Money Troubles

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. 

New UK Surrogacy Ruling: Much To Consider When Things Go Wrong

Here’s a fairly recent opinion from the UK involving surrogacy.  If you’d rather not read the actual opinion, there’s a bit of press coverage, but I think the opinion itself is really worth a look.  (To give credit where credit is due, I found this case via The Spin Doctor.  I don’t entirely agree with the analysis of the case that’s posted there, but that’s a different matter.) 

I sometimes think that surrogacy is the most controversial of the ART practices.   It’s a topic that I’ve written about fairly frequently (you can find most of the posts under the tag “surrogacy“), sometimes at length.   Perhaps because it is controversial, stark differences in practices permitted/available in different countries, which means every case must be considered carefully in its own context.   

Global Surrogacy Round-Up, I

Okay, time to play serious catch-up.   I think this may take more than one entry, which is why I’ve included the “I” in the title here.  

I’ve written in the past about the globalization of surrogacy.    It’s really just a more specialized form of medical tourism. But it brings its own very special complications, largely because variations in law regarding parentage.    There have been a few stories in the news recently that really drive that point home. 

Consider this story, for instance.   The UK has its own rules regarding surrogacy.  (I’ve written about this, too, in the past.)   Surrogacy is legal but you are not allowed to pay the surrogate fees (as distinguished from expenses.)   Not surprisingly, this means there are fewer surrogates available in the UK.    Thus, it has become somewhat common for people to use a surrogate in another country–one where the surrogate can be paid.   India is a popular destination, and though far more expensive so, it seems, is the US.  

Views of Surrogacy

There have recently been a couple of interesting articles about surrogacy worthy of comment but I’ve just been too busy.   Now I’ll play catch-up.  The more prominent article was on the front page of the Sunday NYT.   I guess it’s third in a series, and I’ve commented on the earlier articles as well.   The article offers several anecdotes of people using surrogacy and, for the most part, focusses on the legal uncertainties and risks.  

A couple of weeks earlier there was an article focussed on a single clinic in Madison, Wisconsin, in the Madison Isthmus.  It offers a much more positive view of surrogacy.   

I’ve been thinking about how these two news stories fit together, and I’ve been thinking back on what I’ve written about surrogacy in the past.   (I’ll link to the entries collected under the tag and you can thread some of those together if you want to get a more detailed sense.) 

I’ve come to the conclusion that surrogacy is, in and of itself, neither necessarily good nor necessarily bad.  

Surrogacy at Its Best?

I came across this story on the web this AM.   It seems to me to illustrate surrogacy at its finest.   Because I’ve gone at length about surrogacy at a number of different times  in the past, and because I am deeply skeptical of much about surrogacy, I thought it might be worth lingering here for a few moments. 

Jamie Underwood Collins is 8 1/2 months pregnant with a baby that is intended for a New York couple.    She’s married and has four kids of her own.   While she’s being paid something around $25,000 it doesn’t seem that the need for money was her primary motivation.   Rather, this was something Collins wanted to do for someone.   There’s nothing shameful about being a surrogate, at least as Collins sees it.   (She wears a T-shirt that says “This is not my husband’s baby” on the front and “But it’s not mine either.  I’m a proud surrogate” on the back.  

The Wrong Embryo, II

I just sat down to write this entry, inspired by this morning’s Today Show and lo, I found I had already used my title.  Six months ago I wrote about another wrong embryo case, but I guess I’d forgotten.   Just goes to show that, as I said in that earlier post, accidents will happen.  

Anyway, here is the story from this AM:  Carolyn and Sean Savage had used IVF to conceive their third child.  They had left-over embryos which were frozen.   They decided they wanted to try to have a fourth child and so went to have the embryos thawed and transferred. 

A pregnancy resulted.   But it turned out the clinic had used the wrong embryos–embryos that had been prepared and stored for some other couple.   Somehow this came to light quite quickly (though obviously not quickly enough) and so the news of the error arrived along with the news that Carolyn was pregnant.   

