate” the right to such a protected relationship. Instead, he said, it “carves out a narrow and limited exception to these state constitutional rights, reserving the official designation of the term ‘marriage’ for the union of opposite-sex couples as a matter of state constitutional law.”
The 18,000 existing marriages can stand, he wrote, because Proposition 8 did not include language specifically saying it was retroactive."
Update, hugging: Jorge Ortiz directs my attention to a story in today's NY Times that I had overlooked, some high schools are banning hugs:
"And schools from Hillsdale, N.J., to Bend, Ore., wary in a litigious era about sexual harassment or improper touching — or citing hallway clogging and late arrivals to class — have banned hugging or imposed a three-second rule. "
An innovative early paper on repugnance: Ravi Kanbur, "On Obnoxious Markets", July 2001. Revised version published in Stephen Cullenberg and Prasanta Pattanaik (editors), Globalization, Culture and the Limits of the Market: Essays in Economics and Philosophy. Oxford University Press, 2004.
Professor Kanbur argues that extreme outcomes, and asymmetric and inadequate information, and inequality are big components in making markets obnoxious, and I agree.
I'm personally reluctant to set out a theory of what makes markets repugnant since I always find markets that don't fit into any simple framework. Same-sex marriage, for example, is a transaction that many people find repugnant (and is now once again illegal in California, see above), but it is no more extreme, or subject to asymmetric information, or unequal than heterosexual marriage, which is just about the opposite of a repugnant transaction, what we might call a "protected" transaction.
Wednesday, March 12, 2014
Vocabulary in the fertility business
Over at Bill of Health, Dov Fox starts a post on some tax litigation with some linguistic notes from the field:
Can you be taxed for selling your eggs?
"Those who deal in alternative ways of making families use euphemisms that obscure the market mechanisms at work when individuals ‘‘donate’’ their eggs or sperm, couples ‘‘contribute’’ their embryos, surrogates ‘‘offer’’ their wombs, and orphans are ‘‘matched’’ to adoptive parents. Make no mistake, family formation is big business. "
Can you be taxed for selling your eggs?
"Those who deal in alternative ways of making families use euphemisms that obscure the market mechanisms at work when individuals ‘‘donate’’ their eggs or sperm, couples ‘‘contribute’’ their embryos, surrogates ‘‘offer’’ their wombs, and orphans are ‘‘matched’’ to adoptive parents. Make no mistake, family formation is big business. "
Saturday, February 20, 2010
Books about markets for body parts (for and against)
Below are a mix of books, some scholarly some popular, mostly harvested by clicking on the Amazon links "people who bought this book also bought," from one book to the next. The descriptions are from Amazon:
Body Shopping: Converting Body Parts to Profit by Donna Dickenson
Product Description
According to law, you don't actually own your own body, and you might be shocked by the cunning ways everyone from researchers and entrepreneurs to doctors, insurers, and governments are using that fact to their advantage. Thanks to developments in biotechnology and medicine, cells, tissues, and organs are now viewed as both a valuable source of information and as the raw material for new commercial products.This 'currency of the future' might be fueling the new biotechnology industry, but the former owners of that flesh and bone aren't entitled to one fraction of the proceeds. In "Body Shopping", award-winning writer Donna Dickenson makes a case against the newfound rights of businesses to harvest body parts and gain exclusive profit from the resulting products and processes. To illustrate her case, she presents a series of compelling stories of individuals injured or abused by the increasingly rapacious biotechnology industry. Some cases have become public scandals, such as the illicit selling of the late broadcaster Alastair Cooke's bones by a body parts ring involving surgeons and undertakers.Others are hardly known at all, including the way in which for-profit umbilical cord blood banks target pregnant women with offers of a 'service' that professional obstetrics bodies view as dangerous, the leukemia patient who tried and failed to claim property rights in a $3 billion cell line created from his tissue, and the real risks facing women who provide eggs for the global market in baby-making. "Body Shopping" offers a fresh, international, and completely up-to-date take on the evolving legal position, the historical long view, and the latest biomedical research - an approach that goes beyond a mere recital of horror stories to suggest a range of new strategies to bring the biotechnology industry to heel. The result is a gripping, powerful book that is essential reading for everyone from parents to philosophers, and from scientists to lawmakers - everyone who believes that no human should ever be reduced to the sum of their body parts.
Black Markets: The Supply and Demand of Body Parts by Michele Goodwin, 2006
From Publishers Weekly
Law professor and bioethicist Goodwin sheds much needed light in this disturbing examination of yet another failure of the American health care system: an organ donation process that leads to the sale of human organs. Despite some highly technical sections, the author artfully uses case law and tragic stories of people caught in the machinery of an organ marketplace that favors the well connected. Even readers well versed in current events are likely to be shocked by the prevalence of "presumed consent" legislation in 28 states that shifts the choice to donate away from potential donors —corneas, for instance, are routinely harvested by local coroners unless a specific prior refusal has been communicated (and sometimes even despite such a directive). The author does a good job of linking this country's history of medical scandals that victimized African-Americans to that community's misgivings about serving as either donors or seekers of a spot on the coveted transplant waiting lists. Her controversial recommendations, which include lifting the taboo on selling cadaveric organs to address the organ deficit, should spark much discussion. (Mar.)
Tissue Economies: Blood, Organs, and Cell Lines in Late Capitalism (Science and Cultural Theory) ~ Catherine Waldby (Author), Robert Mitchell (Author)
Product Description
As new medical technologies are developed, more and more human tissues—such as skin, bones, heart valves, embryos, and stem cell lines—are stored and distributed for therapeutic and research purposes. The accelerating circulation of human tissue fragments raises profound social and ethical concerns related to who donates or sells bodily tissue, who receives it, and who profits—or does not—from the transaction. Catherine Waldby and Robert Mitchell survey the rapidly expanding economies of exchange in human tissue, explaining the complex questions raised and suggesting likely developments. Comparing contemporary tissue economies in the United Kingdom and United States, they explore and complicate the distinction that has dominated practice and policy for several decades: the distinction between tissue as a gift to be exchanged in a transaction separate from the commercial market and tissue as a commodity to be traded for profit.
Waldby and Mitchell pull together a prodigious amount of research—involving policy reports and scientific papers, operating manuals, legal decisions, interviews, journalism, and Congressional testimony—to offer a series of case studies based on particular forms of tissue exchange. They examine the effect of threats of contamination—from HIV and other pathogens—on blood banks’ understandings of the gift/commodity relationship; the growth of autologous economies, in which individuals bank their tissues for their own use; the creation of the United Kingdom’s Stem Cell bank, which facilitates the donation of embryos for stem cell development; and the legal and financial repercussions of designating some tissues “hospital waste.” They also consider the impact of different models of biotechnology patents on tissue economies and the relationship between experimental therapies to regenerate damaged or degenerated tissues and calls for a legal, for-profit market in organs. Ultimately, Waldby and Mitchell conclude that scientific technologies, the globalization of tissue exchange, and recent anthropological, sociological, and legal thinking have blurred any strict line separating donations from the incursion of market values into tissue economies.
Body Brokers: Inside America's Underground Trade in Human Remains (Paperback)~ Annie Cheney 2006
From Booklist
*Starred Review* Here's one with the potential to keep folks up nights, wondering whether the urn on the mantel contains 100-percent Uncle Fred or a blend. Before journalist Cheney began an assignment for My Generation magazine, she had never suspected there might be diverse career opportunities for cadavers, that whatever one wants to be when one grows up, options continue to exist postmortem. But consider the ever-popular organ donor program. And then there's the option of donating one's body to a medical school for the betterment of mankind through science. Once that latter choice is made, Cheney learned, alternatives multiply, and a corpse can follow one of several roads. On a lower thoroughfare, big bucks are waiting for the cold-blooded entrepreneur ready to carve human bodies up like chickens and parcel them out to the highest bidder for such uses as military bomb test dummies, lifelike operative subjects for medical seminars, and resource troves for the machine-tooling of bones into orthopedic apparatus. Even if one never willingly donates one's body, there are enough unscrupulous morticians and morgue workers who will surreptitiously carve out an ulna or a femur and replace it with a PVC pipe, then sell the goods on the not-so-open open market. This is a chilling expose of the grisly industry of body trading. Donna ChavezCopyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.
