Harvard University business professor, Debora Spar, has apparently written a remarkably silly book on the practice of assisted reproduction in the United States. According to the Harvard Gazette, Spar's new book, The Baby Business: How Money, Science and Politics Drive the Commerce of Conception, poses hard questions that show the crying need for regulation of the fertility industry. Reason's Kerry Howley has already taken Spar to task.
Nevertheless, I will answer a list of her allegedly "hard" questions below:
Should we, as a society, prohibit women from selling their eggs, their wombs, their embryos, or their children? NO
Should we allow parents to select traits of their children? YES
And who, in a world of fluid boundaries and invisible trade, gets to decide? Individual people seeking to be parents.
Will people protest when two lesbian mothers use cutting-edge techniques to conceive a child that is biologically 'theirs'? Probably, but it's none of their business if the techniques are safe.
Will ethicists object when women in Cambodia bear infants for middle-aged lawyers in New York?" Probably, but again it's none of their business if no coercion is used.
Spar says the business of babies needs a regulatory framework in order to define rights, lower prices, and expand access. Given that most people who interact with the assisted reproduction never complain or sue, she has no evidence that regulation is necessary.
One of her primary concerns is the lack of clear property rights in current law: "Who owns human embryos? The would-be parents do. Do clinics? No, unless the would-be parents donate their embryos to the clinics. Do parents? YES. Though they may contractually decide in advance what should be done with embryos if they should later disagree.
What are the rights and responsibilities of sperm donors, and of the children conceived through donor sperm?" Whatever was contractually arranged at the time of the donation. See my colleague Kerry Howley's thoughtful treatment of gamete donation.
What about equity? "As a society, we need to think about what fairness means," Spar says. "Is the ability to reproduce a basic human right? NO
Is it part of medical care? NO. As emotionally devastating as it may be for some people, infertility is not classically a disease of individuals. However, assisted reproduction can be analogized to elective cosmetic procedures which physicians can make available to patients who want it and can pay for it.
And does it extend to all people, regardless of their age, sexual preference, and health condition? Generally YES, especially if we would not forbid similarly placed fertile people from producing children. Of course, physicians can choose not to offer their services if doing so violates their personal ethics.
Once we get even a rough consensus around this issue (even if it is forged at a state level) we can begin to craft policies that make sense. NO NEED FOR CONSENSUS. We have no consensus about which fertile people get to have children so we do not need a "consensus" for infertile people.
Where should we draw the line on what kinds of children people can create, and what kinds of technology they can employ? People may not seek procedures whose aim is to produce mentally or physically diminished children. That would be the moral equivalent of child abuse. They may employ any technology that can reasonably be thought to be as safe as current assisted reproduction techniques.
We've already said no to reproductive cloning. Actually, "we" have NOT said no to reproductive cloning at the Federal level, although some states do prohibit it.
The fertility "business" is not broken and doesn't need Spar's meddling fixes. If readers would like a fuller discussion of the future of the assisted reproduction, may I suggest purchasing my book Liberation Biology and reading chapter 5, "Hooray For Designer Babies!."
Special thanks to long time Reason subscriber Mark Lambert for the heads up.