There is a long story in today’s NYT which, while somewhat off-topic, illustrates the problematic role of money in a lot of the ART stuff I discuss here. It’s about the commodification of breast milk. While the story bears reading, the critical point to understand is that there is an emerging industry–and I do mean industry–built around processing breast milk. One person calls it “white plasma”–which for me seems to echo the designation of oil as “black gold.”
There are doubtless many reasons why the industrialization of breast milk is disturbing even as its potential to save or enhance the lives of premature infants is clearly beneficial. I just want to focus on one thing, though, and it has to do with money.
Human breast milk can only be obtained from one source–women. The question raised in the article–and the one I want to think about here– is whether women should be paid to produce breast milk. It’s easy for me to see the two sides.
On the one hand, there are all sorts of risks of paying women. There’s concern about that odd form of coercion that comes, I think, from people who think about paying human subjects for participation in experiments. (I’ve talked about this before. I see the concern, though it seems odd to me because the coercive effects of offering money depend entirely on how much the particular women need money.) There’s the vision of women being farmed like cows–horrible to even imagine for a moment. There’s the specter of women denying their own children milk to have more to sell, or adulterating it, or damaging their own bodies to produce more. All real concern.
But on the other hand, if everyone else in the process makes money, how can it be that the women who are uniquely able to do this thing are not allowed to make money? Hasn’t altruism–women should just do things for the good of the world without nasty concerns about payment–been used to keep women’s work from being valued for long enough? Generations of women took care of families without being paid–and look how well that has served women. I am deeply suspicious when it looks like everyone else in the process is going to be making money off of women’s work and that the women alone will not be paid.
But how is one to resolve this? The root of the problem, perhaps, is that the commodification of the breast milk is in and of itself disturbing to me. Maybe breast milk shouldn’t be bought/sold for money. And yet is there any hope of keeping money out of it? Obviously it costs money to store it, to transport it, to do whatever it is that needs to be done to render it useful in all these many ways. People who do that work should be paid to do that work.
Maybe the ideal would be if it is was all not-for-profit. Perhaps the trouble comes from the profit part? I confess skepticism. To put it simply, not-for-profits are big business these days. Executives in not-for-profits are paid massive salaries–whether you think about the Red Cross or your major universities. Maybe it is measure of our deep attachment to money, but nothing seems to remain free of its taint–not even not-for-profits.
And so? I do not have a good answer. But this is not an unfamiliar dilemma. It’s obviously reminiscent of surrogacy. Only women can be pregnant, only women can produce breast milk. Do you pay the surrogate or the producer of breast milk?
I’ve actually written about this fairly recently–in the surrogacy context. You can read it yourself right here. (You may need to register to get the whole thing, but it is free.) For those who do not care to do so, the conclusion I reached is that framing the question as pay/don’t pay isn’t quite right. I think it should be permissible to pay women who are surrogates but I think we must carefully scrutinize the conditions under which surrogates function. Probably I would reach the same conclusion here–it’s okay to pay women for their breast-milk, but we sure better look closely at the dynamics of the industry.