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Silja j.a. Talvi
Silja j.a. Talvi
Stephen R. Shalom
Nonviolence Versus Capitalism
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Jan knippers Black
Eleanor J. Bader
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Assisted Reproductive Technologies
If youre shocked by the above advertisements, chances are you havent perused a college newspaper lately. If you had, youd know that such requests are commonplace. As student publications scramble for cash, advertising is widely seen as a savior, the provider of at least half the operating revenue for any given year. Call it reproductive capitalism, a laissez faire system of buying and selling on the open market.
Like cosmetic, fashion, and music promoters, advocates of reproductive capitalism specifically target college-age womenpreferably from Brandeis, Brown, Columbia, Harvard, Penn, Princeton, Stanford or Yaleas the laborers of choice. Consumers, in this case infertile couples, are lured by the prospect of a solution to their problem, a way to getor buywhat they most want: a healthy, smart, and socially adjusted newborn baby.
Assisted Reproductive Technology (ART) is big business and by all accounts it is expected to get bigger in coming years. In 1996 more than six million Americans spent approximately $2.6 billion on infertility care. The National Infertility Association, estimates that 25 percent of the total U.S. health care budget for that year went to treatment.
Jews, as well as Asians, are particularly hard-hit; one in three Jewish women reportedly has problems getting, or staying, pregnant. Abigail Pickus, in The Modern Dimensions of Jewish Infertility, attributes this to the tendency to forestall pregnancy until graduate or professional degrees are completed.
Statistically, the facts bear her out. Infertility among 35- to 44- year olds is 21.4 percent. Among 15- to 24-year olds it is 4.1 percent. Whats more, women over 40 have a 30 percent higher infertility rate than younger women. While the causesfrom aging eggs to tubal and ovulatory disorders, endometriosis, and low sperm countsare well documented, the ethical and moral concerns surrounding the treatment of fertility problems are not as widely or publicly discussed.
Take egg donation. To begin, not every fertile woman can be a donor. Fertility Awareness Inc., a San Diego, California agency that deals with the problem, is one of hundreds of private, for-profit programs that run without government oversight or regulation. Marketing themselves as specialists in Jewish surrogacy and egg donation, they require donor candidates to be between the ages of 19 and 31. According to their website (www.offc.com/fertility- alternatives/news.3371) all donors are attractive, intelligent and healthy physically, emotionally and genetically. As well they must be within normal height/weight ranges. Absolutely no smokers, drug users or obese applicants will be accepted. The group also boasts another category of donor. Called exceptional women, these donors are under 30 and have a college degree or are currently attending a major University, with excellent grade point average [3.5+] and SAT/ACT scores [1400+SAT]; [28+ACT]. These donors also have proof of their academic status or are willing to undergo an IQ test if requested.
Once a donor passes an arduous physical, psychological, and genetic screening processincluding tests for HIV and other sexually transmitted diseasesshe, the agency and the intended parents negotiate a compensation rate. Although the sale of body parts is illegal in the United States, egg donors typically receive between $2,500 and $50,000. Dubbed a donation, the payment allegedly compensates the donor for inconveniences encountered. And what inconveniences they are.
The process begins with a visit to an endocrinologist who prepares the woman for egg retrieval. This involves daily hormone injections for between four to six weeks. During this time the donor must be sexually abstinent. Among the hormones used is Lupron, a drug that puts the body into a temporary menopausal state complete with hot flashes, nausea, and vaginal dryness. A follicle stimulant is also administered. This causes severe bloating as the ovaries become larger and larger; the swelling usually lasts two-to- three weeks after the eggs are retrieved. Another drug, HCG, is administered intramuscularly exactly 40 hours before surgery. The operation is done laparascopically, on an out-patient basis. Fifteen to twenty eggs are usually retrieved, a number five to six times higher than the number released without hormonal intervention.
About 48 hours after the eggs are gathered and combined with sperm in a petri dish, the intended mother is inseminated with 3 to 4 embryos. Within 2 to 3 weeks she will know if she is pregnant, a victory claimed by 25 to 35 percent of In Vitro Fertilization (IVF) patients. Despite this relatively low rate of success, one in five multiple births is attributed to IVF. The process will cost the intended mom between $15,000 and $25,000.
