Should women who do not seek fertility treatment provide egg cells for stem cell research?

Jan Deckers, Lecturer in Health Care Ethics, University of Newcastle

Progress Educational Trust

08 March 2006

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[BioNews, London]

The UK's Human Fertilisation and Embryology Authority (HFEA) is reported to be considering allowing women to donate eggs specifically for cloning research. Three issues must be considered to address this question: firstly, if creating life to kill it is justifiable; secondly, if the expected benefits outweigh the costs; and thirdly, who should decide?

With respect to the first issue, women giving eggs to researchers who then create embryos from them, are consenting to the creation of life subsequently to be destroyed, in the hope of therapeutic benefits. The essential issue at stake is whether the embryo volunteered in this way should be granted equal status with born humans. If the HFEA allows women to contribute voluntarily to the creation of embryos destroyed for research purposes, there is no reason why women should not also have the right to create babies voluntarily, who are then killed after being anaesthetised for similar purposes. If the latter is not justifiable, neither is the former.

Species membership has a part to play here. Many animals have natural inclinations which predispose them to favour the needs of their own species members. Humans are no exception. We have all been embryos. Strong feelings of identification underlie the perception of similarity between ourselves and other human embryos, which is not morally neutral. The argument has been made that, even if embryos have full personhood status, the hope that the lives of many embryos may be extended, might outweigh the costs of sacrificing some embryos to research. Similar reasoning would justify sacrificing some adults to provide badly needed organs for others. If the latter is invalid, so is the former.

As some concerns stand irrespective of one's position on the embryo's status, I now turn to the second issue. The argument has been made that women should be permitted to take on the health risks associated with such donations, for example the potentially lethal ovarian hyperstimulation syndrome (OHSS) or other rare complications, because of the benefits involved. The problem with adding financial incentives to these risks, however, is that they increase the likelihood of coercion. Some might argue that those willing to sell a kidney in the hope to escape from poverty should be allowed to do so, as a good chance of living with one kidney would be preferable to a good chance of dying early in poverty. Yet we must ask if those who contemplate providing such financial incentives are not responsible for maintaining financial inequalities. Even with smaller financial incentives, the risk of coercion for some women may be hard to exclude. Offering incentives also undermines respect for the integrity of the body. Blood donors might agree that the real value of their donated blood is tainted by giving them monetary rewards.

But what about women who wish to donate purely altruistically, hoping that those suffering from disease might benefit? The possibility of coercion is not excluded here either. If people have the right to refrain from donating a kidney to a sibling; even if it could save their sibling's life, the right of women not to donate eggs for stem cell research is even stronger. The expected benefits of such research are more unclear and remote than the benefits achieved by kidney donation. Unknown future health damages might occur to the egg donor even when known complications such as OHSS fail to occur. To put the last nail in the coffin: the goods that might be obtained from stem cell research must be weighed against any goods forsaken. The resources poured into speculative high-tech stem cell research would be better spent on low-tech activities. Better health education, for example, might yield greater benefits for many conditions.

Those who accept democracy would accept that whatever the majority decides should be law. People's judgements, however, might be based on distortions, sometimes created by groups with vested interests. I name but a few that are rife in the debate on the embryo's status: that the embryo is not an individual, only potentially human, or not an ensouled living organism. While recognising these distortions may not resolve all value conflicts, the widespread acceptance of these misconceptions should be a cause for concern.

Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.