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Reproductive Tourism

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This kind of out-of-control globalization, wherein wealthier women are able to rent the wombs of poorer ones, makes me extremely uncomfortable.

I’m certainly sympathetic to the plight of couples who can’t conceive for whatever reason. And it certainly makes sense for women to voluntarily carry someone else’s pregnancy if it means making a lot of money. But I think it’s possible to be skeptical of this situation without passing judgment on the people involved in it, most of whom are doing the best that they can in tough circumstances.

An article published in The Times of India in February questioned how such a law would be enforced: “In a country crippled by abject poverty,” it asked, “how will the government body guarantee that women will not agree to surrogacy just to be able to eat two square meals a day?”

One could argue that surrogates are simply providing a service like any other. But I’m not sure that we want to turn reproduction into a service industry. The inequalities here are so stark — and the carrot of thousands of dollars so tempting for women in a country with astounding poverty rates — that writing if off as purely business is inadequate.

“Surrogates do it to give their children a better education, to buy a home, to start up a small business, a shop,” Dr. Kadam said. “This is as much money as they could earn in maybe three years. I really don’t think that this is exploiting the women. I feel it is two people who are helping out each other.”

Mr. Gher agreed. “You cannot ignore the discrepancies between Indian poverty and Western wealth,” he said. “We try our best not to abuse this power. Part of our choice to come here was the idea that there was an opportunity to help someone in India.”

In the Mumbai clinic, it is clear that an exchange between rich and poor is under way. On some contracts, the thumbprint of an illiterate surrogate stands out against the clients’ signatures.

Thoughts?


58 thoughts on Reproductive Tourism

  1. Yeah, this to me is like organ sales — the need is compelling (infertility, kidney disease) but it’s just so damning that only poor people are “choosing” to fill the demand. There are some things you just cannot be allowed to ask of others, EVEN if they would say yes.

  2. “It’s just a regular business transaction” cuts both ways. Could any wild-eyed Communist propagandist of a century ago have invented a more hyperbolic caricature of the evils of capitalism?

  3. I’ve always felt that your body was intrinsically part of you, and selling it is slavery. Giving it away voluntarily is one thing, because you give yourself away to your friends and family all the time. But selling it: that’s an entirely different story.

  4. Though I am unable to have children myself, I just can’t wrap my mind around the idea of going to a foreign country to get someone else to carry my baby. I adopted, and I think that even if someone offered to do it for free, I would rather adopt again rather then using a surrogate. It just seems … I don’t know weird and uncomfortable. And there are so many children who need homes…

  5. This reminds me of the situation in “A Handmaid’s Tale”, and anything that reminds me of that situation makes me extremely discomfited.

  6. I think of it this way: As I understand, Amazon.com hires people to trawl through its thousands of pages and flag up duplicated webpages. They do this because there is no bot program complicated enough to to it for them, this is known as artificial artificial intelligence.

    This strikes me as the same thing – we dont have artificial wombs, so artificial artificial wombs will have to do. I really dont see this catching on though.

  7. I’m worried about this too…not only because it seems so exploitative of poor women, but also because there are so many children who are already here who sure would like homes. Why fly to the other side of the globe to get a child when there are hundreds of thousands right here in America who desperately need parents?

    I have a feeling that the answers to that question might piss me off just a bit. It’s actually cheaper, maybe? Then shame on you; if you can afford to fly to India and maintain a surrogate pregnancy, you could have afforded to adopt. The kids in our orphanages are too old, you say? Boo. You want an “exotic” baby that will make you the envy of your husband’s country club, but you won’t adopt an African-American kid? BOO.

    I understand the desire and the biological urge to pass on your own unique genetic package, but come on. As overpopulated as we already are, the wish to go to such lengths…I can’t understand.

    There has to be a way to help these poor women that doesn’t turn them into brood mares.

  8. I think there are some overlaps with some previous discussions of sex work that are worth looking at. In both cases, we of course have to look at the overall economic context as part of the picture: the relative lack of options for survival, for making money, for getting ahead that some people have compared to others, and what that means for the labor market — for people who are buying services or labor, whether that’s Kathie Lee paying kids in Honduras to make clothes for her, sex tourists going to Thailand and paying for it, rich infertile couples going to India to rent poorer women’s wombs. Heck, even video game players in wealthier nations now rent the time, keyboard labor, and gaming skills of video game players in less wealthy Asian countries (especially China and Indonesia) to play games for them since they don’t have enough time!

