The ethics of sperm donation

The ethics of sperm donation
Should donators of sperm remain anonymous? Some people say yes, others say no. But most assume that the argument is in principle resolvable if we can apply the right principles in relation to accurate evidence.

But supposing it isn’t? Supposing the argument is demonstrably irresolvable? Supposing that here we come up against an ethical impasse: an example of what the ancient Greeks called ‘aporia’, when either way to go is equally impossible? What would that imply?

I shall return to the last question presently. To begin with I want to argue that this argument indeed issues in an ‘aporia’.

On the one hand, sperm donors should remain anonymous. This is because they would otherwise become personally connected with a situation with which they should not really be personally connected. For even if the donor is known to the recipient he has not been selected as a friend, but as someone whose sperm is instrumentally useful – likely to be healthy, genetically reliable and so forth. His sperm supplies a material lack either within a personal relationship or for an individual woman. Hence disclosure implies a meaningful connection which is inappropriate. To the male partner in an unfertile relationship the donor must then inevitably appear as a kind of virtual adulterer. Equally, for the offspring of sperm donation, affection will naturally reach out towards the biological father, even though he has no intention of establishing a social relationship of paternity. Hence the properly instrumental function is subverted with inevitably ensuing suspicions and rivalries between male partners and male donors that can be catastrophically damaging for family relationships. One might say that these are natural rivalries artificially induced.

On the other hand, sperm donors should not remain anonymous.

A child has every right to know the identity of his/her natural parents. Any other view would render biology irrelevant to our sense of who we are, which would be an ironic conclusion in the light of our modern knowledge of genetics. Quite apart from the medical importance of knowing one’s genetic inheritance, our sense of identity requires us to relate to our natural forebears as well as to our cultural forebears. We need to make sense of both sets of influences, because only an unwarranted dogmatism would deny that both are equally important.

Therefore disclosure is wrong and non-disclosure is equally wrong. Above all, both courses of action are potentially of equal damage for offspring. A further aporia results from the question of whether a child should be told the artificial circumstances of their birth or not. Again, they have a right to know their natural origin and yet one can also claim that the knowledge that personal and natural union have here been divided is inherently disturbing. No such division occurs in the case of adoption and the common idea that this provides is a parallel shows an inability to think clearly in the ethical field.

So what does it mean when a proposed course of action leaves one with two equally unacceptable choices? Does it mean that one should throw a dice or leave choices to individuals? No, it is rather a sign that the proposed action is wrong in the sense of being practically-speaking incoherent or irrational.

For on either side of the aporia the problem is the separation of the interpersonal from the natural. This denies our strange hybrid nature as specifically rational animals. Whatever science may say, this is how in practice we have hitherto regarded ourselves. This is what makes us human. We stop being human if down one fork we deny our rational power of choice or down the other we deny our animality. Thus in relation to reproduction we only remain human when sex and procreation and so love and sex – even the love of a one-night stand – are held together. Then and then only we can say to ourselves that our very animality is the result of an interpersonal choice. Clearly, of course, this can only be a heterosexual choice, not because homosexual relations are wrong (I would not argue this) but because they cannot naturally issue in procreation.

Therefore one should welcome the fact that few men are prepared to donate their sperm. Implicitly they are following the correct line of practical reasoning which I have just sketched by not randomly dispersing their seed as if they thought of women like mere terrain.

To medicalise and sociologise this reluctance is to surrender to market and state infiltration into the very heart of human intimacy. It is to go along with the commodification and bureaucratisation of human reproduction. It is to promote a fascistic mass control of human biology which alienates the ‘rational’ side of our animality to science and reduces the animal side to that of nature in general. Under the illusion of an impossible ‘choice’ that we should not be granted, the power of human reproduction is gradually removed from the free control of human beings in relationship.

That, of course, is what has already happened in the field of production in general. For capitalism, as for technocratic science and bureaucracy, ordinary parents and families are like peasant proprietors and smallholdings. Eventually, of course, their function must be abolished as inefficient, unreliable, uncontrolled and likely to yield too many ‘poor crops’. Only naivety of the direst kind would fail to realise that the secret, usually unconscious aim of practices of surrogate birth is to legitimate only technologised, artificial reproduction removed from the scope of human inter-relationship, which is to say, removed from the scope of human love.