Paying for a Child

There’s a not so very recent story from Alternet that I’ve been meaning to comment on for some time.  I’ve been waiting until my thoughts were properly collected, but I’m beginning to think that will take too long, so I figured I’d just start thinking out loud, as it were. 

The story is really worth a read.   It starts me down two different trains of thought.  One is really about surrogacy and that whole set of questions.  I’ve said quite a lot about all that before (just look at the tags–altrusitic surrogacy, gestational surrogacy, plain surrogacy, and so on.)  I should revisit all that to see if I’d still say the same thing, but I won’t do that just now. 

Instead, this story set me thinking about a different and broader topic:   what can/should/do people pay to have a child.   There’s at least two different ways in which one could expand this question.  

I take it as a given that children are not to be bought/sold, but you could quibble with this assumption if you chose to.  Given that point, you could think about all the different things that might count for some as buying a child.  

Egg Buying, II

The story I blogged about a week-and-a-half ago has finally reached the NY Times.   (This is the one about NY state now paying women to donate eggs for stem cell research.) 

The story prompted me to return to this thread for a moment.  As the NY Times makes clear, for some the concern about buying the eggs is that women will give their eggs for other than altruistic reasons. 

This suggests two distinctions are being drawn–first, between altruistic and non-altruistic behavior, and second, between donating eggs for IVF as opposed to donating eggs for research.  It’s apparently okay to donate eggs for IVF no matter what your motivation but, at least for some people, it’s only okay to donate eggs for research for altruistic reasons.  

Global Surrogacy Update

Here’s a recent article from the BBC. It’s been quite a while since I’ve discussed the globalization of surrogacy in any detail.   It sounds as though some sort of regulatory legislation may be proceeding in India, which is one of the main foreign destinations for intended parents.

Three things particularly strike me in the article.   First, the reference to someone as a professional surrogate mother.   There’s really no reason why only the brokers in the middle should be considered professional, but it does seem a bit at odds with the ideal of altruistic surrogacy.

Second, the reference to restrictions the intended parents place upon the surrogate–here the foods she eats and the methods of transportation she utilizes.   Actually, perhaps as much as anything what’s striking here is the phrase used in the story–“dictate terms.”    It’s all about control.   For that period of time during which she is pregnant, the surrogate may be subject to the terms dictated by the intended parents.   It’s really not that surprising, given how carefully pregnancy is managed these days.

Finally, the description of the relationship between surrogate and IP towards the end of the article as “mutually beneficial.”   The following quote is  “[s]he is getting the money she wants and we are getting a baby.”   I guess that makes it seem pretty stark to me.  And again, I am left to ponder the difference between the transaction described here and the actual purchase of a child.

Perhaps I just need to get over that hurdle and say that under certain circumstances, baby-selling could be okay.  But surely if I were to go down that path, I’d insist on rigorous regulation of the practice, which seems at odds with the current largely unregulated state of surrogacy.

Surrogacy Gone Bad

I digress from my discussion in progress to comment on this item from today’s news.   This is indeed surrogacy gone bad but not, I suspect, in the manner that most people think about.

It appears that SurroGenesis, a for-profit web-promoted, globally marketed surrogacy agency, has taken the money and run.   (I’m astonished to find that the website it still up and running.  I imagine it won’t be for long.)  SurroGenesis is one of a number (does anyone have any idea how many?) of for-profit surrogacy agencies that essentially act as a brokers and facilitators.  They locate surrogates and intended parents, as well as egg donors.   They connect them up with each other and, at least ostensibly, deal with a host of details.   Perhaps most important for the moment, they hold the money that is to be paid the surrogate.

Except, of course, in this case they didn’t hold the money.  They took it.   Perhaps as much as two million dollars all told.   For some couples this means they’ve paid SurroGenesis and lost their money.   That’s bad, of course, but there are a small number of people who find themselves in a much worse position.  In at least two instances recounted in the paper, there are women who are pregnant as surrogates, expecting to be paid and to deliver the children (in both senses of the words) to the intended parents in the not-too-distant future.  But now the money that made these transactions work is gone.  The intended parents have paid it, but the surrogates have not (and likely never will) receive it.