A few weeks ago, Aaron D. Levine (Assistant Professor, Georgia Institute of Technology) visited my Taboo Trades and Forbidden Markets seminar in advance of the release of his Hastings Center Report: Self-Regulation, Compensation, and the Ethical Recruitment of Oocyte Donors. The report represents an important effort at bringing empirical analysis to bear on questions that are often answered largely through anecdote: who are egg donors, how much are they paid and why, and how are they found? (Paul Caron has links to the extensive media coverage).
The report uses a novel data set—a collection of oocyte donor recruitment ads published in college newspapers across the country—to assess the extent to which advertisements that recruit donors comply with the ASRM guidelines for compensating oocyte donors, which specify maximum compensation levels of $5000, in the absence of justification, and prohibit compensation above $10,000. Levine finds that $5,000, the maximum compensation level acceptable under the ASRM guidelines without justification, was both the modal and median value among the set of 105 advertisements.
Roughly 50% of the advertisements offered compensation in excess of $5000 and roughly 23% offered compensation in excess of $10,000. Some of the ads offering more than $5000 and most of those offering above $10,000 also contained appearance or ethnicity requirements, which is prohibited by the ASRM compensation guidelines. Finally -- and this is the portion of the report that has generated the most media attention -- Levine’s data strongly suggest that donor agencies and couples are placing more value on oocytes donated by women with higher SAT scores, which would violate the ASRM guidelines. Indeed, in one model, an increase of one hundred points in the SAT score of a typical incoming student increased the compensation offered to oocyte donors by $1,930 for general advertisements placed by donor agencies; by $3,130 for advertisements placed on behalf of a specific couple; and by $5,780 for advertisements placed by a donor agency on behalf of a specific couple.
It’s a testament to Aaron’s good nature that he’s still friendly to me, after I first invited him to Duke for a workshop, then attacked his paper for an hour and a half. (I did buy several rounds of drinks at the Washington Duke as reimbursement, as I’m a strong believer in just compensation). Though Levine’s research brings much-needed empirical insight to bear on questions of egg donor compensation, I very much disagree with the report’s normative position – that the ASRM oocyte donor compensation restrictions are justifiable and their violation a cause for industry, public, and government concern.
The report’s conclusion relies on three highly contestable assumptions: (1) that oocyte donor compensation is commodifying; (2) that oocyte donor compensation, especially at high levels, is coercive or exploitative; and (3) that selecting and compensating oocyte donors on the basis of personal characteristics, such as ethnicity or intelligence, is ethically problematic. The first two assumptions – commodification and coercion – are ones that I’ve critiqued at length, both in recent scholarship (see here and here) and on this blog (see the links below).
But the third assumption – that selecting and compensating oocyte donors on the basis of personal characteristics presents ethical problems – is dubious as well. The fertile have always selected reproductive mates based on qualities such as appearance, race, ethnicity, and intelligence. Their sorting process is normally more subtle than a four or five figure advertisement in a prestigious college newspaper, but the infertile have fewer options at their disposal and the end result is the same – some traits are more highly valued in a reproductive mate than others, a realization that should have no shock value among even the most sheltered of academic sensibilities.
In his response accompanying the report, John Robertson (Texas, law) questions whether there are really any ethical problems raised by the study – after all, Levine finds compliance with the ASRM guidelines in at least half the advertisements in his sample. I would argue, however, that Levine’s study highlights a serious ethical issue, though it is not infertile couples or the agencies working on their behalf whose behavior is ethically troubling. It is ASRM’s paternalistic and misguided attempts to control oocyte donor compensation through the same type of professional guidelines that courts have rejected when employed by engineers, lawyers, dentists, and doctors that should raise an ethical red flag.
U.K. Oocyte Raffle
How Is An Egg Donor Like A Prostitute?
Like A Virgin? We Sell That Here!
Sunny Samaritans or Entrepreneurs? New York Allows Egg Donor Payments For Stem Cell Research
A New Meaning To "Nest Egg"
U.K. To Reconsider Payments to Egg and Sperm Donors