Kidney for Sale by Owner: Human Organs, Transplantation, and the Market )~ Mark J Cherry, 2005
Product Description
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. He carefully examines arguments against a market for body parts, including assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational "moral repugnance" of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.
The Ethics of Organ Transplants: The Current Debate (Contemporary Issues (Buffalo, N.Y.).) (Paperback 1999)~ Arthur L. Caplan (Author, Editor), Daniel H. Coelho (Editor)
From Library Journal
Renowned bioethicist Caplan (Ctr. for Bioethics, Univ. of Pennsylvania) and medical writer Coelho have selected 35 articles that are representative of the ethical issues surrounding organ transplantation. Scarcity of organs and the high costs involved in these procedures force difficult legal, philosophical, scientific, and economic choices. What are the sources of organs used in transplantation? How can we make the procurement system more efficient? Should we pay for organs? Should someone who has already received one transplant be allowed a second? Should alcoholics be given liver transplants? Are transplants really worth the tremendous costs? These are just a few of the questions discussed here. In many cases, the editors have selected companion articles that illustrate contrasting viewpoints on a particular issue. Although some articles are slightly dated, the issues are still relevant. This well-balanced, reasonably priced compilation is recommended for all libraries.ATina Neville, Univ. of South Florida at St. Petersburg Lib.Copyright 1999 Reed Business Information, Inc.
The U.S. Organ Procurement System: A Prescription for Reform (AEI Evaluative Studies.) (Hardcover) by David L. Kaserman and A. H. Barnett
Product Description
Experts make a compelling and persuasive case for markets in human organs.
Kieran Healy, Last Best Gift. Altruism and the Market for Human Blood and Organs. Chicago University Press, 2006
The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception (Hardcover)~ Debora L. Spar
From Publishers Weekly
Among the troubling aspects of new reproductive technologies is the takeover of reproduction by the marketplace. This probing study accepts the free market process while casting a discerning and skeptical eye at its pitfalls. Harvard business prof Spar (The Cooperative Edge: The Internal Politics of International Cartels) explores many aspects of the high-tech commodification of procreation: the fabulous revenues commercial fertility clinics earn from couples' desperate desire for children and the ensuing conflicts between medical ethics and the profit motive; the premiums paid for sperm and eggs from genetically desirable donors; the possible exploitation of poor, nonwhite and Third World surrogate mothers paid to gestate the spawn of wealthy Westerners; the fine line between modern adoption practices and outright baby selling; and the new entrepreneurial paradigm of maternity, in which the official "mother" simply finances the assemblage of sperm, purchased egg and hired womb and lays contractual claim to the finished infant. Spar considers most of these developments inevitable and not undesirable (they provide kids to parents who want them), but calls for government regulation to curb excesses and protect the interests of all involved. Her sanguinity will not satisfy all critics, but she offers a lucid, nuanced guide to this brave new world. (Feb. 14) Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Body Shopping: Converting Body Parts to Profit by Donna Dickenson
Product Description
According to law, you don't actually own your own body, and you might be shocked by the cunning ways everyone from researchers and entrepreneurs to doctors, insurers, and governments are using that fact to their advantage. Thanks to developments in biotechnology and medicine, cells, tissues, and organs are now viewed as both a valuable source of information and as the raw material for new commercial products.This 'currency of the future' might be fueling the new biotechnology industry, but the former owners of that flesh and bone aren't entitled to one fraction of the proceeds. In "Body Shopping", award-winning writer Donna Dickenson makes a case against the newfound rights of businesses to harvest body parts and gain exclusive profit from the resulting products and processes. To illustrate her case, she presents a series of compelling stories of individuals injured or abused by the increasingly rapacious biotechnology industry. Some cases have become public scandals, such as the illicit selling of the late broadcaster Alastair Cooke's bones by a body parts ring involving surgeons and undertakers.Others are hardly known at all, including the way in which for-profit umbilical cord blood banks target pregnant women with offers of a 'service' that professional obstetrics bodies view as dangerous, the leukemia patient who tried and failed to claim property rights in a $3 billion cell line created from his tissue, and the real risks facing women who provide eggs for the global market in baby-making. "Body Shopping" offers a fresh, international, and completely up-to-date take on the evolving legal position, the historical long view, and the latest biomedical research - an approach that goes beyond a mere recital of horror stories to suggest a range of new strategies to bring the biotechnology industry to heel. The result is a gripping, powerful book that is essential reading for everyone from parents to philosophers, and from scientists to lawmakers - everyone who believes that no human should ever be reduced to the sum of their body parts.
Black Markets: The Supply and Demand of Body Parts by Michele Goodwin, 2006
From Publishers Weekly
Law professor and bioethicist Goodwin sheds much needed light in this disturbing examination of yet another failure of the American health care system: an organ donation process that leads to the sale of human organs. Despite some highly technical sections, the author artfully uses case law and tragic stories of people caught in the machinery of an organ marketplace that favors the well connected. Even readers well versed in current events are likely to be shocked by the prevalence of "presumed consent" legislation in 28 states that shifts the choice to donate away from potential donors —corneas, for instance, are routinely harvested by local coroners unless a specific prior refusal has been communicated (and sometimes even despite such a directive). The author does a good job of linking this country's history of medical scandals that victimized African-Americans to that community's misgivings about serving as either donors or seekers of a spot on the coveted transplant waiting lists. Her controversial recommendations, which include lifting the taboo on selling cadaveric organs to address the organ deficit, should spark much discussion. (Mar.)
Tissue Economies: Blood, Organs, and Cell Lines in Late Capitalism (Science and Cultural Theory) ~ Catherine Waldby (Author), Robert Mitchell (Author)
Product Description
As new medical technologies are developed, more and more human tissues—such as skin, bones, heart valves, embryos, and stem cell lines—are stored and distributed for therapeutic and research purposes. The accelerating circulation of human tissue fragments raises profound social and ethical concerns related to who donates or sells bodily tissue, who receives it, and who profits—or does not—from the transaction. Catherine Waldby and Robert Mitchell survey the rapidly expanding economies of exchange in human tissue, explaining the complex questions raised and suggesting likely developments. Comparing contemporary tissue economies in the United Kingdom and United States, they explore and complicate the distinction that has dominated practice and policy for several decades: the distinction between tissue as a gift to be exchanged in a transaction separate from the commercial market and tissue as a commodity to be traded for profit.
Waldby and Mitchell pull together a prodigious amount of research—involving policy reports and scientific papers, operating manuals, legal decisions, interviews, journalism, and Congressional testimony—to offer a series of case studies based on particular forms of tissue exchange. They examine the effect of threats of contamination—from HIV and other pathogens—on blood banks’ understandings of the gift/commodity relationship; the growth of autologous economies, in which individuals bank their tissues for their own use; the creation of the United Kingdom’s Stem Cell bank, which facilitates the donation of embryos for stem cell development; and the legal and financial repercussions of designating some tissues “hospital waste.” They also consider the impact of different models of biotechnology patents on tissue economies and the relationship between experimental therapies to regenerate damaged or degenerated tissues and calls for a legal, for-profit market in organs. Ultimately, Waldby and Mitchell conclude that scientific technologies, the globalization of tissue exchange, and recent anthropological, sociological, and legal thinking have blurred any strict line separating donations from the incursion of market values into tissue economies.
Body Brokers: Inside America's Underground Trade in Human Remains (Paperback)~ Annie Cheney 2006
From Booklist
*Starred Review* Here's one with the potential to keep folks up nights, wondering whether the urn on the mantel contains 100-percent Uncle Fred or a blend. Before journalist Cheney began an assignment for My Generation magazine, she had never suspected there might be diverse career opportunities for cadavers, that whatever one wants to be when one grows up, options continue to exist postmortem. But consider the ever-popular organ donor program. And then there's the option of donating one's body to a medical school for the betterment of mankind through science. Once that latter choice is made, Cheney learned, alternatives multiply, and a corpse can follow one of several roads. On a lower thoroughfare, big bucks are waiting for the cold-blooded entrepreneur ready to carve human bodies up like chickens and parcel them out to the highest bidder for such uses as military bomb test dummies, lifelike operative subjects for medical seminars, and resource troves for the machine-tooling of bones into orthopedic apparatus. Even if one never willingly donates one's body, there are enough unscrupulous morticians and morgue workers who will surreptitiously carve out an ulna or a femur and replace it with a PVC pipe, then sell the goods on the not-so-open open market. This is a chilling expose of the grisly industry of body trading. Donna ChavezCopyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.