    I hope it’s clear that I’m not saying any of these things are equivalent — but they all take advantage of massive differentials in power, wealth, the global economy, exchange rates, etc to rent other people’s time and bodies for the purposes of the wealthier. But that’s the basis of industrial capitalism. If you support capitalism — or even tacitly accept that at the moment, it’s what we have to work within to effect change — then I think the questions are:

    a) how do we improve material conditions and available choices for people on the labor end of the equation? how do we make sure they have autonomy, rights, better conditions, more options for what they can do in life, better ability to set prices, the option to leave a line of work or take it up, etc

    That’s the labor rights angle, which is used by a lot of the international sex workers’ rights movement as well (as I understand it). I think it can be used as a lens here too — and there are some advantages vs. more underground forms of work, because as far as I can tell this is legal, the women are not being coerced, the conditions are good (and the people paying have an interest in making sure they’re good, because of the nature of the work) etc.

    But the other question is:

    b) where do we draw the line? Are there places where we insist capitalism cannot go? Obviously the default assumption is that you can pay for the labor of someone’s body, within certain bounds (no children, nothing that kills or harms the laborer TOO much). But are there other areas that we ought to declare off limits?

    We don’t let people sell organs, even a single kidney, because it involves obvious physical harm and reduction in bodily function and capacity in exchange for money. We want to avoid the resulting effects.

    Also, a central rift in the debate over sex work is about something similar: whether anyone can truly consent to renting the use of their body in certain ways, or whether it’s too inherently harmful / degrading for anyone to consent to without some kind of mental problem or false consciousness. (It’s probably obvious that I think this point of view is incredibly patronizing to sex workers who choose to do sex work, even if they have limited choices.)

    So what are the characteristics of surrogate motherhood? Someone’s body — and kind of their entire body, because it’s not like you can detach a womb, and the health of your whole body is closely related — is being rented for nine months. I think the biggest problem here has to do not with the sanctity of the womb or anything like that — people should be able to do whatever they want with their wombs, right? (Hello reproductive rights.) It has to do with the term and termination of the economic arrangement. What if a woman wants to quit? How does that work? What about getting attached to a nascent being that’s developing towards life inside of you? The choice of the surrogate mother in this arrangement is probably pretty prescribed, especially due to the power & money differential. But if a woman cannot decide to quit this kind of job, that’s a labor problem and a problem of bodily self-autonomy. And that might be why several states in this country have declared that although surrogacy may not be illegal, contracts relating to it are unenforceable! I actually think this is an important concept, even though it may shaft potential surrogate parents. They are renting out some woman’s body for nine months — and I don’t think they should have the power to compel every single thing about that woman. Maybe a payment contract related to not smoking, drinking, or doing drugs. But the surrogate has to retain the right to terminate, just for starters; maybe they don’t get paid the big bonus at the end I think this is where it connects back to the first point — labor rights. And I think one of the reasons that “international outsourcing” is a concern is that there is more potential for abuse or using power to compel or abuse workers.

    This has probably been discussed more in great detail elsewhere. But if an arrangement could be reached in which a surrogate mother was definitely NOT a slave — where she had the ability to leave the job, to renegotiate, where her hands are not totally tied by a contract, or a power differential, or maybe even a ridiculous sum of money — then I think that would be a desirable situation, possibly even a model for what rental of your labor or body should look like.

  9. I adopted overseas. The reason we did that is we didn’t want to bond to a child then have the possibility of it being taken away. I just couldn’t face falling in love with a child then having someone change their minds later or a relative pop up out of nowhere. Now that we have our daughter we’re looking into the foster system to adopt again. One warning… be careful of slamming people who don’t want to adopt an older child. There can be many many things you will have to deal with when adopting an older child. For our child alone we’re dealing with Sensory Issues, RAD (Reactive Attachment Disorder), and speech delays. We take her to 2 therapists and she’s been in Birth to 3 and is now in Early Education. We adopted her at 16 months. The longer that children are in abusive/neglectful situations, the more likely they will have problems. Not that there aren’t rewards! Our child is a joy and I know of many people who’ve adopted older children and had wonderful outcomes. BUT there are times when the child’s issues are so bad that the adoptive parents disrupt the adoption. I would suggest reading “Toddler Adoption: A Weaver’s Craft” if you’re interested.

  10. Holly — sadly, advocacy for allowing organ sales is vociferous and they ARE allowed some places. Organ sales and paid surrogacy do have some overlap with paid sex. Unsurprisingly, men are far more likely to receive purchased organ transplants than are women. Articulating a persuasive ethic that says all of these practices are impermissible involves a hard fight against empty-headed “rational choice” and market logic rhetoric; and against racism and of course sexism. I must say I don’t think your discussion of how to make the rental of a woman’s womb more fair is a step in the right direction. I think we should be articulating an absolute “no” to all of these practices, and crafting policy in which penalties (if any) fall on purchasers and assistance goes to sellers.

