Free IVF Offered as A Prize

Yesterday’s NYT has a story about fertility services being offered as prizes in variously structured contests.   I’ve written about this idea a couple of times in the past couple of years–once a couple of years ago when a UK clinic offered a IVF as a door prize and more recently when there was a Facebook contest with free IVF as the reward.

Yesterday’s story suggests that these were just early instances of what is becoming a more widespread phenomenon.    All manner of prize-oriented promotions are cropping up–video essay contests, raffles, lotteries, race sponsorships and so on.   It makes perfect sense, really.  As Douglas Quenqua, who wrote the NYT piece, notes:

The people who stage the raffles say that both sides benefit: one woman gets free treatment, and the sponsor gets publicity.

This makes it seem like a win/win.   Yet someone it seems we ought to think a little harder about this.  Is it win/win all around?  Are there losers we should be concerned about?

Here I think of unsuccessful contestants–the people who enter the contest but do not win.   The people entering these contests are vulnerable–they are presumably people who have had trouble with fertility for starters.   There’s no doubt that this is traumatic and it might make the desperate–particularly if they don’t have tons of money.  (I’m inclined to be a good deal less concerned with those who can buy all the best possible access to IVF.)   Thus, it seems to me we could worry about potential exploitation.

I think my actual level of concern will vary depending on the sort of contest being held.  Consider on the one hand a contest where you buy what amounts to a raffle ticket and on the other a contest where you submit some sort of video entry for public voting, a la the Facebook competition.   The latter is doubtless more valuable to the sponsoring clinic for publicity purposes and also poses the greater risk of exploitation of the entrants.   While no one is forced to enter, I really do worry about the pressures that lead people to enter and the consequences of an unsuccessful entry.  What happens to you when you make these intensely personal and painful videos and then not many people vote for yours?

Now perhaps there are other things to worry about here as well.  I know that for many people–me included–there’s something at best unsettling about offering fertility services as a prize.    What is that about?   For me, raffling off fertility services is not at all the same thing as raffling off a baby.  (I do quite see that if you think about it that way it is wholly unacceptable.)

Perhaps Professor Nir Eyal put her finger on it:

I think it’s a good parody of the unfair system in which important medical services are only available to those who can afford them,” said Nir Eyal, a professor at Harvard Medical School who specializes in ethics. “Nevertheless, sometimes these raffles exploit the despair of couples or their misunderstanding of statistics to extract money from them.”

Maybe I’d feel the same way about any other important medical service made available via contest.   Enter to win heart bypass surgery?   Win treatment for your ulcer?   If the service is that important then your ability to have access to it should not be conditioned on your willingness to enter a potentially exploitative contest where you’re a vehicle for free publicity for the fertility clinics.   At least, that’s what I find myself thinking right now.

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8 responses to “Free IVF Offered as A Prize

  1. Hey on your post yesterday I my comment references your old What’s Wrong With The Raffle series of posts – where one of my comments goes off the rails about the redefinition of words and lying and whatnot. I got so much freaking email from people looking for their families after I wrote that comment about stringing enough wrong words together you get a lie. As a matter of fact that particular Raffle post of yours had what felt like every donor offspring activist from Canada to Australia up in a twist. You have lots of readers.

    I still think its difficult to articulate what’s wrong with the raffle because this industry has altered the lexicon to the point where they’ve taken the words right out of our mouths. Sometimes they use the right words but get us to think they don’t mean what they say like

    “Donor conceived individual”-That would be an individual that a donor conceived. Julie, even you have said that you don’t think it means that the donor is actually conceiving anything. Then why not just call them sperm conceived? It may not feel like the donor conceives or reproduces, but honestly, the people writing the check can’t conceive or reproduce which is why they need a donor – to do it with them or for them.

    “3rd Party Reproduction” Honestly, how many parties does it take to reproduce by standard IVF or AI? You don’t need the 3rd party you just need the 2 that are going to reproduce, the 3rd is a bystander a thumb-twiddler, an odd-man-out as it were.

    “Donor Assisted Reproduction” This is my favorite, the doctor’s assist the donors in reproducing so that their customers can take and raise the resulting kids. When donors are involved the doctor is not assisting anyone infertile or sterile in coneiving or reproducing, they are assisting them in obtaining a baby that is someone else’s offspring without having to go through a court approved adoption. That is the service they offer sterile men and infertile women and healthy people who don’t have partners to reproduce with. Getting them other people’s children to raise without having to adopt them.

    So is anyone hurt by the raffle, well sure: Those who are led to believe that this process nets them a child that is theirs, all theirs no different than had they reproduced to create them with the love of their life. Those who are led to believe that this process does not form their family by separating another one. Those who are led to believe that the outrage is from a small but vocal minority who are dissatisfied with the way their parents raised them (it will always be some other way than the way they are planning to raise their donor offspring child). So those people are hurt by being led to believe that this is just another way of forming a family, and that the people they bring into the world are so wanted they won’t feel deprived at all.

    Who else is hurt? Angling different today…How about the donor’s relatives? I would not want to be the full blooded sister of an egg donor who had 18 anonymous children living in the same region as my kids, her nieces and nephews – those would be my kid’s first cousins! How dare she take away my kid’s ability to prevent themselves from inbreeding. Other Aunts can go get a copy of the birth record for every kid their sister has but not me my sister is a donor and now an entire family is at risk because she donated her eggs? No she donated a heck of a lot more than her eggs. This is why its so unsettling the raffle because its not the promise of an egg its the promise of a donor’s baby.

