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Department of Medical Humanities
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NEWSLETTER
 
medical humanities newsletter
The Bioethics Center, University Health Systems of Eastern Carolina
Department of Medical Humanities, The Brody School of Medicine at East Carolina University
 
 
 
Eggs for Sale
David B. Resnik, Ph.D.

In the Fall of 1999, Ron Harris held a human egg auction on his web-site. The site featured three female models with accompanying photos and descriptions. Bids started at $15,000. According to Harris, “choosing eggs from beautiful women will profoundly increase the success of your children and your children’s children, for centuries to come.” The Associated Press, New York Times, CNN, and other news services soon learned about this web-site. The volume of people trying to connect to the site overloaded Harris’ server, and he had to discontinue his on-line egg auction. Since Harris’ site also sold pornography, many commentators dismissed the auction as nothing more than a sales gimmick.

Perhaps the auction was just a gimmick, but human egg commerce is a serious and rapidly expanding business. In 1999, an estimated 5,000 women in the United States (US) were impregnated with donor eggs (or oocytes), many of which came from female college students. Recruiters (or egg brokers) “prospect” for eggs on college campuses; student newspapers carry advertisements for egg donors. One ad promised $50,000 for eggs from tall, athletic women who have high IQs. Another offered $15,000-$20,000 for Caucasian egg donors who are at least 5’6” tall with blue eyes. Although these ads first appeared in Ivy League newspapers, they can now be found on campuses across the US.

Oocyte donation has occurred for many years. In the procedure, women take hormones to stimulate the production of oocytes, which are harvested with a 12-inch needle inserted through the vagina to the ovaries. The needle vacuums oocytes from the woman’s follicles and deposits them into a test tube. The oocytes can then be fertilized in vitro and implanted in the uterus. The procedure causes some pain and discomfort but it can be done on an outpatient basis. Women run a risk of some medical complications, such as infection or ovarian hyperstimulation syndrome. Although women typically produce 400-500 oocytes in a lifetime, most women are born with about 400,000 follicles. Thus, there is little danger that a woman will run out of eggs.

The procedure is called “egg donation” in order to downplay its commercial implications. In most cases, women are putatively compensated for their services (time and inconvenience), not for their goods (eggs). However, it is clear from the previously mentioned ads that egg brokers are interested in compensating women for the characteristics of the egg that is donated, not just for their labor. Why else would someone offer to pay $50,000 for an egg from a tall, athletic, and intelligent woman but would not offer the same amount to a short, athletically-challenged, unintelligent woman?

These transactions are currently legal in the US and many other countries, although it is illegal in the United Kingdom (UK) and France. In the UK, donors may be compensated for time and inconvenience, but payments for oocyte donation are strictly limited. Some states, such as New York, prohibit the selling of eggs, but permit reimbursement for time and inconvenience. The American Fertility Society officially opposes the sale of human eggs, but states that donors may be compensated for inconvenience and time.

Although it is not likely that Harris was able to sell any human eggs through his web-site, many people found the very idea morally disturbing or even sickening. Although the egg auction shocked many people, it is arguably a natural outgrowth of the burgeoning reproductive assistance industry, which has created an uneasy tension between economic interests and human dignity. On the one hand, people who donate sperm or eggs claim to have a right to remuneration for goods and services. On the other hand, the commodification of those tissues with the potential to become adult human beings threatens human dignity and other moral values. To understand whether selling human gametes (sperm or eggs) is immoral, we must first examine arguments for and against commodifying human body parts and products.

Commodification is a social practice for treating things as commodities, i.e. as properties that can be bought, sold, or rented. The moral basis for treating these body parts or products as commodities stems from the body-as-property view found in some strains of libertarian political thought, which holds that the body and its parts may be bought, sold, and rented. The principle of autonomy provides additional support for the body-as-property view. Most of our autonomous choices presuppose some control over our own bodies. If we think of ownership of an object as a collection of rights to control the use of that object, then autonomous individuals might be said to own their bodies, body parts, and body products.

The body-as-property view provides the strongest case for allowing people to buy and sell human oocytes. Additionally, one might defend the commodification of oocytes on the grounds that it benefits donors and recipients. Donors derive economic benefits from selling oocytes, and recipients receive the benefit of fertile oocytes that can be used to produce human progeny. There are several objections to commodifying human oocytes, however.

