Leading Article: We don't want a free market in body parts

Thursday 01 July 1999 18:02 EDT
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THE DISCONCERTING thing about public morality is the way that it keeps changing. Ten years ago, the Human Fertilisation and Embryology Authority criticised allowing private clinics to offer free sterilisations to women who agreed, in return, to donate their eggs for use in IVF treatment. This year, when a similar proposal came before the authority, its members overcame their previous doubts and gave the go-ahead for this quasi-market in human reproduction.

Technically, this barter exchange does not breach the rules against paying substantial amounts for the donation of human eggs. All that happens is a woman who is intending to be sterilised on the NHS gets her operation quite a bit sooner (and in somewhat nicer surroundings), and eventually a woman looking for a donor egg has her chances of finding one improved. The benefits to the donor are small, the gains to the receiver great.

Yet the principle - payment for undergoing an invasive medical procedure - breaks a taboo widely felt. There's a continuum between paying for blood donations, paying for surrogacy, paying for spare kidneys... and at some point along this line everybody jumps off. There is a superficial attraction in travelling to the end of the line and letting the market sort out all these matters. If a woman wants to sell her eggs and someone in great need wants to buy them, it seems at first glance oppressive to interfere.

But a moment's reflection raises some difficult concerns. It is wrong to tempt impoverished people to hurt their own health, whether that be by giving blood too often or by undergoing unnecessary medical treatment, with its accompanying, incalculable risks - let alone parting with vital organs. Also, as countries who find themselves buying blood from drug addicts and drifters have found, those who are desperate enough to sell parts of themselves for money are often parting with infected goods.

As the number of women who can benefit from IVF rises, so does the demand for genetic material. Payment should not encourage donation of eggs and sperm, but it can compensate for such discouragements as cost and discomfort. We don't need a free market in human parts, but we do need fresh thinking to keep up with changing needs.

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