Feminists divided over stem-cell politics
Monday, September 18, 2006
By: Lee Rominey - Los Angeles Times
Egg sales long accepted for fertility clinics, but controversial in research
Should a woman be allowed to sell her own eggs?
The question never triggered much debate in the private world of fertility medicine, where Ivy League beauties can earn tens of thousands of dollars per "donation."
But everything about stem cell research is political.
A spirited disagreement over payment has split feminists, with some calling compensation to research subjects coercive and others contending banning it is paternalistic. The dispute has some pro-choice organizations lining up on the issue with outspoken conservative Christian groups that oppose embryonic stem cell research altogether. It also has driven a wedge between two historic allies -- stem cell scientists and fertility clinics, which have long relied on an open market for egg sales.
The conflict has been building for years. Human eggs are crucial for stem cell research, but harvesting the eggs entails medical risks, some potentially lethal.
In California, hoping to pre-empt a controversy, the authors of Proposition 71 declared that scientists who received grants from the $3 billion California stem cell agency could not pay egg donors, but merely reimburse their expenses.
A bill now on Gov. Arnold Schwarzenegger's desk, sponsored by state Sens. Deborah Ortiz, D-Sacramento, and George Runner, R-Antelope Valley, would extend those payment restrictions to privately funded laboratories.
The Center for Genetics and Society in Oakland, Calif., and the Pro-Choice Alliance for Responsible Research in Los Angeles are the two most vocal supporters of the measure. Both describe themselves as staunchly feminist.
Emily Galpern, reproductive health and human rights director for the Center for Genetics and Society, said her fear is that without the legislation, poor and minority women would be exploited for their eggs.
While the group expresses some concern that women who sell their eggs for in vitro fertilization are being exploited, it notes that those donors tend to be white, well educated and well paid -- often between $5,000 and $50,000 -- because of their perceivedly elite genetic material.
Stem cell researchers, in contrast, are only seeking eggs as a vehicle for someone else's DNA so all viable eggs can be used, regardless of class or race. That, critics contend, will inherently prompt researchers to turn to poorer women, who may disregard the risks because of their need for the cash.
"How much money is enough to coerce a poor woman? And do we up the ante until they bite?" said Susan Fogel of the Pro-Choice Alliance for Responsible Research.
After pointed public debate, the stem cell agency created by Proposition 71 recently decided that women are entitled to only out-of-pocket costs, such as gas money, a restriction mirrored in the Ortiz-Runner bill.
The California Family Council, affiliated with the conservative Christian group Focus on the Family, has also backed Ortiz's bill on the grounds that a ban on payments would likely slow embryonic stem cell research, which the group opposes because present methods require the destruction of embryos.
Opponents of the bill, which also broadens informed-consent requirements, argue that it is paternalistic to assume women can't make an informed choice on their own.
"I consider myself a feminist," said Pamela Madsen, founder and executive director of the New York-based American Fertility Association. "I get concerned when some women's groups say, `Oh, no, we have to make these decisions for women.' "
The American Society for Reproductive Medicine recommends paying $5,000, regardless of whether the eggs are used by scientists or fertility clinics. The group is pressing Schwarzenegger to veto the Ortiz-Runner bill.
Other critics point out that it's illogical to regulate payments to some egg donors but not others.
"Shouldn't we be worried about the women" donating eggs to fertility clinics? asked Radhika Rao, of the University of California's Hastings College of the Law and a member of a state commission that crafted guidelines for stem cell research. "If you pay women a lot and they're white, it isn't exploitation?"
Fertility clinics that have long distanced themselves from the politics of stem cells -- while providing left-over embryos for research -- have grown increasingly uncomfortable.
"The fertility industry really wants to have nothing to do with the stem cell issue," said Harvard Business School professor Debora Spar, who studies the politics of reproductive medicine. "They have been able to operate under the regulatory radar and are perfectly happy that way."
As the Ortiz-Runner bill moved through the state Legislature, the American Society of Reproductive Medicine and the American College of Obstetricians and Gynecologists successfully lobbied to ensure that the restrictions pertained only to research labs, not fertility clinics.
But as the issue grows more polarized, they fear a ban on human egg sales could spill over to them.
"That will be the end of egg donation," Madsen said. "It would be a disaster." -- Times staff writer Karen Kaplan contributed .
Payment vs. Exploitation
Researchers find the focus on payment puzzling. Ann Kiessling, director of the Bedford Stem Cell Research Foundation in Massachusetts, noted that banning it is no guarantee that women won't be exploited.
"They're only going to be protected by good medical care and fully informed consent. How well they're cared for is independent of whether they're going to be compensated."