  11. Antigone said it, I think, first in this thread: Selling one’s body. But it’s really not selling one’s body for parts, so I am skeptical of the organ sales analogy. More fittingly, I think, we might ask ourselves the following:

    In the economics of bodies, how is selling one’s body for child production services different than selling one’s body for orgasm production services? Is surrogacy another way of prostitution?

  12. “I have a feeling that the answers to that question might piss me off just a bit. It’s actually cheaper, maybe? Then shame on you; if you can afford to fly to India and maintain a surrogate pregnancy, you could have afforded to adopt.”

    I don’t know. I feel like if I was going to have to spend tens of thousands of dollars in order to get a child, I’d be more comfortable giving it directly to the woman who’s growing, birthing, and being separated from the child rather than to an agency while the birth mother potentially gets nothing but a thank you and (hopefully) her immediate medical bills paid. The sticking point is that you’re actively causing the child to be conceived rather than just receiving a windfall on account of someone else’s misfortune.

  13. It seems most western feminists are pro-choice only in a very narrow sense of the word. So what if these women are renting out their wombs? Do you think they are too dumb to decide what’s the best course of action for themselves? They don’t even look like teenagers and this is India, not some starving African country. Its their body, their choice should extend all the way to them as well.

  14. (Disclaimer: I’m infertile due to recurrent pregnancy loss, and plan to start domestic adoption proceedings in the fall if I don’t get successfully pregnant before then)

    I can see being squicked out by this, because I frankly am. But, aside from the gene issue, what’s the difference between this type of surrogacy and international adoption? Is it that the mother gets the money? Why do people have a problem with this and not adopting a Korean or Somali baby?

  15. And that might be why several states in this country have declared that although surrogacy may not be illegal, contracts relating to it are unenforceable!

    Leaving aside the moral aspects, how could a surrogacy contract possibly be enforced? What happens if the birth mother changes her mind (which, as we all know, has happened)—does the sheriff tear the baby out of her arms?

    In many contracts, if one party reneges, the other is entitled to a specified refund or monetary penalty. But a woman poor and desperate enough to do something like this probably wouldn’t be able to pay anything. I think Holly is on the right track: Most of the power should rest in the hands, as well as the womb, of the surrogate.

  16. It seems most western feminists are pro-choice only in a very narrow sense of the word. So what if these women are renting out their wombs? Do you think they are too dumb to decide what’s the best course of action for themselves? They don’t even look like teenagers and this is India, not some starving African country. Its their body, their choice should extend all the way to them as well.

    You make yourself look like a moron when you clearly didn’t read the article. Many Western nations have laws against renting out your womb, so it’s not about thinking women in non-Western nations are too dumb to decide for themselves.

  17. Whenever there are power differentials, you have to wonder what kind of factors played in their decision. If you live in abject poverty, you’re going to do just about anything to put food on the table, whether it be sell their organs or blood, prostitute, send their kids to work in a sweatshop, and be a surrogate for a rich family.

  18. You make yourself look like a moron when you clearly didn’t read the article. Many Western nations have laws against renting out your womb, so it’s not about thinking women in non-Western nations are too dumb to decide for themselves.

    Many western nations also have laws against abortion or used to in the near past. Just because it is abhorrent to your sensibilities doesn’t mean that you should try to push for laws between what consenting adults can do especially when what they are doing is not affecting anyone else.

  19. I can see being squicked out by this, because I frankly am. But, aside from the gene issue, what’s the difference between this type of surrogacy and international adoption? Is it that the mother gets the money? Why do people have a problem with this and not adopting a Korean or Somali baby?

    The big difference between international adoption and surrogacy is that in international adoption, the child is already born, and has been abandoned by the parent/parents but surrogacy is creating a new child. There are many many children out there stuck in orphanages who desperately need homes. I know that in Mongolia (where we adopted) most of the children that “graduate” from the orphanages end up living on the streets (thus ending up getting pregnant at a early age, and then abandoning their children, rinse and repeat).

  20. Interestingly, thinking more about it, it seems to me that the argument that they could be economically coerced so we shouldn’t let them decide could be used against poor people rather effectively to reduce their choices to their own detriment.

  21. I must say I don’t think your discussion of how to make the rental of a woman’s womb more fair is a step in the right direction. I think we should be articulating an absolute “no” to all of these practices, and crafting policy in which penalties (if any) fall on purchasers and assistance goes to sellers.

    There’s a reason I had an question “a” and a question “b” in my earlier post. What you’re suggesting has more to do with the approach of “B” — asking at what point we draw the lines (and there are definitely multiple lines) when it comes to renting out use of your body for labor, sex, carrying a child to term, organs, etc. And I agree that’s absolutely a direction that also has to be looked at and pursued in some way. I’m just not sure outlawing is the most effective angle. Some of these lines I think we’re very clear about drawing: Minors? Not allowed. Violent coercion, imprisonment of various sorts? Of course not. Something that causes death? Obviously not. But others I don’t think we articulate well enough, and I think we need to. Certainly in a more thought-out way than appealing to the sanctity of the womb, which would be the right-wing approach.

