THE LEGISLATURE is about to pass a bill that threatens the future of stem cell research in our state. The bill prohibits stem cell scientists from offering compensation to women who agree to provide essential raw material for this promising research -- human eggs. It’s a shortsighted law, both in its ethics and in the threat it poses to the nascent field of regenerative medicine.
Proposition 71, the 2004 initiative that authorized state-funded stem cell research, already prohibits the use of taxpayer money to pay egg donors. The current bill applies the same prohibition to all research, regardless of the funding source. The National Research Council has recommended a no-compensation policy, and Connecticut and Massachusetts recently enacted laws to this effect.
The primary justification offered for banning compensation to egg donors is that financial incentives will unduly induce women, particularly those of lower socioeconomic status, to undergo egg extraction without fully considering the significant risks and inconveniences associated with the weeks-long process, which requires hormone injections and minor surgery. Money, it is argued, will enable overzealous scientists to coerce women to become egg providers.
This argument relies on an unusual and indefensible view of what constitutes coercion. In a free-market economy, financial inducements are ubiquitous, especially when socially valuable activities entail some degree of risk or inconvenience. Coal mining is dirty and dangerous work, but we don’t claim that paying miners is coercive and expect altruists to do the job for free. Certainly there is no movement afoot to ban payments to soldiers or peace officers in the name of protecting them against placing themselves in harm’s way for profit. In fact, just the opposite. We sometimes provide extra hazard pay to public servants who take on the greatest risks in recognition of their valuable contributions.
If anything, ethics requires the affirmative compensation of individuals who sacrifice so that the rest of us can reap the benefits of biomedical research. Medical research subjects commonly are paid a fee for their participation. There is no justification for ushering women of reproductive age into a separate and wholly unequal category -- ineligible for compensation solely because of the nature of their research participation.
In addition, there is no reason to believe that the paternalism inherent in a no-compensation policy is justified. A 2001 study looking at the effects of compensation on egg donors found that doubling payments as a way of inducing women to serve as donors had no effect on the social characteristics of the donors. Even when fees were increased, the pool of donors remained socially and psychologically constant. In other words, economic necessity didn’t warp the decision-making process any more than an altruistic urge to provide eggs. More money didn’t skew the donor pool toward poorer women.
As important, if payments are banned and researchers must rely on unpaid donors for eggs, scientific progress will be placed in great peril. There is no law prohibiting compensation for eggs provided to infertile couples for reproductive purposes, and women who are paid generally receive $5,000 for a cycle’s worth of eggs, sometimes more. So stem cell researchers would not only need women willing to make their eggs available for free but women willing to forgo a substantial amount of money in the bargain.
Not surprisingly, stem cell researchers in Massachusetts are beginning to report on the futility of attempting to recruit volunteers willing to undergo the rigors of egg extraction for no return.
Women should not be required to be totally altruistic when it comes to helping the many through medical research, especially when they can be mercenary in the aid of the childless few. It turns out that women are more than capable of understanding this calculation. Creating a system that offers only risks and no benefits could end stem cell research before it can really begin.