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Thursday, September 14th 2006

We Do It For Chickens

Is cloning and stem cell research being hampered by a lack of eggs? Donated eggs for fertilization and donation to other couples routinely net women (often college students) thousands of dollars. But paying for eggs for research is unethical.

[S]tem cell researchers are forbidden to pay for eggs by ethical guidelines from some of the most influential scientific organizations in the world, including the National Academies, which advises the U.S. government on scientific issues. California, Massachusetts, Canada, South Korea and the European Union all have passed laws barring payments.

Laurie Zoloth, a bioethicist at Northwestern University’s Feinberg School of Medicine, said payments to donors would create an exploitative trade, taking advantage of women who might be so desperate for money that it clouded their judgment about the medical risks of the harvesting procedure. Bone marrow and kidney donors are unpaid for that reason, she said.

But stem cell researchers argue that it is only fair to pay donors because of the time, discomfort and risks involved. They note that research subjects are compensated for their time.

It seems like other “subjects” are compensated for their time. Such as subjects in drug trials, which as we’ve learned from TGN1412 are risky to an individuals health. Granted the health risks and concern associated with the collection of eggs is far beyond those associated with most drug trials. But as the San Francisco Chronicle points out, the challenges in collecting eggs is precisely why women should be compensated.

Eggs should not be sold, but women who produce eggs for research should be compensated for the time and effort involved. They must undergo a series of painful injections with drugs to stimulate their ovaries and undergo a collection procedure that involves inserting a large needle through the vaginal wall into each ovary. The drugs can cause mood swings, and there are rare but life-threatening risks associated with them. Why would anybody do this without appropriate compensation?


The rationale for this ban becomes even murkier when we consider that human participants in other painful or risky research are usually paid. Federal regulations permit such payments as long as they do not constitute an “undue influence” that distorts free and informed consent. If the validity of the consent process is ensured and payment levels are kept reasonable, why are women treated as though they cannot make these decisions themselves?

In Britain they have a nifty way around the growing egg shortage. Women who are already undergoing IVF can donate eggs much easier. They’re already going through the drugs and the procedure. If they volunteer to donate some of their eggs to science, then they get large discounts on the IVF procedure from at least one fertility clinic in the country.

WOMEN undergoing IVF treatment will be able to cut thousands of pounds from the cost by donating some of their eggs for cloning research, after the practice was approved in Britain for the first time.

The licence from the Human Fertilisation and Embryology Authority (HFEA) means that patients at the Newcastle Fertility Centre at Life will in effect be paid in kind for their eggs. Up to half their treatment costs will be covered by a scientific team investigating stem cells, if they agree to give up 50 per cent of the eggs that they produce for use in experiments.

Not everyone thinks the plan is so clear cut in its ethics,

The HFEA ruling is controversial as it introduces the principle that women can be rewarded for donating eggs to be used purely for research. Several British clinics already operate schemes in which eggs are shared with other couples for use in fertility treatment. It is illegal to pay egg donors directly for any purpose.

Compensating women for eggs given to science makes sense. Despite FDA guidelines to the contrary we all know that compensation influences who enrolls in drug studies, so the idea that lower socioeconomic classes might be exposed to be levied with a further burden of health risks is simply not a valid argument against paying for eggs for research.

The consent process for the procedure can be set up to make sure the women accurately not only understand the risk but are reasonably factoring it into their personal decision. And that really is what this is. Paternalistic laws and ethical guidelines like this are out dated. They should focus on a rigorous consent process, with strict and vigorous punishment for researchers who may fall short in informing compensated subjects of the risks of egg extraction. But to ban payments? I just don’t buy it.