    At the same time I don’t think we can entirely do just one approach or the other. If there are women out there, in markets where it’s allowed, then their conditions, agency, and access to power in decision-making about their body and livelihood is important and should be addressed. Even if you outlaw one of these practices, there will still be a market, and a route has to be found that improves conditions and agency for the workers. On the other hand, even if it’s legal or decriminalized, it’s still important to articulate what lines we don’t cross. For instance, the whole contractual-enforcement issue with surrogate mothers; there’s value in putting a stake in the ground over her continued freedom of reproductive choice. I’d like to just be able to say “you have to take both approaches” but of course it’s far more tangled and incompatible and contentious than that — just like the relationship between trafficking, legalization, social stigma, decriminalization, and the “Swedish model” is a very contentious topic within sex work discussions.

    If there’s any good news, it’s that in this particular economic transaction, the buyers and the sellers both have the well-being of the seller’s body in mind. Which I guess is why I’m more worried about choice.

    By the way, there are only six states in the US where commercial surrogacy is illegal. I think we actually had someone comment who had worked as a surrogate mother the last time this subject came up, didn’t we? And she said yes, she did it to make ends meet and pay the bills. It’s not just an international issue, although I think that exacerbates it for reasons that the New York Times blog article from January made very clear:

    “The legal issues in the United States are complicated, having to do with that the surrogate mother still has legal rights to that child until they sign over their parental rights at the time of the delivery. Of course, and there’s the factor of costs. For some couples in the United States surrogacy can reach up to $80,000.”

    This was “Julie,” an American thirtysomething who’d come to India to pay a poor village woman to bear her baby. She went on:

    “You have no idea if your surrogate mother is smoking, drinking alcohol, doing drugs. You don’t know what she’s doing. You have a third-party agency as a mediator between the two of you, but there’s no one policing her in the sense that you don’t know what’s going on.”

    So basically — this woman went to India because she can avoid a complicated situation in which the surrogate she’s hiring has too much say in what’s going on. She not only wants a cheaper labor market — an inevitable result of global capitalism, right — but also wants laws that favor her and give less autonomy to the surrogate. No escape clauses like exist in the United States — plus she gets a more controlled environment in India since the surrogates stay in a clinic or a special home the whole time.

    This kind of control just wouldn’t be possible in the States, says Julie.

    (Apparently you can listen to the original news report here.)

  22. What happens if the birth mother changes her mind (which, as we all know, has happened)—does the sheriff tear the baby out of her arms?

    Yes. That happened repeatedly over the course of the Baby M case. It was horrible.

  23. 1. I have no condemnation for the Indian women doing this. Though for the brokers who undoubtedly set this up? Buckets.

    2. I have no sympathy–none–with couples who hire women’s bodies. Zippo, zero, nada, zilch. It is exactly like prostitution, and johns are hardly the role models I personally would want to emulate. I have sorrowed quite a bit at not being able to have another chlid of my own, but I would never consider paying someone to bear a child for me. This is abhorrent. It is the reduction of another person to “container for my baby.” It makes me sick.

  24. I think paying someone to surrogate is totally legit –
    IF they understand what they are getting into
    IF they are not in extreme poverty compared to you
    in short, if they really are choosing. In these cases the women are “choosing” between being surrogate mothers and poverty. That’s not really a choice.

    I personally have no desire to give birth, and to answer a question asked early on, I can imagine desiring only children related to me – I could donate a kidney. I could be proud of their intelligence. I could feel like I did that thing that we’re meant to do – spread my genes. If I wanted kids and I had a stronger genetic drive, I’d do anything to be able to have a surrogate.

    I’m an environmentalist and I wish more people would adopt (I’m planning on it if I get those parental urges), but I can understand the desire to continue the genes, even at the cost of the environment. (It’s a commons, and there’s the tradgedy 🙂 )

    As for adopting a baby vs. an older kid, if you see the “firsts” I bet it feels more like “yours”, and you feel more responsible, so even if your genes aren’t continued, your legacy is, in a way. Probably the sooner the better.

    Don’t think that everyone can overcome this instinct with their human brains and human logic. Even some of my smartest friends cannot. If we could, there wouldn’t be kids up for adoption. It’s natural to want “you” to continue, whether logically and environmentally sound or not.

  25. My parents used – and I use that word deliberately – a surrogate to have me. This was almost 24 years ago, and they traveled to the US to do so. They told me they’d used a surrogate when I was about 8, and it has always struck me as exploitative. I’m uncomfortable with my parentage, especially because I’ve never been able to contact the woman who gave birth to me and ask her how she felt. I realize that might be even more imposing of me, but I can’t help but wonder if she resents me, or my parents.

