Abstract
This paper explores one aspect of the social implications of new reproductive technologies, namely, the impact such technologies have on our understandings of family structures and our expectations of children. In particular it considers whether the possibilities afforded by such technologies result in a more contractual and commodified understanding of children. To do this the paper outlines the possibilities afforded by NRTs and their commodificatory tendencies; second, it explores the commodification debate using the somewhat parallel example of commodification of organs; and third, in light of these debates the link between the commodification of body parts and persons is addressed. It will argue that there is a prime facie connection between body parts and persons and thus, although needing to be balanced with other ethically relevant factors, commodification remains an issue of ethical concern. Accordingly we should only be supporting potentially commodifying practices when there are ethically pressing reasons to do so (such as in organ transplantation). Moreover given this link between body part and persons we should attempt to lessen commodifying attitudes and thus should resist the increasing use of practices which regard children as having choose-able parts.
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Notes
Other social consequences could also be explored. For example whether or not genetic-relatedness should be given such high priority in a society where most children do not live with two genetically-related parents [19].
Physically the process of IVF is traumatic and demanding. Women undergo at best uncomfortable and at worst, potentially dangerous, processes of hormone therapy, follicle stimulation and egg harvesting. Moreover, the psychological stress that both women and partners are subject to in the process of ongoing IVF treatments is considerable; stress that is added to with every failed cycle of treatment [13]. The physical and psychological pressures are compounded by a significant financial burden: A cycle of IVF costs around £3000 to £4000. For many couples meeting the cost of the treatment means a severe reduction in quality of life. For example, one couple in a UK study spent £60,000 on consecutive IVF treatments which meant that, for the duration of the treatment they were unable to go on holiday, make repairs and improvements to their home and move house, all of which they report they would have done if they had not had to pay for treatment [4]. In addition to the risks to the woman there are also risks to the child, risks derived from the likelihood of multiple gestations. As Mary Mahowald notes “with each order of multiples, risks to both the fetus and pregnant women escalate” [5]. The risks for the child include not only increased risks in pregnancy and birth (such as respiratory distress and haemorrhage), but also long term risks and disadvantages associated with premature births [7, 18]. However the physical risks to the child are reduced as the possibility of multiple births is reduced—something which is increasingly legislated for (it is best practice in the UK is to implant one embryo).
The Yuk factor is used in bioethics to refer to an emotional rather than reasoned rejection of certain scientific advances. Rather than providing reasons, a practice or procedure is rejected out of hand as ‘revolting’, ‘repugnant’, ‘repulsive’ and ‘grotesque’. The term was used particularly with regard to the cloning debate—procedures which were initially uniformly rejected as unethical, and even inhuman—despite the obvious naturally occurring instances of clones in the form of identical twins. This is the classic example of the ‘yuk’ factor at work—and it is something that bioethicists tend to take seriously as they attempt to unearth moral significance behind such rejection [6].
Questions of commodification are also raised in the parallel debate about ‘saviour siblings’ in which a second child is created as a ‘match’ for the first [17].
The website suggests that you should use their services to have a ‘better child’ or in the vocabulary of Rons’ Angels “a better version of you” [12]. It suggests that to do so is to give the best to your child as; “Beauty is its own reward. This is the first society to truly comprehend how important beautiful genes are to our evolution … Any gift such as beauty, intelligence or social skills will help your children in their quest for happiness and success” [12].
There is a parallel debate about ‘baby selling’ and surrogacy which is also relevant to this discussion [21].
For example such an argument is put forward by Julian Savulescu, who argues that “If we should be allowed to sell our labour, why not sell the means to that labour? If we should be allowed to risk damaging our body for pleasure (by smoking or skiing), why not for money which we will use to realise other goods in life? To ban a market in organs is, paradoxically to constrain what people can do with their own lives” ([15], pp. 138–139). For Savulescu seemingly the only, ethical issue is that of autonomous choice, thus he argues “Think about a couple with two young children who are contemplating buying a house. They find one for £150 000, but in a heavily polluted and unsafe area. They could spend another £50 000 and live in a cleaner safer area. But they decide to save the money and expose their children to a greater risk in order to pay for private education….People take risks for money. They judge that the benefits for their own lives or their family’s outweigh the risks. To prevent them making these decisions is to judge that they are unable to make a decision about what is best for their own lives ” ([15], p. 139). In this framework ethics is simply about choice and the avoidance of the curtailing of choice thus commodification and all other issues are irrelevant.
This argument address what constitutes a commodity namely its lack of subjectivity, its instrumentality and its fungibility [20]. First, a kidney is not conscious nor does it have feelings; second, it has instrumental value only, in the sense that it is merely a means in the transplant process and third, it is replaceable with any other kidney or money. However, even on these terms it is not clear that this is the end of the argument—for example, although in one sense it is true that for the recipient one kidney is replaceable by any other kidney, in the current landscape of scare resources the kidney is in some senses ‘priceless’ and thus not obviously or easily replaced by money.
Third world kidney sellers have been studied in India, Iran, the Philippines, and Moldova and all suffer these experiences ([16], p. 1646).
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Widdows, H. Persons and Their Parts: New Reproductive Technologies and Risks of Commodification. Health Care Anal 17, 36–46 (2009). https://doi.org/10.1007/s10728-008-0107-7
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DOI: https://doi.org/10.1007/s10728-008-0107-7