Kidney for Sale by Owner: Human Organs, Transplantation, and the Market )~ Mark J Cherry, 2005
Product Description
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. He carefully examines arguments against a market for body parts, including assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational "moral repugnance" of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.
The Ethics of Organ Transplants: The Current Debate (Contemporary Issues (Buffalo, N.Y.).) (Paperback 1999)~ Arthur L. Caplan (Author, Editor), Daniel H. Coelho (Editor)
From Library Journal
Renowned bioethicist Caplan (Ctr. for Bioethics, Univ. of Pennsylvania) and medical writer Coelho have selected 35 articles that are representative of the ethical issues surrounding organ transplantation. Scarcity of organs and the high costs involved in these procedures force difficult legal, philosophical, scientific, and economic choices. What are the sources of organs used in transplantation? How can we make the procurement system more efficient? Should we pay for organs? Should someone who has already received one transplant be allowed a second? Should alcoholics be given liver transplants? Are transplants really worth the tremendous costs? These are just a few of the questions discussed here. In many cases, the editors have selected companion articles that illustrate contrasting viewpoints on a particular issue. Although some articles are slightly dated, the issues are still relevant. This well-balanced, reasonably priced compilation is recommended for all libraries.ATina Neville, Univ. of South Florida at St. Petersburg Lib.Copyright 1999 Reed Business Information, Inc.
The U.S. Organ Procurement System: A Prescription for Reform (AEI Evaluative Studies.) (Hardcover) by David L. Kaserman and A. H. Barnett
Product Description
Experts make a compelling and persuasive case for markets in human organs.
Kieran Healy, Last Best Gift. Altruism and the Market for Human Blood and Organs. Chicago University Press, 2006
The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception (Hardcover)~ Debora L. Spar
From Publishers Weekly
Among the troubling aspects of new reproductive technologies is the takeover of reproduction by the marketplace. This probing study accepts the free market process while casting a discerning and skeptical eye at its pitfalls. Harvard business prof Spar (The Cooperative Edge: The Internal Politics of International Cartels) explores many aspects of the high-tech commodification of procreation: the fabulous revenues commercial fertility clinics earn from couples' desperate desire for children and the ensuing conflicts between medical ethics and the profit motive; the premiums paid for sperm and eggs from genetically desirable donors; the possible exploitation of poor, nonwhite and Third World surrogate mothers paid to gestate the spawn of wealthy Westerners; the fine line between modern adoption practices and outright baby selling; and the new entrepreneurial paradigm of maternity, in which the official "mother" simply finances the assemblage of sperm, purchased egg and hired womb and lays contractual claim to the finished infant. Spar considers most of these developments inevitable and not undesirable (they provide kids to parents who want them), but calls for government regulation to curb excesses and protect the interests of all involved. Her sanguinity will not satisfy all critics, but she offers a lucid, nuanced guide to this brave new world. (Feb. 14) Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Wednesday, April 14, 2010
Egg donor compensation
Study hard. The Globe reports: Yes, top students reap rich rewards, even as egg donors
Would-be parents want high scorers
"The Harvard Crimson was one of three college newspapers that ran an identical classified ad seeking a woman who fit a narrow profile: younger than 29 with a GPA over 3.5 and an SAT score over 1,400. The lucky candidate stood to collect $35,000 if she donated her eggs for harvesting.
The ad was one of 105 college newspaper ads examined by a Georgia Institute of Technology researcher who issued a report yesterday that appeared to confirm the long-held suspicion that couples who are unable to have children of their own are willing to pay more for reproductive help from someone smart. The analysis showed that higher payments offered to egg donors correlated with higher SAT scores.
“Holding all else equal, an increase of 100 SAT points in the score of a typical incoming student increased the compensation offered to oocyte donors at that college or university by $2,350,’’ wrote researcher Aaron D. Levine.
The paper, published in the March-April issue of the Hastings Center Report, examined ads in 63 student newspapers in spring 2006 and was billed as the first national cross-sectional sample of ads for egg donors. "
...
"Concerned about eggs being treated as commodities, and worried that big financial rewards could entice women to ignore the risks of the rigorous procedures required for harvesting, the American Society for Reproductive Medicine discourages compensation based on donors’ personal characteristics. The society also discourages any payments over $10,000.
Levine’s paper points out, however, that no outside regulator enforces those guidelines and that they are often ignored.
Of the advertisements Levine examined, nearly one-quarter offered donors more than $10,000, and about one-quarter of the ads listed specific requirements, such as appearance or ethnicity, also in violation of guidelines that discourage greater payment for particular personal characteristics."
...
"The issue of the report containing Levine’s analysis also offers a counterperspective from John A. Robertson, who chaired the ethics committee of the American Society of Reproductive Medicine. He casts doubt on the notion that it is an ethical problem to pay more for eggs from a woman with a particular ethnic background or high IQ. “After all, we allow individuals to choose their mates and sperm donors on the basis of such characteristics,’ Robertson wrote. “Why not choose egg donors similarly?’’ "
See also The Value of Smart Eggs from The Faculty Lounge by Kim Krawiec.
"In his response accompanying the report, John Robertson (Texas, law) questions whether there are really any ethical problems raised by the study – after all, Levine finds compliance with the ASRM guidelines in at least half the advertisements in his sample. I would argue, however, that Levine’s study highlights a serious ethical issue, though it is not infertile couples or the agencies working on their behalf whose behavior is ethically troubling. It is ASRM’s paternalistic and misguided attempts to control oocyte donor compensation through the same type of professional guidelines that courts have rejected when employed by engineers, lawyers, dentists, and doctors that should raise an ethical red flag."
And here is the Hastings Center Report: Self-Regulation, Compensation, and the Ethical Recruitment of Oocyte Donors by Aaron D. Levine
Would-be parents want high scorers
"The Harvard Crimson was one of three college newspapers that ran an identical classified ad seeking a woman who fit a narrow profile: younger than 29 with a GPA over 3.5 and an SAT score over 1,400. The lucky candidate stood to collect $35,000 if she donated her eggs for harvesting.
The ad was one of 105 college newspaper ads examined by a Georgia Institute of Technology researcher who issued a report yesterday that appeared to confirm the long-held suspicion that couples who are unable to have children of their own are willing to pay more for reproductive help from someone smart. The analysis showed that higher payments offered to egg donors correlated with higher SAT scores.
“Holding all else equal, an increase of 100 SAT points in the score of a typical incoming student increased the compensation offered to oocyte donors at that college or university by $2,350,’’ wrote researcher Aaron D. Levine.
The paper, published in the March-April issue of the Hastings Center Report, examined ads in 63 student newspapers in spring 2006 and was billed as the first national cross-sectional sample of ads for egg donors. "
...
"Concerned about eggs being treated as commodities, and worried that big financial rewards could entice women to ignore the risks of the rigorous procedures required for harvesting, the American Society for Reproductive Medicine discourages compensation based on donors’ personal characteristics. The society also discourages any payments over $10,000.
Levine’s paper points out, however, that no outside regulator enforces those guidelines and that they are often ignored.
Of the advertisements Levine examined, nearly one-quarter offered donors more than $10,000, and about one-quarter of the ads listed specific requirements, such as appearance or ethnicity, also in violation of guidelines that discourage greater payment for particular personal characteristics."
...
"The issue of the report containing Levine’s analysis also offers a counterperspective from John A. Robertson, who chaired the ethics committee of the American Society of Reproductive Medicine. He casts doubt on the notion that it is an ethical problem to pay more for eggs from a woman with a particular ethnic background or high IQ. “After all, we allow individuals to choose their mates and sperm donors on the basis of such characteristics,’ Robertson wrote. “Why not choose egg donors similarly?’’ "
See also The Value of Smart Eggs from The Faculty Lounge by Kim Krawiec.
