The ASRM - cough - I Mean HFEA Set to Enact Payment-for-Eggs Plan in Britain

The Observer in London points to a shocking move by the HFEA to increase the supply of eggs for embryonic stem cell research, following on the suggestions of the initial report by the new stem cell research association ISSCR:

Women who go through the medical procedure to harvest the eggs from their ovaries, which doctors describe as 'invasive' and possibly dangerous, will be paid 250 Pounds plus travel expenses, the existing maximum compensation for any egg or sperm donor. Anyone agreeing to donate will have to show that they are acting for altruistic reasons, for example because they have a close relative suffering with one of the conditions scientists are trying to develop new treatments for with the aid of human eggs.

What a fabulous decision, in light of the fact that HFEA was the last governmental organization to hold out for conservative policies with regard to this matter, against such outliers as the South Korean Hwang group, where payment for egg donation worked out so well that it resulted in the obvious oppression of women, including the most obvious donors - those who work in labs that need eggs.

Thankfully there were ethicists in the Hwang lab. Not so thankfully, they published a report claiming beyond a shadow of a doubt, on the basis of their very close observation of the egg donation process, that the Hwang group was doing a fabulous job, and that no coercion occurred, only to later back up a little bit, then retract their claim. Even less thankfully, the loudest claim to date by an ethicist to the effect that payment for eggs is a great idea is the same author of that article, whose observations led him to conclude that he was - quoting here - 100% certain of the ethical propriety of the Hwang group's procurement group. The group - remember them - that coerced at least one team member to donate eggs because she knocked a petri dish containing eggs onto the lab floor. Obviously it was a popular view among the ISCRR crowd who lack funding for stem cell research or a good supply of eggs - but a shortsighted view to say the least, and informed by zero research - except for that lovely article retracted from AJOB.

There are those who have suggested that perhaps there might be problems with payment:

There were also warnings last night that poor women could be tempted or coerced into taking part for the money. 'The HFEA could be unwittingly opening the door to barter or sale of eggs, including women in Britain as well as abroad, even though it is saying that women doing this would do so for purely altruistic reasons,' said Donna Dickenson, emeritus professor of medical ethics and humanities at the University of London and one of Britain's leading experts on the issue.

'The sum of £250 would still be enough of an inducement for women from eastern Europe, for example, to come to Britain to sell their eggs. That's clearly turning eggs into an object of trade and that's disturbing. Once the principle of egg donation for research is established, it will become harder to prohibit paid egg donation.'

But at the end of the day, HFEA will ignore the several leading stem cell researchers who begged it to reconsider on moral grounds despite the scientists support for embryonic stem cell research:

The HFEA, chaired by Shirley Harrison, is set to approve the policy despite a host of leading scientists voicing a range of concerns during the consultation process.

Some argued that the putative benefits of stem cell research had been exaggerated, while others highlighted the medical dangers to women who undergo the painful and invasive three-stage process to remove the eggs.

So a stunning move by Britain into the wild wild west of egg donation, and without data or careful regulations or a provision to re-examine the policy in short order on the basis of the experiences of women and clinics. At least it is stunning to me based on the work of our research group concerning the disposition of the Brits toward this sort of issue. To say nothing of the outstanding work by AAAS commissions chaired by among others Jonathan Moreno and Alta Charo, which counseled quite clearly of the issues here.

Close the Human Fertilisation and Embryo Authority?

Lord Robert Winston is arguably Britain's most distinguished and certainly most outspoken participant in the IVF debates. Today, he proposed something that will be seen as absolutely outrageous in the rest of the developed world, which admires Britain's HFEA. The HFEA is responsible for all sorts of regulations, research and policymaking in reproductive technology, ranging from the storage of embryos to the selection of sex to the cloning of embryos for stem cell research. Winston says shut them down.

And he has recruited some unlikely allies. The big problem in the critics' eyes is that HFEA believes its own publicity, thinking it cannot really improve much. Because of this, say Winston and others (including Josephine Quintavalle, spokesperson for Comment on Reproductive Ethics), they miss the need for big reforms. What's needed? A great big bioethics committee for HFEA. Hard to see why the HFEA would benefit from that, given that ethics committees of that sort very, very rarely work as intended. But perhaps the British critics of HFEA are as sharp as those who brought that 'brilliant' institution to life.

Wilmut the Clinical Researcher

Ian Wilmut has applied to HFEA for a permit to investigate potential cell therapeutics for ALS, using human embryonic cells produced through cloning. The news announcements, even this one come from a short news conference so little is really known. Wilmut's presence in this area at this time could scarcely be more volatile for the US election-year debate about "who will get ahead" in hES research under US restrictions.