    Raffles for babies are off-putting for obvious reasons. I’d think that cultures who had some heavy history in being owned and sold and what not would be turned off by this but they are not. Maybe I’ve got it all wrong maybe they don’t own the donor’s offspring. Then why do they want their name on all the records, because they are raising them? That only lasts 18 years. Why can’t the donor offspring be legal kin to the donor? What’s the harm? There are oodles of benefits for the Offspring and all the donor’s relatives. Oh, but they are not paying or being paid.

    How about they get the title to the EGG and the IVF but not the resulting person, THEN they could say they were not buying people.

    • First to address the main substance of your comment and then a longer discussion of language that folks can skip if they are not interested. I think the objections you raise to the raffle/doorprize/whatever it is are objections generally to use of third party gametes. (They actually wouldn’t apply to a couple planning to do IVF with their own gametes, right?)

      I don’t mean to ignore these objections and I think we have (and will continue) to discuss them here. But in this post I meant to ask whether there was anything especially wrong with the raffle/doorprize/whatever practice in addition to whatever is you think is wrong with all ART anyway. If you’re particularly troubled by the use of someone else’s gametes, maybe you could imagine the contest was only open to couples using their own gametes–any problems with that contest? I still think there’s something exploitative about having people who need but cannot afford treatment publically compete for free treatment when the clinic benefits from the competition.

      As to language–I tend to use “donor conceived” because that is how I see other people describe themselves. I figure it’s their right to name themselves and I will use the chosen name. I imagine not everyone elects to use the name and I’m sure at some point it could change, but it does seem to me that it is a widely-used designation within the community of people it describes and so I use it.

      It actually doesn’t match up with other terms I use. I try not to use “donor” (except when I really mean it) because of the money involved in the process of providing sperm/eggs. I think for most of the people involved in providing sperm and eggs the money is important even though it may not be the entire and total motivating factor. What I mean is most people wouldn’t provide sperm/eggs were it not for the money. This makes me think that “donor” can be misleading. I tend to use “provider” if I can–as in “sperm provider,” “egg provider” and “gamete provider.”

      As for “third-party” terminology: I use that because in the classic case with a sperm provider, say, the idea is that two people are wanting to raise a child they are using a third person’s sperm to make that happen. There is no intention that the third person will act as a parent to the child and everyone is on the same page about that. So I think of the sperm provider as the third party involved. I understand that there will be many cases where in fact the sperm provider is only the second party involved (because the intended parent is a single woman). But it will only confuse things to renumber the sperm provider in those instances so I think of the third party terminology as using a term of art. (This is quite common in law–and the best analog is probably “third party beneficiary” language in contracts or “third party practice” in civ pro, where the people involved may actually be fourth parties or whatever, but we still use that term.) I don’t think anyone else uses this language–and some do use “donor assisted conception” but you can see why I don’t want to.

      • OK yeah if it were open to people using their own gametes I think it smacks of behavior un-befitting of a licensed professional. There are likely cannons of professional conduct for licensed physicians as there are for licensed architects which is my line of work. Professionals in law, medicine architecture are not selling products like babies they perform services. The raffle turns their professional services into a novelty. I bet the raffle crosses the line – they are not suppose to ambulance chase right? Its probably in the rules for advertising services.

      • I did respond to the heart of your question thank you for clarifying. Thanks for addressing the language comment – others can ignore if they want: You said you “tend to use “donor conceived” because that is how I see other people describe themselves. I figure it’s their right to name themselves and I will use the chosen name.” So the variations of that term like donor conception or donor reproduction heck even provider reproduction are not titling a group but rather describing a process where a donor conceives or reproduces. It’s true right? Any person with offspring will always be one of at least two people whose act of reproduction conceived the offspring that they now have. You seem now to agree with that where before you did not. Good I’m glad your down with logic. You seem also to agree that donors or providers are one of the two people who reproduced and that the whole third party thing is about feeling and intention rather than the reality of who is reproducing and conceiving. I’m happy to hear your just going along with the crowd and don’t really think that the donor is not reproducing or conceiving. Its bad to forget there is a consenting person behind the gamete. Don’t want to dehumanize the process for the recipients. I’ll be watching to see where the language goes around here for kicks of course.

      • I taking a fresh look at your old post “The Egg Raffle Once More” and there too you talk about it being inappropriate to offer medical services as in a raffle or rather as a door prize is how you described it.

        I think its interesting if the recipient of the prize is an infertile woman then she is not being offered a medical service as a raffle prize. Someone else will be the patient and she is the recipient of the outcome which is the donor’s embryo which she and her male co-reproducer conceived with medical assistance. It’s hard to say those people are patients I know especially if there is nothing physically wrong with them and the medical assistance does not correct, fix or adjust their bodies in any way. But their consent to a medical procedure is required and of course their consent to reproduce with one another. So in that way I suppose the donor and the man she reproduces with are the patients.

        If their own gametes are used in the ivf prize they won then they won a medical procedure. Still thinking through the implications.

        • Note that the prize is ivf and not the implantation of an embryo into the body of a host for gestation/delivery. I want to say the prize is a baby – you know I do. The gamete donor agrees to give up their offspring when born at the time they give up the egg but the raffle prize is more finite. I’d say the prize is a shot at another woman’s embryo if the medical service is not with them as the patient. Worded terribly sorry

  2. Lots of interesting comments on the original thread.

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