    It was – is – tough to deal with, the underlying feeling of having been bought rather than born. And I can only imagine it must be worse for the woman who carried me, though according to my parents she treated it purely as a business transaction, and I don’t want to force my feelings on the matter onto her.

  26. My parents sent me stuff on “Snowflake Adoption” where you adopt donated embryos. I kinda got a squicky feeling about that. I mean if I’m going to adopt (again) I don’t think that having a child who could have fraternal twins out there somewhere (and God knows with the multiple rate going up as fast as it is) would be the way I’d go. It just kinda feels like giving birth to photo copies. And again, yes I would get to do all the “firsts” etc but if you’re going to adopt… an already born child seems a lot more like you’re helping to balance things out. Besides Bush loves the idea of Snowflake Adoptions, and that’s enough to make me run screaming in the other direction.

  27. As long as we’re talking about the economic situation, consider how this creates even more disincentives to help the impoverished get a leg up. If surrogates could afford to make money in other ways, we wouldn’t have cheap surrogates–so it’s in Western interests to make sure we have this as another source of cheap, powerless labor.

  28. I’m not sure why people are comparing this to selling organs. It’s perfectly legal to donate organs, just not sell, them, which makes no sense to me. To those who are making this comparison, would it make you feel better if surrogates volunteered their services?

    I also don’t understand the comparison to slavery. How is it slavery if one is being paid? I voluntarily give up some of my free will in exchange for money all the time. It’s called a job. Is that slavery too? It’s slavery when someone else benefits from the use of our bodies and skills, even if we’re getting paid?

    That’s not to say that I think the whole thing is A-OK. It’s just that some people are acting like the whole concept is inherently wrong, which I don’t agree with.

  29. It’s perfectly legal to donate organs, just not sell, them, which makes no sense to me. To those who are making this comparison, would it make you feel better if surrogates volunteered their services?

    The reason for that is to eliminate the element of economic coercion and exploitation, so that the rich aren’t literally harvesting the bodies of the poor. And yes, I wouldn’t have a problem with volunteering.

  30. Coercion? I don’t understand how its coercion when someone is getting paid and they’re doing it voluntarily because they need the money.

    I mean, I donate blood all the time. So what if I was paid, instead? What if I did it only because I needed the money? How is that different from working a job because I need money? Is that coercion? I mean, it’s like I’m FORCED to have a job because I need the money it will provide me. Right?

  31. I’m not sure why people are comparing this to selling organs. It’s perfectly legal to donate organs, just not sell, them, which makes no sense to me. To those who are making this comparison, would it make you feel better if surrogates volunteered their services?

    In fact, that is the only option in countries and states where commercial surrogacy is illegal — the surrogates have to be volunteers. Apparently it still happens, and I guess yes, the people who outlawed commercial surrogacy feel that it’s then OK for the same reason that voluntary organ donation is — nobody is incentivizing you to rent out your womb, you’re doing it entirely without a ethically-suspect carrot being dangled in front of you (and the corresponding stick of having-less-money that always goes with it, in capitalism).

    I also don’t understand the comparison to slavery. How is it slavery if one is being paid? I voluntarily give up some of my free will in exchange for money all the time. It’s called a job. Is that slavery too? It’s slavery when someone else benefits from the use of our bodies and skills, even if we’re getting paid?

    It’s only slavery if you’re not allowed to leave your job. I mean, even slaves are “paid” in room and board, right? The distinction is that you have no choice about whether to have the job or not. And part of the problem with surrogacy in some places is that women may not have a choice as to whether they can quit — at least not for nine months.

    And yeah, some people would say that all money-for-the-use-of-your-body is problematic, whether it’s labor or pregnancy or what. They’re called Marxists.

    Coercion? I don’t understand how its coercion when someone is getting paid and they’re doing it voluntarily because they need the money.

    Economic coercion isn’t the same as coercion. Actually it probably shouldn’t be called economic coercion. But there is a moral principle here — you can’t pay someone $10,000 to give you a kidney, and you can’t pay them to light themselves on fire, there are all sorts of limits as to what you can pay someone to do, and that’s in part because we understand that dangling money in front of someone means they are not making an entirely free choice. You’re bribing them to do something that might damage their well-being; and sure that’s probably also true of everyone who does a job, especially dangerous ones, but there’s a line we don’t go beyond.

    The French equivalent of the Supreme Court laid down the line on surrogacy when they outlawed it and said,

    “The human body is not lent out, is not rented out, is not sold.”

