Friday, May 6, 2011

The hidden costs of commercial conception

Damian Adams | Thursday, 5 May 2011

What price baby bliss?

Social acceptance of commercial conception ignores all the hidden costs.



It is often said that we cannot put a price on happiness. However, for those who are medically or socially infertile, happiness has a dollar value. For the first time in history adults can use technology to create their babies, with the only restriction being their ability to pay.

Accessing “donated” gametes has become increasingly easy with websites such as SpermBank California offering semen for US$300 to 500 per vial, while egg donation services from providers such as Fertility Bridges range from $3,500 to 35,000 or more. A child carried by an overseas surrogate can be arranged for as little as $22,000 through companies such as Medical Tourism Corporation. Many of these companies and clinics provide catalogues of available donors whose profiles contain information about such factors as academic and sporting prowess, in addition to photographs.

Are we, then, moving towards the acceptance of eugenics as well as commercialism in the begetting of children, or does this just continue the normal process of mate selection for procreation?

To answer this question we first have to look behind the language of the baby industry.

Is it correct to speak of “donors”? To donate is to give without expecting anything in return. In the reproductive industry there are few truly altruistic donors; the vast majority are either paid or reimbursed for “legitimate expenses”. In any case, a financial transaction has taken place. “Reimbursement” is a weasel word.

Donating blood is more invasive and time consuming than donating sperm, but no money changes hands. A better term than “donor” is supplier.

It is difficult not to believe that the main motive for donation and surrogacy is money. Research indicates that financial gain motivates both egg donation and sperm donation when it occurs in a commercial environment. While it may be nice to think that poor surrogates can use the money to better their families’ lives, at what point does a society accept or condemn the use of the human body to construct a family for those who can afford it? Whenever money is involved, there is always the potential for illegal and immoral exploitative treatment of those less fortunate, as we saw in a Thailand surrogacy ring earlier this year. Would any of these women have been so altruistic if money were removed from the equation?

While the term “patient” is reassuring and respectable, I prefer the word “customer”. After all, the father or mother’s infertility remains uncured after the transaction.

Nor is the process without its physical costs. Commercial conception and the need to provide good success rates lead to multiple embryo implantation for IVF cycles which is now known to be causatively linked with an increase in morbidity and mortality of the foetus.

Egg donors can suffer ovarian hyperstimulation syndrome which can lead to hospitalisation and, more rarely, sterility and death.

Hidden costs

It is the emotional costs, however, that are increasingly coming to light.

Everyone sympathises with the pain of childlessness. But is commercial, artificial reproduction utilising “donated” gametes or wombs the answer? Achieving happiness through artificial reproduction soothes the customer’s immediate pain by deferring it, although the pain can potentially be passed on to their children.

For recipient parents there is deferred emotional cost. Typically, one parent will not be biologically related to the child. Raising what can be viewed as another person’s child can undermine the relationship between the non-biological parent and the child. It may create an unequal balance of power between the raising parents. This may be why there are higher divorce rates among couples utilising donor gametes. For those maintaining secrecy the burden of preserving the deception may also weigh heavily on their mind.

Donors suffer, too, sometimes for the rest of their lives. What does their child look like? Why can’t they link up? This may not happen at first, but frequently their attitudes change over time. The same can happen for surrogates as reported recently. Contending with the idea of selling your biological children or your body to someone else is a difficult process to navigate once a person’s thoughts turn to this different perception.

Then there are the costs to the families of donors and surrogates. Relatives must grapple with the notion that they may never meet or know their descendants or kin. This extends to not only the parents of the donor, who are the child’s biological grandparents, but also the child’s siblings, aunties, uncles and cousins. This family not only has to assimilate the emotional and physical loss of what they may view as a family member but that they may need to process concepts of that child being sold or given away.

Then, most importantly, there are the costs and pain suffered by the children. They are, according to the commissioning parent(s), the most precious of all. Yet their rights and welfare have been subordinated to adult desires and needs. The imbalance can cause lifelong trauma for the child which may be passed on to future generations. With the exception of same-sex couples, it is far too easy for the parent(s) to actively and deliberately deceive the child about the truth of their origins. In fact, most parents fail to inform their children. While some may argue, “what the child doesn’t know won’t hurt them”, constructing a family on a lie instead of on truth is clearly unethical.

The use of donated gametes deprives the child of their biological father/mother and associated kin, their heritage and place in the world, their identity, and a family medical health history which can be vital for their physical well-being. Not only does this provide ethical and moral concerns, it also contravenes the United Nations Convention on the Rights of the Child, which all countries except the US and Somalia have signed.

While there is a trend in countries such as the UK, Australia and New Zealand to use donors who are willing to be identified, deception by recipient parents places their own desires above the rights of the child. In any case, many countries, including the US, have anonymous donation systems and run their industry as a laissez-faire market place.

To know that one of the reasons you exist is because your biological mother or father essentially sold you for cash, thereby rejecting you and making you the equivalent of a piece of property is degrading and dehumanising.

I am donor conceived and I know. Many others of the Donated Generation have also expressed this view.

With increasing evidence that children born through donated gametes want to know their biological origins, that they are traumatised when they learn later in life that they have been deceived about their origins, and that, like adopted people, they have higher rates of mental, substance and delinquency problems, we must start to ask, “Is the cost worth it?”

Damian Adams is a medical research scientist at the Women’s and Children’s Health Research Institute. However, he is writing here as a Donor Conceived person. Damian lobbies for the welfare of children conceived through reproductive technologies as the paramount concern and guiding principle for a paradigm shift toward a child-centric ethos.

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Retrieved May 6, 2011 from http://www.mercatornet.com/articles/view/what_price_baby_bliss/

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