Let us salute then, the reluctant. May they long hold out against the liberal elites – both those who know too well whither they tend, and the vast majority who, in their folly, do not.

New York State Allows Payment for Egg Donations for Research

June 26, 2009, New York TImes

Stem cell researchers in New York can now use public money to pay women who give their eggs for research, a decision that has opened new possibilities for science but raised concern among some bioethicists and opponents of such research.

The decision by the Empire State Stem Cell Board, announced two weeks ago, is believed by the board to be the first in the country allowing state research money to be used for this purpose. The board agreed that women can receive up to $10,000 for donating eggs, a painful and sometimes risky process.

Until now, researchers have relied on unused embryos from in vitro fertilization, as well as reprogrammed skin cells, for their work. Eggs, which offer other avenues for research, have proved more difficult to obtain.

Proponents say compensating women for their eggs is necessary for research, and point out that women who give their eggs for fertility purposes are already paid. Others worry that the practice will commodify the human body and lead to the exploitation of women in financial need.

“What we’re doing is making it in some ways more reasonable for women who are interested in donating for research to do so,” said Dr. Robert Klitzman, director of the new master’s degree program in bioethics at Columbia University and a member of the stem cell board’s ethics committee. “And at the same time, the goal is to move the science ahead, but we don’t want to just move science ahead regardless of people’s rights.” The board’s ethics and finance committees voted to approve compensation.

National Academy of Science guidelines prohibit paying women for eggs used in stem cell research, but researchers say recruiting unpaid donors has been unsuccessful.

“There are many questions you can only answer by studying human eggs,” said Dr. George Q. Daley, a stem cell researcher at Harvard and at Children’s Hospital Boston. “I think it’s a gold step for New York State, and it will mean a tremendous advantage for New York.”

Dr. Daley’s research has so far used poor-quality eggs discarded after in vitro fertilization, a process he said has yielded modest returns but no stem cells.

However, Dr. Daley said, concerns that payment alone could induce women to give eggs were valid.

In New York, payments will be carefully evaluated by an institutional review board, Dr. Klitzman said. But that safeguard did not assuage the concerns of some critics that money, and not altruism, would motivate women to give their eggs.

“You don’t have to be a rocket scientist to understand that this is going to create a kind of undue inducement, a scenario in which a person can feel unduly compelled to take advantage of a situation,” said the Rev. Thomas Berg, director of the Westchester Institute for Ethics and the Human Person, a Roman Catholic research group, and the only member of the stem cell ethics committee to vote against compensation.

Stem cells, the origin of all cells in the human body, have the potential to transform medicine by providing new ways to treat diseases and disorders that include cancer, Parkinson’s and Alzheimer’s diseases and paralysis. But because stem cell research often involves human embryos, its financing has been a source of controversy for more than a decade. Congress bans the use of tax dollars for any research that results in the destruction of human embryos. In March, President Obama removed restrictions on federally financed stem cell research, but the Congressional restrictions are still in place.

States responded to the federal financing restrictions by pledging money of their own, including $600 million from the New York Legislature in 2007 for an 11-year stem cell research plan. Scientists say the New York board’s decision to permit compensation, reported online Thursday by The Washington Post, is likely to give the state an advantage.

Father Berg, who opposes stem cell research and in vitro fertilization, said he had found “strange bedfellows” in bioethicists who share his concern. Among them is Arthur Caplan, director of the University of Pennsylvania Center for Bioethics, who said he feared that compensation would lead poor women to ignore the risks egg donation can pose.

“The image of women having their eggs harvested in a market is one that the industry is going to find difficult to destigmatize,” he said. “That notion of being treated as an object to derive those kinds of materials is not one that will sit well.”

The internal guidelines of some New York stem cell research centers, including Rockefeller University, Cornell University and the Sloan-Kettering Institute, prohibit paying for eggs. But for researchers without those prohibitions, it opens possibilities, said Susan Solomon, founder and chief executive of the New York Stem Cell Foundation.

“If you’re donating oocytes, there is time and burden,” Ms. Solomon said. “And in our society, we compensate for time and burden.”