    However, I kind of think they’re deluded about that. Of course people’s bodies are rented all the time. I’m renting my hands and eyes and brain to a company at this very second, or I’m supposed to be if I would get back to work and stop blogging — this is technically a violation of my rental agreement.

    I’m FORCED to have a job because I need the money it will provide me.

    Yes, you are forced to have a job because you need the money. Aren’t you? Or are you independently wealthy and just doing the job because you like it? Everyone else is forced — yes, FORCED, as in you don’t have a choice — to work somehow for money.

  32. Holly I’m not quite sure if you’re disagreeing with me. It seems like you are… Not quite sure what you’re trying to get at though.

    What’s so wrong with getting paid to give someone your kidney if people can give away their kidney for free?

    I assume surrogates are aware that they’re getting into a nine-month commitment when they agree to do it, and that they know what they are getting into. Haven’t most surrogates had children before?

    What’s wrong with incentives? Incentives make the economy work.

    I think if I needed a kidney, and I couldn’t count on one being donated, I’d want to be able buy one. It’s better than just dying. What’s wrong with that? If I wanted to pay someone to light themselves on fire, that’s kinda different isn’t it? In one case I want to pay someone for something that I need to live, in the other I’m apparently just some kind of a sadist.

    I know that I am forced to have a job in order to survive. That was my point. Few people think that there’s something wrong with that… it’s just that they object to the nature of some “jobs.” Or I guess when they think the service should be given freely, like sex. It can’t just be the risk of a job though, because like you pointed out, there are risky jobs, and the workers get paid for that risk. So how does the government decide where to draw this line? I would personally say OK to surrogacy but say no to setting people on fire. Doesn’t mean everyone will agree with me. So, we go by majority rule, and then I lose my option to set myself on fire for money? I suppose I would be able to do it for free, though, because then you know for sure that I’m actually OK with being set on fire, and not just doing it for money.

    Actually that reminds me of something I saw on National Geographic Channel once, on the series “Taboo.” There was this “Circus of Pain” type thing, where the performers would voluntarily inflict pain on themselves for the amusement of the audience. I assume they charge an admission fee, and apparently its legal. And there was even fire and burning involved.

    Sorry that was kind of ramble-y, it’s really late. Or early, rather.

  33. Rika, imagine that I arrange to have your house burned down, your bank account looted and everything you own stolen so that you are more desperate for money. Are we now in the same bargaining position as before? Is your “choice” as free as before?

  34. Ok, mythago, please link me to a case where that has happened. Is this a problem? Infertile women routinely go to foreign countries, ruin someone’s life, and then make an offer?

    Personally, my “choice” would be to take you to court. Also to continue working the job that I assume I already have to replace the things that you destroyed. Hey, maybe I have a bunch of money invested in the stock market. Did you manage to burn that too? Or perhaps in this fantasy you’ve created I can live off of air and tree bark. And what are you, some kind of a mob boss?

    Such a ridiculous point you make.

  35. Surely you’re not pretending that you have just as much choice (to take a job or walk away, for instance) if you’re destitute as you do if you have a lot of money and other assets, Rika.

    If anything’s ridiculous, that would be.

    The counterpoint was the only point mythago was trying to make, I think.

  36. Surely I’m not. My point was that mythago made up a ridiculous situation with no basis in reality.

    S/he could easily have just said that if I am not making a good enough wage to live on, had no particularly valuable skills with which to get a better paying job, didn’t have enough resources to obtain those skills, etc., then I won’t have as many choices, since money is power.

    Mythago said, “what if this and this and this happened?” Anyone can do that, doesn’t mean its realistic. We’re not playing pretend here. Like I said I highly doubt the situation that mythago described happens much, if at all. If your point is that when you don’t have many resources, you have less power, then just say it, instead of some ridiculous, “what if I burned all of your possessions” fantasy situation. Like I said, if she did that, then I’d take her to court. Now how does all of this have any bearing on the discussion? It was an ineffective (and dumb) tactic and I was responding to that.

    It almost sounded to me like she wanted such a thing to happen, so I could “see how it felt.” Personally, I don’t much like “how would YOU feel” arguments.

  37. btw I posted another comment that is apparently in moderation. I don’t think that’s happened to me before… Did I say something that triggered it?

  38. As long as we’re talking about the economic situation, consider how this creates even more disincentives to help the impoverished get a leg up. If surrogates could afford to make money in other ways, we wouldn’t have cheap surrogates–so it’s in Western interests to make sure we have this as another source of cheap, powerless labor.

    Eloquently stated.

    From what I know on this, after a nauseating back and forth with a poster on a different forum, in the US surrogacy costs around 60-80K. In India it is around 15K If that isn’t exploitative outsourcing, I don’t know what is.

