Thursday, December 15, 2011

Paying for sperm and ova? A British think tank says 'no.'

 In October, the U.K. Nuffield Council on Bioethics, issued a set of recommendations regarding Human Bodies:  Donation for Medicine and Research (§45-54).

When it comes to the use of gametes for reproduction this think tank emphasized an “altruist-focused” approach, as against an outright payment for sperm and ova.  It specifically rejected “the concept of paying a ‘purchase’ price for gametes, where any payment made is understood as payment for the gamete itself, rather than as recompense or reward to the donor herself or himself.”

You will notice the difficulties the Council gets into here.  It specifically rejects the idea of paying people for gametes and instead recommends reimbursement for time and effort involved in making the gamete donation.  Even so, the Council itself lapses into using the language of ‘payment’ where it clearly means reimbursement.  And that’s sometimes the difficulty here, especially for male donors.  An acquaintance of mine told me that he made more than $5,000 ‘donating’ sperm while in college.  I suppose we could think of that as ‘reimbursement,’ but that’s not how the money felt to him.  $5,000 looks virtually indistinguishable from payment, all the more so since that was $5,000 in early 1980s money.

In any case, the Nuffield Council does not think that the current reimbursement in the U.K. – currently capped at £250 – is enough for the efforts involved for egg donors.  That amount is too low relative to the time and effort involved, not to mention the risk.  So the Council is open to the idea of more money for reimbursing women who want to donate eggs so that others may use them in an attempt to have children. 

That said, they immediately flag the risk of multiple donations, noting that the effect of multiple egg donation is poorly studied.  They want to protect women coming forward as multiple donors if doing so would put them in harm’s way.  And they don’t want ‘reimbursement’ to be so high that it would attract repeat donations, based on the money involved.  So, once again, the line between reimbursement and payment can be very porous.  In any case, the Council endorsed the idea of national registries of gamete donors, in order to study the effects of multiple donations. 

The Council also calls for the study of possible effects of financial incentives on children conceived with donor gametes.  I’m not sure what the Council is fishing for here.  People who offer blood in exchange for money, as against altruistic donors’ may be more likely to exhibit certain problems with their blood, but I’m not sure that people who offer gametes in exchange for money will be more likely than altruists to have some kind of heritable disorders.  Maybe, but I suspect the Council is only being extra-scrupulous here.  Either that, or it’s trying to raise as much suspicion as it can about paying people who offer sperm and ova, as against only reimbursing them.  I think that the real issue here is probably not finances, but multiple donations ending in lots of half-siblings.  That issue should be addressed directly, I think, by capping donations rather than by smuggling it into the discussion through questions of money.

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