Here’s a recent articlefrom the Timesonline (of London) about the risks of egg donation and the morality, in light of those risks, of paying egg donors. I’ve touched on this topic in other contexts several times recently so it seemed worth commenting on this article.
The article first raises a crucial factual question: How dangerous is it to be an egg donor? Clearly in the view of a number of those interviewed, the answer is “pretty dangerous.” That’s actually a surprise to me, but not because I’ve actually seen statistical studies to the contrary. I’ve just never seen this contention seriously advanced before. Perhaps that is unsurprising, given the market conditions here in the US. (I’ll return to this point in a moment.) Anyway, if anyone has links to other sources on the risk involved, I’d be interested to see them.
A bit of background on UK law is useful in understanding the article. Paying egg donors more than a nominal sum is unlawful in the UK. By contrast, it is a generally accepted practice here. The same rule applies to sperm donors. This has lead to a shortage of both eggs and sperm. It’s in this context that the proposal t pay egg donors arises.
At the outset, it seems to me clear that we ought to treat egg donors and sperm donors differently. The process of extracting eggs is vastly different from the process of obtaining (not extracting) sperm. Even if one does not want to create a commerical market for sperm and eggs, it seems wildly formalistic to treat male and female donors alike. Even were there no risk at all, an egg donor should still recieve greater compensation than a sperm donor because of the massively greater infringment on her bodily integrity.
(Let me note as an aside that there is one standpoint from which you can argue for treating egg and sperm donors the same–you could generally prohibit all gamete donation or prohibit any compensation of any sort in exchange for a donation. It’s possible to assert that these materials should not be transferable at all, in which case you’d treat men and women the same or to assert than any form of compensation for the materials–even payment of expenses– is improper.)
Aside from that, it would seem that if there is a substantial risk to egg donation, that any compensation has to be enough to offset that risk. That might mean massively raising the price of eggs. And this might be why the risk is downplayed in the US–a steady supply of egg donors at a relatively affordable price is necessary to the continuation of commercial ART. If the price of eggs were to rise dramatically because of a perception that donation was risky or if fewer women were to donate eggs, the ART industry would contract.
The bottom line is that people are making substantial money off of ART in the US and have an interest in continuing to do so. While this may have various benefits (increased access to ART, no shortages of sperm and eggs, and so on) there are also clearly risks. The UK exemplifies one alternative, though even there a for-profit ART industry creates its own dilemmas.
If ART is health care, then perhaps this ought to be seen simply as part of the larger debate on the role of profit-making entities in shaping health care practice and policy.