"In his response accompanying the report, John Robertson (Texas, law) questions whether there are really any ethical problems raised by the study – after all, Levine finds compliance with the ASRM guidelines in at least half the advertisements in his sample. I would argue, however, that Levine’s study highlights a serious ethical issue, though it is not infertile couples or the agencies working on their behalf whose behavior is ethically troubling. It is ASRM’s paternalistic and misguided attempts to control oocyte donor compensation through the same type of professional guidelines that courts have rejected when employed by engineers, lawyers, dentists, and doctors that should raise an ethical red flag."
And here is the Hastings Center Report: Self-Regulation, Compensation, and the Ethical Recruitment of Oocyte Donors by Aaron D. Levine
Wednesday, May 24, 2023
Egg freezing in China and Hong Kong
The FT has the story:
China’s fertility treatment rules push single women to Hong Kong
Beijing faces calls to ease access to egg freezing and IVF amid demographic crisis
By Eleanor Olcott and Chan Ho-him
…
“As a result, more and more Chinese women travel abroad for the procedure, with Hong Kong a top destination given its proximity and strong healthcare system.
…
“While it is possible for single or gay women to freeze their eggs in Hong Kong, only married heterosexual couples can access IVF treatment. In practice, that means eggs are stored until women get married and begin the IVF process.”
Friday, June 5, 2009
Fertility and religion
The Bible encourages reproduction, but puts bounds on sexuality, and so religious couples seeking treatment for infertility need to navigate carefully. For orthodox Jews, the Puah Institute (named after one of the two Hebrew midwives in the story of the birth of Moses) helps with this navigation. Here's a story about rabbinical supervision of medical fertility treatments involving in vitro fertilization: How to make a kosher baby.
Some of the particular issues that arise with in vitro fertilization involve how to be sure, in a legal sense, who the parents are. (This is presumably also one of the reasons behind the restriction of sex to marriage in so many cultures, when sex was the only reproductive option.)
The problem of how to integrate new technological and commercial possibilities with ancient customs, rules, and practices is very clear when those are religious in nature. But similar problems also present themselves in secular society, in dealing e.g. with issues like surrogacy, or compensation for sperm and egg donors in ways that navigate around repugnance.
In only slightly related news (but still on the subject of being fruitful, and making sure your children have the right parents), the cost of arranged marriages is going up among Israel's most orthodox Jews: Haredi matchmaking rates skyrocketing
Some of the particular issues that arise with in vitro fertilization involve how to be sure, in a legal sense, who the parents are. (This is presumably also one of the reasons behind the restriction of sex to marriage in so many cultures, when sex was the only reproductive option.)
The problem of how to integrate new technological and commercial possibilities with ancient customs, rules, and practices is very clear when those are religious in nature. But similar problems also present themselves in secular society, in dealing e.g. with issues like surrogacy, or compensation for sperm and egg donors in ways that navigate around repugnance.
In only slightly related news (but still on the subject of being fruitful, and making sure your children have the right parents), the cost of arranged marriages is going up among Israel's most orthodox Jews: Haredi matchmaking rates skyrocketing
Wednesday, March 10, 2010
Baby Markets
I've just ordered this new book (only in part to find out why the ratio of female to male authors is drawn from such a different distribution than most discussions of market design and repugnance...):
Baby Markets
Money and the New Politics of Creating Families
Edited by Michele Bratcher Goodwin
University of Minnesota
Published February 2010
View Table of Contents as PDF (94KB) Baby Markets
Cambridge University Press
9780521513739
Contents
PART ONE. WHAT MAKES A MARKET? EFFICIENCY, ACCOUNTABILITY, AND RELIABILITY OR GETTING THE BABIES WE WANT
1 Baby Markets
Michele Bratcher Goodwin
2 The Upside of Baby Markets
Martha Ertman
3 Price and Pretense in the Baby Market
Kimberly D. Krawiec
4 Bringing Feminist Fundamentalism to U.S. Baby Markets
Mary Anne Case
5 Producing Kinship through the Marketplaces of Transnational Adoption
Sara Dorow
PART TWO. SPACE AND PLACE: REPRODUCING AND REFRAMING SOCIAL NORMS OF RACE, CLASS, GENDER, AND OTHERNESS
6 Adoption Laws and Practices: Serving Whose Interests?
Ruth-Arlene W. Howe
7 International Adoption: The Human Rights Issues
Elizabeth Bartholet
8 Heterosexuality as a Prenatal Social Problem: Why Parents and Courts Have a Taste for Heterosexuality
José Gabilondo
9 Transracial Adoption of Black Children: An Economic Analysis
Mary Eschelbach Hansen and Daniel Pollack
PART THREE.SPECTRUMS AND DISCOURSES: RIGHTS, REGULATIONS, AND CHOICE
10 Reproducing Dreams
Naomi Cahn
11 Why Do Parents Have Rights?: The Problem of Kinship in Liberal Thought
Maggie Gallagher
12 Free Markets, Free Choice?: A Market Approach to Reproductive Rights
Debora L. Spar
13 Commerce and Regulation in the Assisted Reproduction Industry
John A. Robertson
14 Ethics within Markets or a Market for Ethics?: Can Disclosure of Sperm Donor Identity Be Effectively Mandated?
June Carbone and Paige Gottheim
PART FOUR.THE ETHICS OF BABY AND EMBRYO MARKETS
15 Egg Donation for Research and Reproduction: The Compensation Conundrum
Nanette R. Elster
16 Eggs, Nests, and Stem Cells
Lisa C. Ikemoto
17 Where Stem Cell Research Meets Abortion Politics: Limits on Buying and Selling Human Oocytes
Michelle Oberman, Leslie Wolf, and Patti Zettler
PART FIVE.TENUOUS GROUNDS AND BABY TABOOS
18 Risky Exchanges
Viviana A. Zelizer
19 Giving In to Baby Markets
Sonia Suter
Concluding Thoughts
Michele Bratcher Goodwin
HT: Kim Krawiec
Baby Markets
Money and the New Politics of Creating Families
Edited by Michele Bratcher Goodwin
University of Minnesota
Published February 2010
View Table of Contents as PDF (94KB) Baby Markets
Cambridge University Press
9780521513739
Contents
PART ONE. WHAT MAKES A MARKET? EFFICIENCY, ACCOUNTABILITY, AND RELIABILITY OR GETTING THE BABIES WE WANT
1 Baby Markets
Michele Bratcher Goodwin
2 The Upside of Baby Markets
Martha Ertman
3 Price and Pretense in the Baby Market
Kimberly D. Krawiec
4 Bringing Feminist Fundamentalism to U.S. Baby Markets
Mary Anne Case
5 Producing Kinship through the Marketplaces of Transnational Adoption
Sara Dorow
PART TWO. SPACE AND PLACE: REPRODUCING AND REFRAMING SOCIAL NORMS OF RACE, CLASS, GENDER, AND OTHERNESS
6 Adoption Laws and Practices: Serving Whose Interests?
Ruth-Arlene W. Howe
7 International Adoption: The Human Rights Issues
Elizabeth Bartholet
8 Heterosexuality as a Prenatal Social Problem: Why Parents and Courts Have a Taste for Heterosexuality
José Gabilondo
9 Transracial Adoption of Black Children: An Economic Analysis
Mary Eschelbach Hansen and Daniel Pollack
PART THREE.SPECTRUMS AND DISCOURSES: RIGHTS, REGULATIONS, AND CHOICE
10 Reproducing Dreams
Naomi Cahn
11 Why Do Parents Have Rights?: The Problem of Kinship in Liberal Thought
Maggie Gallagher
12 Free Markets, Free Choice?: A Market Approach to Reproductive Rights
Debora L. Spar
13 Commerce and Regulation in the Assisted Reproduction Industry
John A. Robertson
14 Ethics within Markets or a Market for Ethics?: Can Disclosure of Sperm Donor Identity Be Effectively Mandated?
June Carbone and Paige Gottheim
PART FOUR.THE ETHICS OF BABY AND EMBRYO MARKETS
15 Egg Donation for Research and Reproduction: The Compensation Conundrum
Nanette R. Elster
16 Eggs, Nests, and Stem Cells
Lisa C. Ikemoto
17 Where Stem Cell Research Meets Abortion Politics: Limits on Buying and Selling Human Oocytes
Michelle Oberman, Leslie Wolf, and Patti Zettler
PART FIVE.TENUOUS GROUNDS AND BABY TABOOS
18 Risky Exchanges
Viviana A. Zelizer
19 Giving In to Baby Markets
Sonia Suter
Concluding Thoughts
Michele Bratcher Goodwin
HT: Kim Krawiec
Thursday, February 20, 2014
Commercial surrogacy: legal in California, illegal in NY
I woke up in England this morning preparing to give the second of two Marshall Lectures, in which I'll talk about kidney exchange, and repugnant transactions. What better to see in the NY Times then the story about a same sex married couple in NY that had a child via gestational surrogacy in California, because it's illegal in NY. But one of the husbands is a NY State Senator who is introducing legislation in the hope of changing that.
