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Some of the advocates of human GE say it's no more than a logical outcome of our consumerist economic system. They may have a point — though many of us think that's an argument for changing the system, not for letting technology run wild.

The modern fertility industry has benefited many people. Arguably, it has also regularly overcharged them (most particularly in the US), frequently inconvenienced them unnecessarily, and quite possibly harmed some of them. Its regulation leaves a lot to be desired, as almost everyone agrees, and that is partly why some people see an expansion of its product range as naturally including human genetic modification.

This chapter's section titles, below, are followed by

There are many more resources in the Appendix.













BOX 5.1 "Can You Make My Kid Smarter?"

BOX 5.2 Got Eggs?

BOX 5.3 Acronyms Relevant to the Fertility Industry

BOX 5.4 The Expanding Industry of Reproduction

BOX 5.5 The Cost of ART Services in the US

BOX 5.6 Comparison of US with European ART Costs

BOX 5.7 MicroSort® — Your Tax Dollars At Work




No one is going to force you to to have designer babies. Not exactly. What they hope to do is sell them to you. Gregory Stock (see Chapter 10) predicted in his 2002 book, Redesigning Humans, "With a little marketing by IVF clinics, traditional reproduction may begin to seem antiquated, if not downright irresponsible. One day, people may view sex as essentially recreational, and conception as something best done in the laboratory."

This is not a joke. Stock may be playful, and deliberately provocative, but he is also absolutely serious. He presents what he calls "Germinal Choice Technologies" as consumer issues, which is the common line among advocates of Human GE. And what can be bought will of course be sold (see Box 5.1).

Forget about mad dictators, cloned armies, and superhuman spies; think instead about advertising and carefully directed peer pressure. It's not the government that's going to promote human genetic engineering, it's commercial interests. What they want to do is keep the government out of it.

Why do advocates of Human GE think this is plausible? Because it's only one step on from what's happening now, particularly in the US. We already have:

  • routine small ads for "egg donors" (with cash almost always in the headline)
  • TV ads for a breast cancer test that 99 percent of women don't need
  • a reality TV show about multiple cosmetic surgeries
  • a patient using a billboard to solicit a liver donation
  • sex selection being advertised in the New York Times

Some of what's happening would be illegal in many countries [and some states]. ... Basically, the market rules. One of the leading entrepreneurs in the area refers to his operation, the Reproductive Genetics Institute of Chicago, as being "at the core of capitalism." He's right. In fact, for better and worse, that is how the fertility industry has always been, in the US. As the noted legal expert Lori Andrews has pointed out:

In vitro fertilization itself was applied to women years before it was applied to baboons, chimpanzees, or rhesus monkeys, leading some embryologists to observe that it seemed as if women had served as the model for the nonhuman primates. ...


Selling Organs

The sale of human eggs is illegal in most countries. Indeed, society has forbidden most kinds of organ sales. Selling your own, or anyone else's, kidney is not legal in the US, and has not been since 1984, when the National Organ Transplant Act ended the practice. This followed a scandal that flared up when a doctor attempted to formalize what had been developing as an anarchic market. (1)

There remains, however, significant support for the idea among some supposedly "respectable" thinkers, such as the prominent British philosopher John Harris, joint Editor-in-Chief of The Journal of Medical Ethics:

"First, it is hypocritical to think that denying poor people an opportunity to sell one of their few saleable assets is doing them any favors, at least so long as no attempt is made to alleviate their poverty in other ways." (2)

The last clause is significant, and suggests (rather obviously) that there are far more humane approaches to the problem of poverty. However, several surgeons have recommended legalizing organ sales, notably in Britain, and libertarians also tend to be strongly in favor of the practice.

Even though it is illegal, there is still a major international black market in kidneys. China and India are both believed to have large dealers and there are credible reports of traders haunting slums in Brazil and the Philippines with offers of up to $10,000 for a "donation." (3) In rural Nepal, some people are so desperate that they have sold kidneys for a promised $2,100 — and been cheated out of at least half of that.

Is this the kind of human society we want to move towards?

(1) Andrew Kimbrell, The Human Body Shop, Regnery Publishing, Inc., Washington, DC, 1997, p. 30

(2) John Harris, "This won't hurt... your bank balance," Guardian, 12/04/03

(3) "Sale of Human Organs in China," Michael E. Parmly, State Department, Congressional Testimony, 06/27/01; Parvathi Menon, "Against the organ trade," Frontline India, 05/11/02; Michael Wines, "14 Arrested in the Sale of Organs for Transplant," New York Times, 12/08/03

(4) Charles Haviland, "Nepal's Trade of Doom," BBC, 09/21/04



Free Documents from the Web

Links were checked and functioning as of 5/08/05; they are supposed to open in new windows. Please report broken ones.

Our Bodies Ourselves (OBOS) is active in several related areas, including the issues of fertility drugs and direct-to-consumer advertising of drugs and medical procedures, not necessarily conducted with reproductive services. The book is, of course, a classic, whose 2005 edition is well supported on the website.

Marcy Darnovsky, "Revisiting Sex Selection: The growing popularity of new sex selection methods revives an old debate," Genewatch, 01/03

The Centers for Disease Control and Prevention (CDC) Assisted Reproductive Technology Reports include annual lists of ART success rates and a general overview of the industry. They are available as web pages or large (over 2mb) pdf files.

The American Society for Reproductive Medicine (ASRM) website includes a number of fact sheets for patients, as well as information for professionals.

The Society for Assisted Reproductive Technology (SART) has over 370 practice members, representing more than 95% of the ART clinics in the US, according to its website, which also includes the 65-page document A Patient's Guide to Assisted Reproductive Technologies, available as a pdf (165k) or very large single web page.




Lori Andrews, The Clone Age, Henry Holt and Company, 1999, is the most easy-to-read, and yet authoritative, book on any of the issues related to Human GE and, despite its title, largely about the ART industry.

Gregory Stock, Redesigning Humans: Our Inevitable Genetic Future, Houghton Mifflin, 2002. The 2003 paperback edition, published by Mariner Books, has a different subtitle: Choosing our genes, changing our future.

Alan Lightman, Daniel Sarewitz and Christina Desser, eds, Living with the Genie: Essays on Technology and the Quest for Human Mastery, Island Press, 2003