22 March 2010
BioethicistAppeared in BioNews 550
BBC Radio 4, Wednesday 17 March 2010
'IVF doctors to raffle human egg' ran the Sunday Times headline on 14 March 2010. A seminar sponsored by an American clinic took place in London at which a human egg and a cycle of IVF treatment was awarded to one couple who attended. Egg donors at the US clinic are paid $10,000, whereas in the UK payment to cover expenses is restricted to £250 by law and this is why, according to certain commentators, there is a shortage of egg donors. The 'winners' will be able to select donor characteristics such as age, social background, intellectual abilities, and looks. The seminar was held to publicise the US clinic's collaboration with the UK's London Bridge Fertility Centre.
In light of this, Michael Buerk dedicated last week's Moral Maze programme (Radio 4, 8.00 pm) to a vibrant discussion of whether the marketing of donor eggs should be permitted. The panel consisted of Clare Fox (Institute of Ideas), Michael Portillo (Former Conservative Cabinet Minister), Matthew Taylor (Chief Executive of the RSA), and Anne McElvoy (Political Columnist of the London Evening Standard). The discussion centred around the panel's questioning of four 'witnesses' on the subject. These witnesses, who were all specialists in the field, included: Professor Gedis Grudzinskas (Consultant in Infertility and Gynaecology), Alexina McWhinnie (Dundee University), Janet Radcliffe Richards (Professor of practical philosophy at Oxford University), and Vivienne Nathanson (Head of Science and Ethics at the British Medical Association).
The views of the witnesses were diverse and the abilities of the panel members to cleverly deconstruct the witnesses opinions - questioning both their reasoning and beliefs, provided for an interesting and lively debate. However, as is so often the case with morality debates, some of the arguments advanced were a little too pragmatic in nature. And whilst most of the commonly raised concerns on this subject were at least touched upon, if not explored in more detail, some important moral issues, such as value-based arguments, were missing altogether.
Witnesses had a designated amount of time to defend their moral positions. Richards and Grudzinskas were both pro donor egg marketing. Whilst Grudzinskas's logic stemmed heavily from analogy arguments (to name one example, he persistently claimed that having transparency about the nature and characteristics of an egg donor is not dissimilar from knowing the characteristics of any friend who acts as a surrogate), Richards, who was by far the most skilful debater of the group, took a different approach. She used a purely moral perspective, arguing that banning donor egg marketing could only be morally acceptable if and when the resultant harm caused to individuals as a consequence of the ban was less than the harm that would be created by allowing such a practice to continue.
Interestingly, Richards also had no moral objection to placing different monetary values on different genes in the market place. In this sense, Richards cleverly drew a clear distinction between two types of value. On the one hand everyone matters equally. But there is also a different sense of value such that someone can be more valuable as a means to an end. I think this latter instance can be explained better with an example: a plumber would be more valuable to a person with a blocked sink than someone who is not a plumber.
The other witnesses were both anti donor egg marketing - though Nathanson, who pragmatically argued more about the possible effects of donor egg marketing on the current egg shortage than anything moral, seemed much more tolerant than McWhinnie. McWhinnie argued that the creation of children via egg selection to meet the needs of adults is morally objectionable. She highlighted the fact that the resultant children would be genetically bewildered and desperate to know and understand their genetic identity. McWhinnie, however, formulated her moral concerns poorly, which were easily refuted by the panelists Clare Fox and Michael Portillo.
Finally, Clare Fox raised a wildly interesting point - I suppose the most original piece of thought during the program. Fox remarked that there is a genetic over-determinism on both sides of the argument (compare the view of McWhinnie, who believes that normality stems from knowing one's genetic identity, with the 'pro selecting donor characteristics' view). Maybe, Fox notes, determinism is something we should be fighting rather than the market.
As the discussion drew to a conclusion, the arguments against donor egg marketing were brought together in terms of harmful consequences - both to the resultant children, and to society (exploitation; harm to donors). Panelists Matthew Taylor and Anne McElvoy argued that if there is a reasonable chance that such harms will ensue, it is better to ban such a practice (otherwise known as the precautionary principle). The question, I suppose, that is left hanging (for a consequentialist anyway) is whether Mathew and Anne are correct in their judgements - are the harms really great enough to warrant a ban?