And Surrogacy Makes 3: In New York, a Push for Compensated Surrogacy
By ANEMONA HARTOCOLLIS FEB. 19, 2014
"They had their baby in California because if they had had her in New York, they would have been breaking a 1992 New York law that bars commercial surrogacy contracts and equates them with baby-selling — a legacy of the notorious Baby M case of the 1980s.*
"Now Mr. Hoylman, as a novice state senator, is in a position to do something about it. He is the co-sponsor of a proposed law that would overturn the current law and make compensated surrogacy legal in New York State.
"Surrogate baby-making has long been a path taken by the affluent and celebrities, partly because it takes good legal advice and money to accomplish. But in recent years, it has been growing among gay men, who in a fundamentally conservative embrace of family values, see having children and building a family as the logical next step after getting married.
“Not to be cliché, but you know how the phrase goes — first comes love, then comes marriage, then comes the baby and the baby carriage,” said Allison Steinberg, a spokeswoman for the Empire State Pride Agenda, which has endorsed the bill.
The bill’s supporters argue that it makes no sense for New York, which has a large number of fertility clinics, not to mention a flourishing gay community, not to be able to offer commercial surrogacy to those who want it. And they say that making surrogacy more widely available could reduce the exorbitant costs, easily as much as $100,000 per baby."
...
*"The Baby M case, in which Mary Beth Whitehead, left with her husband, Richard, refused to give up custody of a baby girl she agreed to bear for a New Jersey couple, led to a New York law prohibiting paid surrogacy."
...
"Surrogate births are a small but growing part of the in vitro fertilization industry. Conservatively, about 1,600 babies a year in the United States are born through gestational surrogacy (which now accounts for almost all surrogacies), more than double the number in 2004, according to the American Society for Reproductive Medicine.
...
"But driven by the law of supply and demand, a first-time egg donor could be paid $8,000 to $10,000, and a first-time surrogate $30,000 and up, bringing the cost of a no-frills contract to $75,000 to $120,000 with medical, legal and agency fees.
“You basically have to take out a loan to have a child,” Mr. Hoylman said.
"Agencies prefer to contract with surrogates who are married with children, because they have a proven ability to have a healthy baby and are less likely to have second thoughts about giving up the child.
"Conversely, gay couples are popular among surrogates. “Most of my surrogates want same-sex couples,” said Darlene Pinkerton, the owner of A Perfect Match, the agency in San Diego that Mr. Hoylman used. Women unable to become pregnant often go through feelings of jealousy and loss, she said. But with gay men, that is not part of the dynamic, so “the experience is really positive for the surrogate.”
"Or as her husband, Tom, a third-party reproductive lawyer, put it, “Imagine instead of just having one husband doting on you, you have three guys now sending you flowers.”
"New York has one of the harshest surrogacy laws in the country, along with Arizona, Indiana, Michigan, Nebraska and the District of Columbia.
...
"It is legal in New York for a volunteer to carry a baby without pay, known as altruistic or compassionate surrogacy. And New Yorkers find ways around the law by shipping frozen embryos to clinics in nearby surrogacy-friendly states — Connecticut, Maryland, Pennsylvania, Massachusetts — for implantation. In New Jersey, paid surrogacy is still considered risky because of case law going back to Baby M. In 2012, Gov. Chris Christie vetoed a law that would have permitted some types of payment, saying he wanted more discussion of such “profound change in the traditional beginnings of a family.”
"Historically, the legal aversion to surrogacy stems from a sort of Margaret Atwood, “Handmaid’s Tale” fear that it lends itself to unnatural social engineering and the subjugation of women. This led to an unusual alliance of feminists, civil libertarians and the Catholic church in the early 1990s, when the New York Catholic Conference joined with the New York Civil Liberties Union and the National Organization for Women to oppose surrogacy.
"The Baby M case led to a pioneering court ruling on the validity of a surrogate-mother contract, and its outcome had a strong impact on New York because it played out across the river in New Jersey. Mary Beth Whitehead was a young homemaker with two children, in a rocky marriage to a sanitation worker, when she agreed in 1985 to have another man’s baby for $10,000.
"Soon after giving birth, she took the baby to Florida and renounced her fee, saying she wanted to keep the child.
"On appeal, the New Jersey Supreme Court restored her parental rights while leaving custody of Baby M with her biological father and his wife. “This is the sale of a child, or at the very least, the sale of a mother’s right to her child, the only mitigating factor being that one of the purchasers is the father,” the high court said.
"“So much has changed since Baby M,” said Sonia Ossorio, president of the New York City chapter of the National Organization for Women.
For one thing, Ms. Whitehead was artificially inseminated using her own egg and the prospective father’s sperm, a process now disdained as “traditional” surrogacy. Today, the pregnancy would involve a third-party egg, so the surrogate would not be genetically related to the baby.
The new technology has given rise to a whole new language — gestational carrier, instead of surrogate mother, “intended parents,” “collaborative reproduction.”
And Surrogacy Makes 3: In New York, a Push for Compensated Surrogacy
By ANEMONA HARTOCOLLIS FEB. 19, 2014
"They had their baby in California because if they had had her in New York, they would have been breaking a 1992 New York law that bars commercial surrogacy contracts and equates them with baby-selling — a legacy of the notorious Baby M case of the 1980s.*
"Now Mr. Hoylman, as a novice state senator, is in a position to do something about it. He is the co-sponsor of a proposed law that would overturn the current law and make compensated surrogacy legal in New York State.
"Surrogate baby-making has long been a path taken by the affluent and celebrities, partly because it takes good legal advice and money to accomplish. But in recent years, it has been growing among gay men, who in a fundamentally conservative embrace of family values, see having children and building a family as the logical next step after getting married.
“Not to be cliché, but you know how the phrase goes — first comes love, then comes marriage, then comes the baby and the baby carriage,” said Allison Steinberg, a spokeswoman for the Empire State Pride Agenda, which has endorsed the bill.
The bill’s supporters argue that it makes no sense for New York, which has a large number of fertility clinics, not to mention a flourishing gay community, not to be able to offer commercial surrogacy to those who want it. And they say that making surrogacy more widely available could reduce the exorbitant costs, easily as much as $100,000 per baby."
...
*"The Baby M case, in which Mary Beth Whitehead, left with her husband, Richard, refused to give up custody of a baby girl she agreed to bear for a New Jersey couple, led to a New York law prohibiting paid surrogacy."
...
"Surrogate births are a small but growing part of the in vitro fertilization industry. Conservatively, about 1,600 babies a year in the United States are born through gestational surrogacy (which now accounts for almost all surrogacies), more than double the number in 2004, according to the American Society for Reproductive Medicine.
...
"But driven by the law of supply and demand, a first-time egg donor could be paid $8,000 to $10,000, and a first-time surrogate $30,000 and up, bringing the cost of a no-frills contract to $75,000 to $120,000 with medical, legal and agency fees.
“You basically have to take out a loan to have a child,” Mr. Hoylman said.
"Agencies prefer to contract with surrogates who are married with children, because they have a proven ability to have a healthy baby and are less likely to have second thoughts about giving up the child.
"Conversely, gay couples are popular among surrogates. “Most of my surrogates want same-sex couples,” said Darlene Pinkerton, the owner of A Perfect Match, the agency in San Diego that Mr. Hoylman used. Women unable to become pregnant often go through feelings of jealousy and loss, she said. But with gay men, that is not part of the dynamic, so “the experience is really positive for the surrogate.”