    Just because someone gets paid for a service, doesn’t mean they aren’t being exploited…

  39. You know, I would argue that economic coercion is coercion (perhaps it’s my Marxist upbringing talking!). If you offer somebody who is utterly destitute with a family to feed 15K, they are being pressured immensely in a way that somebody who is being offered no money, or somebody who doesn’t need the money that badly isn’t.

    But yes, I agree with Holly. There are some forms of labor we as a society and culture accept as being exchangeable on the open market, and some forms we don’t, and the difference is often a matter of the degree of intimacy–and degree matters. But more often, the difference is a matter of the body. If you put a price tag on a kidney, what you are doing is attaching an exchange value to the human body, commodifying human beings. Pregnancy and childbirth are bodily experiences–putting a pricetag on them is also commodifying the body, and I’m opposed to that. Human beings should not be objects for exchange on the open market. The fact that we as a society have created an economic system in which becoming an object of exchange seems like the best option is a matter for deep shame, not a justification for condoning or allowing it.

  40. I think if I needed a kidney, and I couldn’t count on one being donated, I’d want to be able buy one. It’s better than just dying. What’s wrong with that?

    A lot, actually. Which is why our organ donation system works the way that it does.

    There’s a recognition that organs are needed, but in short supply. If we allow the buying of organs, it means that the rich get them and the poor don’t; it further means that there’s pressure on the poor to sell their body parts for profit, and that raises serious ethical questions. Do we really want a system where organs are sold rather than donated? I understand that you would want to be able to buy one, but this is about society as a whole, not just individual desires.

  41. I notice that whenever people make the argument for being able to buy organs, they always put themselves in the position of the person who needs a kidney and has the money to buy one, but never in the position of the person who needs a kidney and can’t afford one, but has to watch all the rich people sail by her in line, and certainly never in the position of the person who has to choose between selling her kidney and watching her kids starve. Further, consider children who need kidneys–a selling system would be one in which the parents of poor children could consent to selling one of their kid’s kidneys. Is that really OK with you?

  42. Regarding organ-buying (after I read the NYTimes article where a doctor argues that she should be able to buy a kidney), my feelings are very similar to the surrogacy situation…

    … in that I think of these people of having a major sense of entitlement. “Entitlement” is perhaps not the right term–especially for someone who desperately needs an organ. But they do seem to come from the background of, “I need something (or want something) very desperately and I should be able to pay a large sum to get that thing.”

    It seems to me that these people have generally been in situations where money has been able to buy them lots of stuff. Food, clothing, education, money.

    I would expect–and maybe I am wrong–that persons who have had to say “no” to major things, or minor things, because of a lack of money, would not immediately jump to the idea that money can buy them something, or that paying money is a solution to many problems. (Because everything EG said above holds true.)

    I’m not saying thinking in terms of “I *would* give anything, I *would* do anything to have a baby/to get better/to cure my loved one” is wrong because people have always had those thoughts and impulses.

    But there’s always a difference between “I *would* pay anything” and “I *could* pay anything” and “I *can and should* pay anything.”

  43. Well certainly I understand that not everyone can afford a kidney. But if given the choice of having a rich person having the option of buying a kidney and a poor person dying because they can’t afford one, or both the poor and the rich person dying because no one donated any, I would prefer the first option, even though its not exactly fair. Why should some people be denied something just because others can’t afford it? Besides, wouldn’t insurance cover the cost of a kidney? We seem to be heading towards universal health care…

    If I put myself in the position of a poor person who can’t afford a kidney, I don’t think I’d wish death upon a rich person who could afford a kidney.

  44. So, if I follow you, Rika, it’s better to keep poor people poor so that there will be kidney donors. If the poor become more well-off, they’ll have no financial incentive to donate kidneys and there will be less kidneys for everyone.

  45. So, cash incentives probably would widen the number of kidneys available, especially from the world’s poor. But I think it would also make organs unattainable for the poor.

    The poor can’t afford to pay lots of money for an organ. The rich can.

    Right now both rich and poor receive a limited number of organs from the same donor pool. Live-donor organs come (in countries like ours) from altruistic strangers and from family members.

    However, I think that few persons who are willing to donate an organ to a stranger would donate it for free when they could be paid a lot of money from it. So the number of free donations might drop.

    Also, once a price is put on an organ you get into squicky situations. Can they be collateral? Can they be seized in bankruptcy situations? Can they be taken from criminals as restitution?

    I have family who work professionally in organ donation networks, and a family member who received a kidney from an uncle. You know what would really increase the number of available organs? Widening the pool of registered after-death donors (by making it opt-out, for example instead of opt-in, and by increasing outreach education) and repealing motorcycle helmet laws.

    But no! We should be able to fix the entire system by (having people who are able to) paying a lot of money! It’s always worked for (people who can afford it) in the past!