Meanwhile, the egg recipient, like the donor, has been pumped full of hormones to increase her receptivity to implantation. Numerous side effects are likely to ensue, including hot flashes, headaches, irritability, joint pain, and breast swelling.
Beyond the not insignificant physical risks of egg donation, retrieval, and implantation lie other concerns. Among the most controversial: the issue of designer babies, infants intended to bear the physical and intellectual characteristics most revered by Americans.
Barbara Katz Rothman, sociology professor and author of The Book of life: A Personal and Ethical Guide to Race, Normality and the Implications of the Human Genome Project, is horrified by what she sees as the resurgence of eugenics and by the classism implicit in fertility marketing. In a system of donating gametes in which banking is the dominant metaphor, sperm and eggs are naturally sorted by worth. That forces us to confront the question of what makes for worth in human beings. We dont like to speak about eugenics anymore, but it is hard not to think of eugenics when people are actively seeking the very best genes money can buy, she says.
Tali Amit, a 21-year-old senior at Brandeis University, likens the process of creating a perfect child to wishful thinking. You can have Einsteins genes but certain things in the environment can stifle intellect or nurture it. You can be born with average intelligence but there is a big environmental component to who youre going to become as a person. I dont understand people who make a plan for what their child will be. Will they love the baby less if she or he doesnt meet their expectations?
Sara Lieberman, a teacher and mother of six, is also leery. I find it repulsive, she says. What do you do if you dont get the perfect child, keep it for 30 days and put it up for adoption or drop it off somewhere like an unwanted puppy or rabbit?
Jamella Jones, a scholarship student at an Ivy League college, sees the ads in her campus newspaper as a personal affront. Why arent the people looking for egg donors asking for me, a smart, tough, low-income woman who works incredibly hard, a biracial person with what it takes to excel as a minority in a mostly white upper-class school? she asks.
Indeed, what does it mean that eggs are sold on the open market, like any other commodity? Rabbi Tsvi Blanchard, Director of Organizational Development at the National Jewish Center for Learning and Leadership (CLAL) and a psychologist in family practice, says, We dont see the problem with other types of organ donation. This problem only occurs when we turn human beings into commodities who are in economic exchange. You want to make the case as clear as possible. One woman needs an egg and another freely agrees to give it. It should be consensual, just as it is when people die and leave their bodies to medical schools.
For Blanchard, the goal should be the creation of a repository in which resources are shared, not sold. The Jewish community could create a fund of eggs for women who need them. Theyd be available as an act of chesed, an act of love. Health risks aside, he argues that colleges would be better off creating this kind of program for women experiencing problems conceiving than in publishing ads for the sale of body parts.
From a rabbinic point of view, he adds, the narrow self involvement that says, if I can have it who cares about you, is a horror. Jewish moral vision is about a covenantal relationship between human beings. The thing that destroys the relationship between people within a society and between God and society is the focus on my, me, mine. In America were enamored of individuality. Choice and autonomy are good values but they get strained by an obsession with individuality and commodification of the individual. Were in this together but thats not how we treat one another. In America, if you want to have a child but cant, its not my problem unless you want to buy a solution from me.
Gone unchecked is the social insistence that a woman is incomplete if she does not bear biological offspring. Likewise, the insistence that this is an individual problem, born out by the fact that fewer than one-third of health insurance plans cover infertility treatments, is both shortsighted and frustrating.
There are thousands of children available for adoption, says New York City reproductive rights activist Tracey Davidoff. These kids are here, in the flesh and in need, but most people who purport to be devastated by their inability to have a child reject them. Instead, they seem to believe that without a biological connection, a child is not fully theirs.
Still, Davidoff does not completely reject technology. Carry- ing an embryo created by someones egg and your partners sperm is certainly an option for those with the money to buy it, she says. But the political implications of egg selling and retrievalespecially when particular kinds of eggs are purchasedare really very scary. Are we sure were ready for a Brave New World where white skin, tall, thin bodies, high standardized test scores and heterosexual behavior trump every other possibility? I shudder at the thought. Z
Eleanor J. Bader is co-author of Targets of Hatred: Anti-Abortion Terrorism, published by St. Martins Press. She is a frequent contributor to Library Journal, Lilith, and the New York Law Journal.