"Or as her husband, Tom, a third-party reproductive lawyer, put it, “Imagine instead of just having one husband doting on you, you have three guys now sending you flowers.”
"New York has one of the harshest surrogacy laws in the country, along with Arizona, Indiana, Michigan, Nebraska and the District of Columbia.
...
"It is legal in New York for a volunteer to carry a baby without pay, known as altruistic or compassionate surrogacy. And New Yorkers find ways around the law by shipping frozen embryos to clinics in nearby surrogacy-friendly states — Connecticut, Maryland, Pennsylvania, Massachusetts — for implantation. In New Jersey, paid surrogacy is still considered risky because of case law going back to Baby M. In 2012, Gov. Chris Christie vetoed a law that would have permitted some types of payment, saying he wanted more discussion of such “profound change in the traditional beginnings of a family.”
"Historically, the legal aversion to surrogacy stems from a sort of Margaret Atwood, “Handmaid’s Tale” fear that it lends itself to unnatural social engineering and the subjugation of women. This led to an unusual alliance of feminists, civil libertarians and the Catholic church in the early 1990s, when the New York Catholic Conference joined with the New York Civil Liberties Union and the National Organization for Women to oppose surrogacy.
"The Baby M case led to a pioneering court ruling on the validity of a surrogate-mother contract, and its outcome had a strong impact on New York because it played out across the river in New Jersey. Mary Beth Whitehead was a young homemaker with two children, in a rocky marriage to a sanitation worker, when she agreed in 1985 to have another man’s baby for $10,000.
"Soon after giving birth, she took the baby to Florida and renounced her fee, saying she wanted to keep the child.
"On appeal, the New Jersey Supreme Court restored her parental rights while leaving custody of Baby M with her biological father and his wife. “This is the sale of a child, or at the very least, the sale of a mother’s right to her child, the only mitigating factor being that one of the purchasers is the father,” the high court said.
"“So much has changed since Baby M,” said Sonia Ossorio, president of the New York City chapter of the National Organization for Women.
For one thing, Ms. Whitehead was artificially inseminated using her own egg and the prospective father’s sperm, a process now disdained as “traditional” surrogacy. Today, the pregnancy would involve a third-party egg, so the surrogate would not be genetically related to the baby.
The new technology has given rise to a whole new language — gestational carrier, instead of surrogate mother, “intended parents,” “collaborative reproduction.”
Friday, September 19, 2014
Diverse approaches to surrogacy in the U.S.
The NY Times has an interesting survey about the divided state of the union regarding surrogacy, with different approaches among states in the U.S.: Surrogates and Couples Face a Maze of Laws, State by State
"While surrogacy is far more accepted in the United States than in most countries, and increasing rapidly (more than 2,000 babies will be born through it here this year), it remains, like abortion, a polarizing and charged issue. There is nothing resembling a national consensus on how to handle it and no federal law, leaving the states free to do as they wish.
"Seventeen states have laws permitting surrogacy, but they vary greatly in both breadth and restrictions. In 21 states, there is neither a law nor a published case regarding surrogacy, according to Diane Hinson, a Washington, D.C., lawyer who specializes in assisted reproduction. In five states, surrogacy contracts are void and unenforceable, and in Washington, D.C., where new legislation has been proposed, surrogacy carries criminal penalties. Seven states have at least one court opinion upholding some form of surrogacy.
"California has the most permissive law, allowing anyone to hire a woman to carry a baby and the birth certificate to carry the names of the intended parents. As a result, California has a booming surrogacy industry, attracting clients from around the world.
...
"Many states are now considering certain limits and trying to find middle ground.
“My sense of the big picture is that we’re moving toward laws like the one in Illinois, which accepts that the demand for surrogacy isn’t going away but recognizes the hazards and adds regulations and protections,” said Joanna L. Grossman, a family law professor at the Hofstra University law school.
"The Illinois law requires medical and psychological screenings for all parties before a contract is signed and stipulates that surrogates be at least 21, have given birth at least once before and be represented by an independent lawyer, paid for by the intended parents.
"The law allows only gestational surrogacy, in which an embryo is placed in the surrogate’s uterus, not the traditional kind, in which the surrogate provides the egg. In addition, it requires that the embryo created in a petri dish must have either an egg or a sperm from one of the intended parents.
“That eliminates some of the concerns about designer babies,” Professor Grossman said.
Lawmakers in New York, Washington, D.C., and elsewhere are considering measures to allow surrogacy.
"But not all states are moving in that direction. In Kansas, for example, there was a hearing in January on proposed legislation that would have imposed a $10,000 fine, or a year in prison, on those entering into a surrogacy contract. The proposal was shelved after a hearing that was packed with supporters of surrogacy, including women who had been surrogates and parents who brought their children through surrogacy, arguing passionately for the benefits.
...
"The Louisiana bill, like some others, would only have allowed “altruistic” surrogacy, in which the surrogate, usually carrying a baby for a friend or relative, receives no compensation beyond the reimbursement of expenses."
"While surrogacy is far more accepted in the United States than in most countries, and increasing rapidly (more than 2,000 babies will be born through it here this year), it remains, like abortion, a polarizing and charged issue. There is nothing resembling a national consensus on how to handle it and no federal law, leaving the states free to do as they wish.
"Seventeen states have laws permitting surrogacy, but they vary greatly in both breadth and restrictions. In 21 states, there is neither a law nor a published case regarding surrogacy, according to Diane Hinson, a Washington, D.C., lawyer who specializes in assisted reproduction. In five states, surrogacy contracts are void and unenforceable, and in Washington, D.C., where new legislation has been proposed, surrogacy carries criminal penalties. Seven states have at least one court opinion upholding some form of surrogacy.
"California has the most permissive law, allowing anyone to hire a woman to carry a baby and the birth certificate to carry the names of the intended parents. As a result, California has a booming surrogacy industry, attracting clients from around the world.
...
"Many states are now considering certain limits and trying to find middle ground.
“My sense of the big picture is that we’re moving toward laws like the one in Illinois, which accepts that the demand for surrogacy isn’t going away but recognizes the hazards and adds regulations and protections,” said Joanna L. Grossman, a family law professor at the Hofstra University law school.
"The Illinois law requires medical and psychological screenings for all parties before a contract is signed and stipulates that surrogates be at least 21, have given birth at least once before and be represented by an independent lawyer, paid for by the intended parents.
"The law allows only gestational surrogacy, in which an embryo is placed in the surrogate’s uterus, not the traditional kind, in which the surrogate provides the egg. In addition, it requires that the embryo created in a petri dish must have either an egg or a sperm from one of the intended parents.
“That eliminates some of the concerns about designer babies,” Professor Grossman said.
Lawmakers in New York, Washington, D.C., and elsewhere are considering measures to allow surrogacy.
"But not all states are moving in that direction. In Kansas, for example, there was a hearing in January on proposed legislation that would have imposed a $10,000 fine, or a year in prison, on those entering into a surrogacy contract. The proposal was shelved after a hearing that was packed with supporters of surrogacy, including women who had been surrogates and parents who brought their children through surrogacy, arguing passionately for the benefits.
...
"The Louisiana bill, like some others, would only have allowed “altruistic” surrogacy, in which the surrogate, usually carrying a baby for a friend or relative, receives no compensation beyond the reimbursement of expenses."
Friday, April 7, 2023
Surrogacy in Spain is hard to suppress
In a widely reported story, a Spanish celebrity has become the surrogate mother of her grandchild, with the help of sperm from her deceased son, and an American surrogate. This has raised controversy in Spain, where surrogacy is illegal.
Here's the Guardian on the story:
Spanish TV star says surrogate baby is actually her grandchild. Ana Obregón, 68, says her son, Aless Lequio García, expressed desire to have a child before death in 2020
"A heated debate in Spain triggered by a 68-year-old celebrity who was reported to have used a surrogate mother in Miami to have a baby took a twist on Wednesday when the woman announced in the socialite magazine ¡Hola! that the baby was actually the daughter of her son who died of cancer in 2020.
...
"Surrogate pregnancies are banned in Spain, although children from such pregnancies in other countries can be registered.
...
"Initial reports about the baby grabbed the attention of the Spanish media and the country’s political parties, sparking criticism from the leftist coalition government. Many leading politicians and outlets of Spanish media refer to surrogacy as “womb renting”.
