Stem Cells-What do you think? Ethical issues? Ideas?

A Market for Human Eggs

            New York State was the first state that legally allowed women to donate their eggs for embryonic cell research.  The women were given $10,000 for their donation and a guarantee that the eggs would be used for research.  This area of research is not without controversy by critics that see this form of research as killing as well as the potential for the exploitation of women, especially poor women, who may not be the ideal candidate for donation. The purpose of this paper is to explore the ethical dilemmas in women that donate eggs to stem cell research or to infertile couples and whether or not they should be compensated for their donation (Stein, 2009).

Background

            The human egg (oocyte) donation has been used for many years.  The women take hormones to hyper-stimulate their ovaries to produce eggs that are harvested by a physician, during a surgical procedure, fertilized in vitro and placed back in the uterus for development. The difference in stem cell research is that the eggs are fertilized in vitro and then the genetic materials (stem cells) are removed for research.  The cells are not allowed to develop into an embryo. Embryonic cell research is considered a promising area in science.  The stem cells have the ability to become any cell that is needed to cure many different diseases and injuries.  According to the Stem Cell Research Foundation (SCRF) stem cell research is showing promise in the treatment of heart disease, arthritis, osteoporosis, cancer, Alzheimer’s disease, juvenile diabetes, and spinal cord injuries (Tong, 2007).

            The ethical dilemma comes into play when the embryonic cells are destroyed when they are only days old.  This is view by the critics as killing.  In Kantian Ethics he believed that Moral rules have no exceptions; killing is always wrong. Critics that consider stem cell research killing have to agree that this does follow Kantian Ethics (Stein, 2009).

            Stem cells can be found in limited numbers in adults and  in newborns’ umbilical cord blood, but most scientists feel that the best source is in the “inner mass of a blastocyst (a stage in the development of a pre-embryo that occurs approximately 4 days after fertilization) or in the gonadal tissue of aborted fetuses” (Tong, 2007, p.221). There are two ways to secure pre-embryos for stem cell research that will be discussed in this essay.  The first is to use the left over embryos from couples that have produced more than it is likely that they will have implanted back into the uterus. Their options are to discard them, put them up for adoptions, keeping them frozen or donate them for research.  The second source of pre-embryos is to advertise and obtain eggs and sperm from random donors.  It is not surprising that stem cell research with embryonic stem cells has some morally and ethical controversy (Tong, 2007). 

            In November 2005 a South Korean scientist,  Woo Hwang, was conducting stem-cell research and started an international debate when it was discovered that the eggs he had acquired were from his junior scientists in his laboratory.  Over a period of three years Hwang worked with over 2000 eggs from 129 different women.  It is not clear the amount that these women received for the donations or if they received any payment at all.  While it is clear that egg donors should be compensated on the basis of time and discomfort the international debate continues on the amount and what expenses will be reimbursed to the donor (Steinbrook, 2006).

The Positives and the Negatives

            Egg donation requires a significant amount of time, as well as discomfort from the medication’s  that can cause hot flashes, vaginal dryness, fatigue, insomnia, body aches, mood swings, breast tenderness, headaches and visual problems.  There is a chance of hyper-stimulation of the ovaries which is usually an unpredictable response to ovulation-induction therapy and it causes a fluid shift causing complication such as ascites, pleural and pericardial effusions.  The risk of venous thromboembolism is increased and there is some concern that the women who receive multiple cycles may have a higher risk of ovarian cancer later in life.  This is based on research in animal because there have not been enough studies on human subjects at this time.    There may be future effects to fertility and the future off-spring of the woman that donates her eggs (Steinbrook, 2006).

The no-compensation policy idea has become the standard for stem cell research across the country and internationally there are drafted guidelines that prohibit “undue inducements”.  The ruling of California’s Proposition 71 “prohibits payment in excess of the amount of reimbursement of direct expenses incurred as a result of the procedure” (Gerber, 2007, p. 220). California’s rules have become the standard for stem cell research retrieval of eggs.  This does not however have any effect on egg donation for in vitro fertilization, only for women who donate their eggs for scientific research.  As a result of this no-compensation ruling the high demand for eggs for embryonic stem cell research has far exceeded the supply and altruism alone may not be enough to meet the demand.  Many states are facing shortages and are contesting the policy of no-compensation.   Women have a choice of donating their eggs to an infertile couple for compensation or donating their eggs to stem cell research for no-compensation (Gerber, 2007).

While we as a society remain uneasy with the sale of eggs, it is an acceptable practice to sell sperm.  Is it because there are only a limited number of eggs that a female produces or because we live in a male dominated society? The procedure is not without discomfort and risk in a female.  There is no risk involved with the donation of sperm and the supply is endless.

People participate in research for many reasons; many of them are self-serving, including securing access to healthcare and furthering the knowledge of a condition that they or a family member may suffer from with the hope that one day there will be a treatment or cure (Johnson, 2006).

            In 1999 Ron Harris held a human egg auction that featured three female models with pictures and descriptions, the bidding started at $15,000.  The high volume of people accessing the site over loaded his server and he had to discontinue his egg auction.  Recruiters look for prospect on college campuses with the promise of $15,000-50,000, depending on your ethnicity, height, IQ, and eye color.  In the United States alone over 75,000 births per year are a result of assisted reproductive technology (Resnik, 2001).  

            There are some benefits for selling human eggs; it helps the donors economically if they use their eggs to help an infertile couple have a child. That couple will have a child and the child will have a life.  There may still be some compensation for time and expenses if eggs are donated to research (Resnik, 2001).   Over all the negative aspects far out weight the positives.  

            Stakeholders are all women that have donated eggs for research.  Infertile couples that desire to have children and the children that will be born from the donated eggs.  As well as all persons receiving treatment as a result of the stem cell research that is being conducted today and in the future.  The list of stakeholders is endless and the possibilities are astounding. 

            After the scandal in South Korea it is uncertain how the research groups will obtain approval and funding for the stem cell research, the number of donors they will be able to obtain, and whether enough women will agree to donate if the only monetary compensation is for their expenses.  There is concern that the only women that will donate will be friends and family of persons with diseases and disabilities, whom have an optimistic point of view that they are helping their family member.  There is extensive publicity and advertising that introduces the idea of egg donation in hope that it could motivate more women to consider donating their eggs to research (Steinbrook, 2006).