First, one might object to the commodification of oocytes on the grounds that human eggs have inherent moral worth due to their human potentiality. An egg contains half a human genome and can unite with a sperm to form a zygote, which can become a child if it implants in a uterus and develops normally. Thus, selling a human gamete is dangerously close to selling a person. However, selling gametes is not the same thing as selling persons, since gametes are not even potential persons. An egg is more like half of a blue print for making a house (person) than a whole blueprint (zygote) or a house that is under construction (fetus or child).

Second, one might object to the commodification of eggs on the grounds that this practice may have adverse effects on our attitudes toward the human body. If we allow the commodification of parts of the body, the argument suggests, people will start to view the whole body as a commodity and they will loose their respect for human life, uniqueness, and dignity. If eggs are sold in fertility clinics and are advertised in magazines, newspapers, or on web sites, then the market could set a price for eggs and those people with the “best” qualities could demand the highest prices for their eggs. The implication of this commerce is that women who can sell their eggs for a high price are more valuable (or better) than women who cannot. This is what is so troubling about Harris’ egg auction: it seems to reduce people to their base market value and threatens our attitudes toward the value of human life.

On the other hand, society already accepts many practices that have exactly the same implications for our attitudes toward the body. These include: wrongful death lawsuits, which compensate plaintiffs for the loss of life; injury lawsuits, which often compensate plaintiffs for bodily damage or the loss of a limb; insurance on particular body parts, such as a dancer’s legs or a baseball pitcher’s arm, which assigns an economic value to particular body parts; the marketing of one’s face, body, or voice, which assigns an economic value to a person’s physical image; selling human hair for wigs; the labor market, which assigns economic value to different actions performed with one’s body: a surgeon is worth more than a janitor.

Even though society already accepts many practices that put a price on the human body and its parts, one might still argue that these practices should be restricted in order to safeguard our attitudes toward the body and the value of human life. Hence, any market in human gametes should be regulated in order to protect and promote important social values. The regulation favored by many is to ban the selling of human oocytes while allowing donors to be compensated for their time and inconvenience. This regulation would prevent people from selling human eggs without crippling the practice of egg donation.

Compensating donors only for their time and inconvenience is dishonest and hypocritical, however. Who sincerely believes that egg brokers are offering $10,000 to compensate women for time and inconvenience? To ensure that compensation is honest and fair, society would need to follow the UK’s example and set strict limits on the amount of money that a woman may be paid for egg donation. But this option, too, could lead to corruption and abuse, since egg brokers might still find a way to attract and compensate desired donors. One need look no further than corruption and abuse in amateur athletics to see how consumers, producers, and suppliers can find ingenious ways of evading limitations on compensation.

The most honest and consistent policy is to ban all forms of compensation for human oocytes, including compensation for time and inconvenience. But this option also has some difficulties. First, since men are routinely compensated for donating sperm, it would be unfair and discriminatory to not allow women to receive compensation for oocyte donation. Both women and men should be compensated for gametes or there should be no compensation at all.

Second, it might be difficult to stop human oocyte commerce, since consumers are likely to pay a high price for these products, and producers, suppliers, and marketers are likely to find ways of satisfying their demands. If one country makes a concerted effort to ban commerce in human eggs, the industry can simply migrate to a country where the practice is legal. Oocytes could be harvested in the country that allows this practice and sold over the Internet. Thus, a black market for human eggs could quickly develop. The market would be international in scope and would take advantage of the Internet and other technologies that can facilitate global trade.

The social and medical harms of a black market for human eggs are likely to be much worse than the harms of commodification. These harms might include violations of informed consent for donors and recipients, exploitation of donors and recipients, and added medical risks to donors, recipients, and children created from black market eggs. The “back alley” abortions of the 1950s provide a grim reminder of the dangers of health care delivered via the black market.

Given the rapid development of reproductive technology and the assisted reproduction industry, it is only a matter of time until we see a thriving market for eggs, sperm, and other reproductive materials. The most prudent course of action is to allow this market to develop, but to regulate the practice of egg selling in order to safeguard our respect for human life and protect the rights and welfare of donors, recipients, and children. Human oocytes can be treated as incomplete commodities.

(This article is based in part on Resnik D. The commodification of human reproductive materials. J Med Eth 24 (1998): 388-93.)