"The equality minister, Irene Montero of the leftist United We Can coalition partner, said surrogate pregnancies were “a form of violence against women”. The coalition’s Socialist party said legislation should be tweaked to prevent Spaniards using surrogates in other countries.
...
"The main opposition conservative People’s party has said it is open to debating legalising such pregnancies if there is no payment involved."
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Recent related post:
Wednesday, April 5, 2023
Tuesday, August 9, 2011
Repugnant transactions involving life and death
A lot of repugnance is associated with transactions that involve the boundaries between the living and the dead--abortion, deceased organ donation (is brain death sufficient), assisted suicide...
In The New Republic, Eric Posner reviews The Law of Life and Death by Elizabeth Price Foley (Harvard University Press).
As he writes,
"The distinctions matter. Killing a human being is murder; discarding unwanted cell tissue is not.
"Familiar culture-war controversies have erupted over these issues. The law embodies uneasy truces and compromises, and, as is always the case, contains ambiguities and inconsistencies; and state laws vary a great deal. But a rough logic has emerged. The gestational blob gains stronger legal protections as it ascends the ladder of development. Sperm, eggs, and embryos lack rights; their owners enjoy the power to control how they are used. Fetuses do better. A woman may not abort the fetus late in pregnancy without good reason, such as risk to life or health, and a stranger commits a crime by assaulting and killing a fetus because the fetus has stronger rights than the stranger does. But the assaulter is not guilty of murder unless the fetus, in an odd turn of the law, manages to get born before it expires from its injuries. A partially born child enjoys stronger rights still.
"Death poses another set of challenges. In the old days, death meant that a person stopped breathing and his heart failed; now this is known as cardiopulmonary death. But when new technology made it possible to animate the heart and lungs in a person incapable of “waking up,” brain death was invented. Brain death enabled surgeons to carve off organs from people deemed alive under the cardiopulmonary definition, but it threw up a new set of problems. Some apparently brain-dead people would regain consciousness; technological advances later revealed that the brains of apparently brain-dead people often threw off occasional sparks—raising the question, how much brain functioning do you need to be alive? Or, if you wish, how much brain functioning does a person need for it to be wrong to kill him? Cryogenics enthusiasts insist that technicians will be able to reanimate a cryogenically preserved corpse by defrosting it. If someone destroys such a corpse, is that murder? If not, is it a wrong at all? The destruction of the corpse of a person disappoints that person’s original plan to reoccupy his body after a temporary vacancy, but prosecution of the wrongdoer would pose problems of metaphysics for which legal training leaves one sadly unprepared.
"Then there is the question of suicide, the refusal of unwanted life-preserving medical treatment, physician-assisted suicide, and euthanasia. Some countries permit euthanasia—the killing of people with severe medical problems, including infants born with horrendous birth defects which condemn them to a short miserable life. In the United States, all states tolerate suicide; two states tolerate physician-assisted suicide; and no states permit euthanasia. The Supreme Court has recognized rights to abortion, contraception, and (obliquely) unwanted life-sustaining medical treatment, but not to assisted suicide. For reasons known only to the justices, a woman’s interest in abortion trumps contrary state law but a person’s interest in ending his life does not, unless he can do so by declining medical treatment. Interests pile up on both sides of each question; it is hard to understand why the Court balances them as it does."
In The New Republic, Eric Posner reviews The Law of Life and Death by Elizabeth Price Foley (Harvard University Press).
As he writes,
"The distinctions matter. Killing a human being is murder; discarding unwanted cell tissue is not.
"Familiar culture-war controversies have erupted over these issues. The law embodies uneasy truces and compromises, and, as is always the case, contains ambiguities and inconsistencies; and state laws vary a great deal. But a rough logic has emerged. The gestational blob gains stronger legal protections as it ascends the ladder of development. Sperm, eggs, and embryos lack rights; their owners enjoy the power to control how they are used. Fetuses do better. A woman may not abort the fetus late in pregnancy without good reason, such as risk to life or health, and a stranger commits a crime by assaulting and killing a fetus because the fetus has stronger rights than the stranger does. But the assaulter is not guilty of murder unless the fetus, in an odd turn of the law, manages to get born before it expires from its injuries. A partially born child enjoys stronger rights still.
"Death poses another set of challenges. In the old days, death meant that a person stopped breathing and his heart failed; now this is known as cardiopulmonary death. But when new technology made it possible to animate the heart and lungs in a person incapable of “waking up,” brain death was invented. Brain death enabled surgeons to carve off organs from people deemed alive under the cardiopulmonary definition, but it threw up a new set of problems. Some apparently brain-dead people would regain consciousness; technological advances later revealed that the brains of apparently brain-dead people often threw off occasional sparks—raising the question, how much brain functioning do you need to be alive? Or, if you wish, how much brain functioning does a person need for it to be wrong to kill him? Cryogenics enthusiasts insist that technicians will be able to reanimate a cryogenically preserved corpse by defrosting it. If someone destroys such a corpse, is that murder? If not, is it a wrong at all? The destruction of the corpse of a person disappoints that person’s original plan to reoccupy his body after a temporary vacancy, but prosecution of the wrongdoer would pose problems of metaphysics for which legal training leaves one sadly unprepared.
"Then there is the question of suicide, the refusal of unwanted life-preserving medical treatment, physician-assisted suicide, and euthanasia. Some countries permit euthanasia—the killing of people with severe medical problems, including infants born with horrendous birth defects which condemn them to a short miserable life. In the United States, all states tolerate suicide; two states tolerate physician-assisted suicide; and no states permit euthanasia. The Supreme Court has recognized rights to abortion, contraception, and (obliquely) unwanted life-sustaining medical treatment, but not to assisted suicide. For reasons known only to the justices, a woman’s interest in abortion trumps contrary state law but a person’s interest in ending his life does not, unless he can do so by declining medical treatment. Interests pile up on both sides of each question; it is hard to understand why the Court balances them as it does."
Wednesday, April 5, 2023
Surrogacy under siege in Italy
Opposition to surrogacy in Italy has taken aim at the babies of same sex couples.
The NYT has the story:
Surrogacy Emerges as the Wedge Issue for Italy’s Hard Right. Prime Minister Giorgia Meloni has ordered municipalities to stop certifying foreign birth certificates for same-sex couples who used surrogacy, leaving some babies in a legal limbo. By Jason Horowitz
"the government of Prime Minister Giorgia Meloni ordered municipalities to obey a court ruling made in December and stop certifying foreign birth certificates of children born to Italian same-sex couples through surrogacy, which is illegal in Italy.
"The decision has left Martino Libero and several other children suspended in a legal limbo, depriving them of automatic Italian citizenship and residency rights like access to the country’s free health care system and nursery school.
...
"Milan, a city that has long served as a cosmopolitan haven for same-sex couples in Italy, has for now complied with the Meloni government order and suspended issuing Italian birth certificates.
"Without official recognition, Libero Martino, 2 months old this month, will have to leave and re-enter the country every few months to remain legal. A court could eventually recognize one of the men as the biological father — they decline to say which one is the sperm donor — and then they could start a separate adoption process for the other.
...
"Ms. Meloni’s government has sought to shift the issue away from the status of the children to the practice of surrogacy, which, while legal in the United States and Canada, is illegal or restricted in much of Europe outside of Greece, Ukraine and a few other countries. In Italy, home of the Vatican, it is not only illegal, but it is also widely opposed, including among Catholic corners of the center-left opposition.
...
"Prominent members of Ms. Meloni’s Brothers of Italy party have called surrogacy a crime “even worse than pedophilia,” in which gay couples, one of whom is usually the biological father, seek to “pass off” children as their own and mistake “children for Smurfs,” saying gay couples can uniquely afford surrogacy, even though it is overwhelmingly used more by heterosexual couples.
"The party is floating a proposal, made by Ms. Meloni when she was a member of Parliament, to make Italians’ seeking of surrogate births abroad — what she had called “procreative tourism” — illegal and “punishable with three months to two years of prison and a fine of 600,000 to a million euros.”
...
