Embryo Donation
The surprise in some recent developments, or potential developments, in assisted reproduction is that public views are not siding with the "shock, horror" responses of some would-be opinion formers. Since egg donation is a relatively new and complex reproductive option, it is often poorly understood by the general public. One should expect that others will not quickly understand these choices. One needs to think through the pros and cons of when and with whom to share this information. Some choose to reveal the child's origins only to supportive friends and family, educating them about the need to be discreet. The first birth of a child conceived through ovum donation occurred in 1984. This important milestone ushered in new era of infertility treatments which have given hope to women unable to achieve a pregnancy because of premature ovarian failure, poor egg quality, cancer treatments or menopause. (Lynn, 52)
First, one may hold that twinning is a form of . On this view, the embryo would, in some pre-gastrular phase, be such that a process of forming new human individuals can still occur via budding. When budding occurs, a part of one individual substance becomes detached and forms a new individual substance in its own right, while the original substance continues to exist. Similar scenarios are known from the vegetable kingdom, where a cutting from one plant may be planted in the soil to result in a new plant without the original plant ceasing to exist as a separate individual. Budding does not entail the destruction of the entity that buds off the new individual. So, if embryonic twinning occurs via budding, the view that the pre-gastrular embryo under favorable circumstances would be trans-temporally identical to the future human being is credible.
If the donation of ovarian tissue is seen simply as the equivalent of sperm donation there should be no argument, in principle. It is unfortunate for the simplicity of that analogy that the discussion should have come up at a time when so many controversies are cluttering the assisted reproduction scene--selection for sex, babies for postmenopausal women and lesbians, the prospect of freezing of oocytes so that women have free choices on both a career and a family. (Lynn, 53) After all, the primary objective of oocyte donation is to help couples whose unwanted infertility is caused by an irreversible gynecological condition. But for them demand exceeds supply, and that is the real issue.
We already accept the ethic of private healthcare. It is not unreasonable that the seriously ill be entitled to spend their own money on saving their own lives. It is preferable that some individuals receive ova, and survive, than none at all. There is a spurious equality in everybody dying. The wealthy will not be the sole beneficiaries of a policy of ovum purchase. (Michelle, 487) For each successful kidney transplant operation, valuable hours on a dialysis machine will be left vacant. The expense of palliative care for an individual requiring a transplant operation will be eliminated.
A legitimate market in human ova would not be inconsistent with either public or private healthcare services. The transplant surgeon, the nursing staff and even the pharmaceutical companies producing the anti-reaction drugs receive payment for each operation performed. (Reg, 487) Why should the donor of the ova, arguably the most important actor in any transplant, not also receive remuneration? The United States already tolerates markets for blood, semen, human eggs, and surrogate wombs. Is there a moral difference between a heart or a lung and an ovum? It is remarkable that a lifesaving treatment should apparently have no financial value.
There is no question of a state financed health service being able to afford the prohibitive cost of purchase of ova. It is believed that a single kidney has a black market price of $20,000. Consequently, the sale of ova will condone the grossest discrimination between rich and poor. The opportunity for those unable to afford to purchase to receive a donated ovum will be eliminated. (Reg, 487) Which family, if prepared to donate the ovum's of a relative, would decide to decline an ex gratia payment of tens of thousands of pounds? There will not be a two-tier market consisting of sale and donation. The donations will disappear and only the rich will survive.
The opportunity for individuals and governments to gain considerable capital for ova sold will lead to appalling human rights violations. Chinese judicial officials are reported to execute prisoners on account of the black market value of their body parts.( In Vitro Fertilization, 78) The lawful sale of ovum's would legitimize human sacrifice.
The sale of ova is a poor solution to a pressing problem. The BMA has proposed a system of ‘presumed consent'. (Reg, 487) This scheme would allow doctors to assume that the ova of a deceased patient can be used for transplant unless the patient or his family has made a contrary request. Alternatively, the BMA has advocated radical revision of the inefficient system by which patients are matched to donors. The U.S. Department of Health and Human Services (HHS) has proposed the development of a website that would link patients, surgeons and donors nationwide. (James, 111) The BMA also envisages the deployment of ‘multi-ovum retrieval teams' led by hospital consultants, in order to ensure that any available ova are not lost from cadaveric donors.
Of course, one may say that the one log is identical to the two logs taken together. But if this is so, then spatial connectedness does not matter in defining what a log is. That is, something can be a log even if its parts are spatially separated. In the case of an embryo spatial separation may not matter either. But the two embryos that would result from the splitting of a single embryo would under normal circumstances develop into two human beings. So if the single embryo were identical to the two embryos taken together, then the single embryo would be identical to two adult human beings, which cannot be the case. Alternatively one but not the other of the twins would be identical to the ancestor entity. But there is no property in virtue of which one but not the other twin could be said to be identical to the ancestor entity. So, if human embryonic twinning occurs via fission, an embryo that results from a twinning process begins to exist when the twinning process is completed. (Becker 345)
But the fact that an embryo ceases to exist when twinning occurs does not rule out the possibility that an embryo that does not undergo twinning is identical to a future human being. So, one may hold the view that, when twinning occurs, the embryo begins to exist when the twinning process is completed, but, when twinning does not occur, the embryo begins to exist at the time of conception. Since we do not know whether a blastocyst would undergo twinning under favorable circumstances, we do not know whether it would be identical to a future human being under favorable circumstances. And since we do not know whether the blastocyst has moral status, destruction of the blastocyst is not justified.
Recent embryonic research has given rise to skepticism about the view that the embryo is a featureless orb of cells prior to gastrulation. It has been shown that the mammalian body plan begins to be laid down already from the moment of conception. (Ford 405) A body axis is present, and there is already a clear division between bits destined to become the placenta (etc.) and bits destined to become the future human being, even at the two-cell zygote stage. Despite the existence of traits that appear to narrow down cell fate, the fact is that pre-gastrular embryos are susceptible to twinning. Even though the cells become biased towards producing certain tissues, those biases are not irrevocable. So the new data do not dispute the claim that the cells destined to become a human being are totipotent. After all, the pre-gastrular embryo does not have the kind of structure that would prevent it from separating into parts that can each produce a complete human being.
Bibliography
Lynn, Chabot-Long. 2003. A Gift of Life: A Page From the Life of a Living Ovum Donor. (ISBN: 0965055558). Pp 52
James, Shanteau. 2004. Ovum Donation and Transplantation (ISBN: 1557980799). Pp 110
Michelle Blackley; "Eggs for Sale": The Latest Controversy in Reproductive Technology: Couples Are Paying Lofty Fees to Egg Donors with the Perfect Combination of Brains and Beauty. Magazine article USA Today (Society for the Advancement of Education), Vol. 132, July 2003
Helen Garston; I WENT THROUGH THE CHANGE ...AT 16!; Menopause Only Happens to Middle-Aged Women, Thought Fiona Jackson. Wrong! She Was Just 16 When It Happened to Her. Newspaper article The People (London, England), October 26, 1997
http://www.biol.tsukuba.ac.jp/~macer/asrep1991-93.html on April 1, 2005
Becker, L.C., Human Being: The Boundaries of the Concept, Philosophy and Public Affairs 4, (2002): 340.
Ford, M. When Did I Begin? Conception of the Human Individual in History, Philosophy, and Science, Cambridge/New York: Cambridge University Press, 2003, 405.
