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January 27, 2005

Morality's Exchange Rate

Multiple angles of the following spin from Pamela Madsen, executive director and founder of the American Fertility Association, "an advocacy group for fertility patients," is head-thrashingly hard to swallow:

Isn't it a travesty that American couples are forced to leave our great nation because only 14 or so states require insurance companies to treat infertility? Less-developed countries, nations struggling with war, understand the importance of family. What does it say about the value we put on families and children?

But I'll leave aside the implication of requiring — by law — anybody who offers insurance to cover particular services or treatments in order to hone in on this morally contemptible attempt at a social guilt trip:

Less-developed countries, nations struggling with war, understand the importance of family. What does it say about the value we put on families and children?

The specific context is a trend toward Americans' seeking in vitro fertilization treatments to other countries to cut expenses:

... help came through a call to Dr. Sanford Rosenberg, a fertility specialist in Richmond, Va., who had started a program capitalizing on lower medical costs overseas. By using an egg donor from Romania and having the eggs fertilized in Bucharest and shipped back to the United States, the Butuceanus cut their costs to $18,000, including enough fertilized eggs for repeated efforts. ...

The vast majority of Americans who are infertile look for help close to home. A small number, though - no one keeps an official count - are seeking help in places like South Africa, Israel, Italy, Germany and Canada, where the costs can be much lower, becoming in essence fertility tourists.

The New York Times article by Felicia Lee from which I've drawn the above quotations emphasizes countries that make Madsen's "struggling with war" comment a little inapt, but "places like" is an extremely open phrase. As difficult as it may be for many in our secular culture, take both sides of the long-running debate between progressives and traditionalists seriously for a moment: What relevance does the fact that 44.5% of Romania's population lives below the poverty line have?

One particularly compelling moral thicket with any IVF that involves egg donors is the treatment of women as egg farms. That women should not be dehumanized in service of the procedure is almost universally understood, and in the United States, it would hardly be unreasonable to suggest that women's dominion over their own bodies has pushed public opinion over the line to legality. There remains something, well, creepy about taking advantage of poverty or the less devastating financial need of young college students to acquire their eggs, but most Americans will understand their right to consent.

Now move this moral balance to Romania, where trafficking in women is widespread and "children in Bucharest are easy prey for child prostitution tourists." Among those willing to sell entire women, separating their eggs is merely maximizing profits. Under poverty so crushing that children must turn to selling sexual favors, the ability to freely consent to egg donation cannot so easily be taken for granted.

Ms. Madsen would surely qualify her statement, if asked, and one must always be wary of extrapolating views from short quotations placed in a specific context in newspaper reports. Nonetheless, to step on such people in order to fling advocacy rhetoric concerning the value that Americans "put on families and children" raises questions about the value that the advocates place on such moral considerations as human dignity.

Posted by Justin Katz at January 27, 2005 1:25 PM