"In an interview shortly before her election, as her young daughter ran around her in a Sardinia courtyard, Ms. Meloni said she opposed gay marriage, not because she was homophobic — “I’ve got many, many homosexual friends” — but because she saw it as a step to same-sex adoption, which she opposed, and which the Roman Catholic Church successfully lobbied to exclude from a civil unions law passed in 2016.
********
Earlier:
Monday, February 20, 2023
Friday, January 5, 2024
Coalition to Modify NOTA (the National Organ Transplant Act of 1984)
Elaine Perlman forwards the following discussion points:
Coalition
to Modify NOTA Talking Points
modifyNOTA.org
What is the Coalition to Modify NOTA proposing? The Coalition to Modify NOTA proposes providing a $50,000 refundable tax credit to remove all disincentives for American non-directed kidney donors who donate their kidney to a stranger at the top of the kidney waitlist in order to greatly increase the supply of living kidney transplants, the gold standard for patients with kidney failure.
What is the value of a new kidney? The value of a new kidney, in terms of quality of life and future earnings potential, is between $1.1 million and $1.5 million.
What is the American kidney
crisis? Fourteen Americans
on the waiting list for a kidney transplant die each day. That number does not
include the many kidney failure patients who are not placed on the waiting list
but would have benefited from a kidney transplant if we had no shortage. The total
number of Americans with kidney failure will likely exceed one million by 2030.
Why not rely on deceased donor kidneys to end the shortage? A living kidney transplant lasts on average twice as long as a deceased donor kidney. Fewer than 1 in 100 Americans die in a way that their kidneys can be procured. Currently, the 60% of Americans who are registered as deceased donors provide kidneys for 18,000 Americans annually. Even if 100% of Americans agreed to become organ donors, this would raise donations by only about 12,000 per year. In the USA, 93,000 Americans are on the kidney waitlist. A total of 25,000 people are transplanted annually, two-thirds from deceased donors and one-third from living donors. The size of the waitlist has nearly doubled in the past 20 years, while the number of living donors has not increased.
What is the extra value that non-directed kidney donors provide? Non-directed kidney donors often launch kidney chains that can result in a multitude of Americans receiving kidneys. Fewer than 5% of all living kidney donations are from non-directed kidney donors who are an excellent source of organs for transplantation because they are healthier than the general population.
How much
does the taxpayer currently spend on dialysis? Kidney
transplantation not only saves lives; it also saves money for the taxpayer. The
United States government spends nearly $50 billion
dollars per year (1% of all $5 trillion collected in annual taxes) to pay
for 550,000 Americans
to have dialysis, a cost of approximately $100,000 per year per patient, a
treatment that is far more expensive than transplantation.
How many
more lives will be saved with the refundable tax credit for non-directed
donors? The number of non-directed donors increased from 18 in 2000 to
around 300 each year. After our Act becomes law, we estimate that we will add
approximately 7,000 non-directed donor kidneys annually. That is around 70,000
new transplanted Americans by year ten.
How much
tax money will be saved once the Act is passed? The
refundable tax credit will greatly increase the number of living donors who
generously donate their kidneys to strangers. We estimate that in year ten
after the Act is passed, the taxpayers will have saved $12 billion.
What is a
refundable tax credit? A refundable tax credit can be accessed by both
those who do and those who do not pay federal taxes.
What do
Americans think about compensating living kidney donors? Most
Americans favor compensation for living kidney donors to increase
donation rates.
Who is able to donate their
kidneys? Donation requires potential organ donors to undergo a
comprehensive physical and psychological evaluation, and each transplant center
has its own rigorous criteria. Only around 5% of those who pursue evaluation
actually end up donating, and only about one-third of Americans are healthy
enough to be donors. Providing financial incentives will encourage more
Americans to donate their kidneys to help those with kidney failure.
Is it moral to compensate kidney donors? Compensation for kidney donors can be viewed as a way to address the current kidney shortage and save lives. Americans are compensated for various forms of donation such as sperm, eggs, plasma, and surrogacy, all of which involve giving life.
How long do we need to compensate living kidney donors? Compensation should continue until a xenotransplant or advanced kidney replacement technology becomes available. In the meantime, it's crucial to prevent further loss of lives due to the shortage.
Primarily middle and low income
kidney failure patients are dying due to the kidney shortage. People with lower
incomes tend to have social networks with fewer healthy people because health
is related to income level. In addition, being placed on a waitlist often costs
money. Kidney donation also costs money, an estimated 10% of annual
income. The refundable tax credit will help low income donors and recipients
the most by making donation affordable and increasing the number of kidneys for
those waiting the longest on the waitlist, frequently middle and low income
Americans. The tax credit aims to help those most affected by the kidney
shortage, as poorer and middle-income individuals often bear the brunt of the
kidney crisis’s consequences. The Act will level the playing field, making it
easier for those at all income levels to receive a life-saving kidney.
Please examine this chart:
Monday, December 14, 2015
Technology watch: does Crispr create a new class of repugnant transactions?
The NY Times has the story:
Scientists Seek Moratorium on Edits to Human Genome That Could Be Inherited
"An international group of scientists meeting in Washington called on Thursday for what would, in effect, be a moratorium on making inheritable changes to the human genome.
"The group said it would be “irresponsible to proceed” until the risks could be better assessed and until there was “broad societal consensus about the appropriateness” of any proposed change. The group also held open the possibility for such work to proceed in the future by saying that as knowledge advances, the issue of making permanent changes to the human genome “should be revisited on a regular basis.”
...
“The overriding question is when, if ever, we will want to use gene editing to change human inheritance,” David Baltimore said in opening the conference this week.
...
"The meeting was prompted by a new genetic technique, invented three years ago, that enables DNA to be edited with unprecedented ease and precision. The technique, known as Crispr-Cas9 and now widely accessible, would allow physicians to alter the human germline, which includes the eggs and the sperm, to cure genetic disease or even enhance desirable physical or mental traits.
...
"“If we are going to view certain applications of human genome editing as permissible, can we draw a line and not throw out legitimate medical applications in order to stave off those that are less palatable to most of us?” Dr. Daley asked.
"Other scientists suggested that the possible risks of human genome editing would be rapidly reduced as the techniques were refined. “Many of these technologies are improving so fast it’s hard to measure,” said George Church, a professor of genetics at the Harvard Medical School. Erroneous cuts made by Crispr-Cas9 can now be reduced to less than one per three trillion base pairs of DNA; the human genome is three billion base pairs in length.
“The concept of a ban on gene editing does not make sense,” Dr. Church wrote in the current issue of the journal Nature. “Banning human germline editing could put a damper on the best medical research and instead drive the practice underground to black markets and uncontrolled medical tourism.”
Scientists Seek Moratorium on Edits to Human Genome That Could Be Inherited
"An international group of scientists meeting in Washington called on Thursday for what would, in effect, be a moratorium on making inheritable changes to the human genome.
"The group said it would be “irresponsible to proceed” until the risks could be better assessed and until there was “broad societal consensus about the appropriateness” of any proposed change. The group also held open the possibility for such work to proceed in the future by saying that as knowledge advances, the issue of making permanent changes to the human genome “should be revisited on a regular basis.”
...
“The overriding question is when, if ever, we will want to use gene editing to change human inheritance,” David Baltimore said in opening the conference this week.
...
"The meeting was prompted by a new genetic technique, invented three years ago, that enables DNA to be edited with unprecedented ease and precision. The technique, known as Crispr-Cas9 and now widely accessible, would allow physicians to alter the human germline, which includes the eggs and the sperm, to cure genetic disease or even enhance desirable physical or mental traits.
...
"“If we are going to view certain applications of human genome editing as permissible, can we draw a line and not throw out legitimate medical applications in order to stave off those that are less palatable to most of us?” Dr. Daley asked.
"Other scientists suggested that the possible risks of human genome editing would be rapidly reduced as the techniques were refined. “Many of these technologies are improving so fast it’s hard to measure,” said George Church, a professor of genetics at the Harvard Medical School. Erroneous cuts made by Crispr-Cas9 can now be reduced to less than one per three trillion base pairs of DNA; the human genome is three billion base pairs in length.
“The concept of a ban on gene editing does not make sense,” Dr. Church wrote in the current issue of the journal Nature. “Banning human germline editing could put a damper on the best medical research and instead drive the practice underground to black markets and uncontrolled medical tourism.”
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