  46. But if given the choice of having a rich person having the option of buying a kidney and a poor person dying because they can’t afford one, or both the poor and the rich person dying because no one donated any, I would prefer the first option, even though its not exactly fair. Why should some people be denied something just because others can’t afford it?

    This is why I get so angry sometimes that I want to scream.

    Your choices completely ignore the part where the organ has to come from somebody.

    The real options are:

    1. A donation system whereby people donate organs for free to be given to people who need them regardless of their economic situation.
    2. A system whereby the poor bear the burden of providing organs for money, while the wealthy are the only people who can afford transplants.

    System 2 is unacceptable. It puts almost all of the burden for providing organs on the working class and the impoverished, while giving all of the benefits of organ donation to the wealthy upper class who can afford the expensive surgery.

    If I put myself in the position of a poor person who can’t afford a kidney, I don’t think I’d wish death upon a rich person who could afford a kidney.

    I don’t think you did, no offense. It’s not about a poor person “wishing death” upon anyone- it’s about whether or not it’s fair to expect our least well of members to bear the sole burden of providing healthy organs for the most well off.

  47. I don’t expect poor people to do anything. If they don’t want to sell their kidneys they don’t have to. And if they can’t afford the darn kidney, can’t they get government assistance? Isn’t that what Medicaid is for?

    The simple fact is that if you pay people for their organs, more people will give up the organs they don’t need. Now a poor person can still have their brother donate a kidney for them, can’t they? It’s my impression that that’s where most kidney donations come from, from family members. Not some random stranger. Or a dead person, right?

    And it wouldn’t be their SOLE burden anyway. Rich people would probably still get donations from their family and friends even if they can buy the organ.

  48. the organs they don’t need.

    I believe medical ethics holds (quite soundly, it seems to me) that people actually DO need both kidneys, as a type of system that you’re better off having redundancy in. You can SURVIVE without both kidneys, but that doesn’t mean you don’t NEED it. I mean, you can survive with one eye and one arm too. There’s a reason we have two kidneys, we live longer with two — it’s not just a matter of “hey you don’t need it, might as well sell it.”

  49. Rika,
    You are right of course. If a poor person doesn’t want to sell their kidneys, they don’t have to. But a poor person can’t buy a kidney, ever. I’m sure they’d be extremely valuable. Poor people can only sell kidneys, and rich people will probably never sell them. Thus the poor are selling their bodies to the rich in pieces.

    Where to draw the line? A simplistic listing:
    Employee working for company – OK (work or starve)
    Poor person doing rich person’s nails – OK (work or starve)
    Poor person cleaning house for rich person – OK (work or starve)
    Poor person babysitting/nannying rich person’s children – OK (work or starve)
    Poor person selling sex to rich person – … OK (rent body work or starve)
    Poor person giving birth for rich couple – ? (rent body or starve)
    Poor person giving up body parts for rich person – ? (sell body forever or starve)

    I think in today’s society, the last 2 are pretty iffy. There is ALWAYS a choice, but is this a good choice to have? Remember, the rich people will never do the poor people’s nails, sit for their kids, clean house for them, sell sex to them or have babies for them either.
    Its like violating the last boundary… forcing people to choose between poverty and selling pieces of their body. Kind of icky.

  50. And if they can’t afford the darn kidney, can’t they get government assistance? Isn’t that what Medicaid is for?

    Medicaid? That underfunded paragon of decent health care? You’re seriously, with a straight face, arguing that Medicaid would pick up the cost of buying a kidney. Medicaid wouldn’t even pay for my best friend’s inhalers. Sheesh.

    The simple fact is that if you pay people for their organs, more people will give up the organs they don’t need.

    The simple fact is that if rich people pay poor people for their organs, more poor people will consent to have their bodies unnecessarily cut open in order in order that an internal organ that provides healthy redundancy and functions normally in their bodies may be removed and given to rich people. Not only will poor people not be able to buy kidneys (and I suspect middle-class people too), but they will be less able to count on donations from family members, as that same class of people will have been far more likely to already have sold kidneys to unrelated rich people.

    We decided 150 years ago that human bodies are not commodities to be exchanged on the open market. You can’t sell yourself into slavery, even if you want to. You can’t sell yourself into indentured servitude. And you can’t sell yourself in pieces, either.

  51. surprised no one mentiond egg donation… western women sell their eggs to each other… lots of college girls do it… they have to take hormones and its painful and takes months… seems sort of like a pregnancy…

  52. Yes, I’m opposed to that. When I was in college, the only woman who even considered it was, surprise, surprise, a working-class girl from rural PA whose parents couldn’t even understand why she was going to college to begin with and who had no other resources whatsoever. I really don’t understand why it’s called “donation,” as though the thousands and thousands of dollars on offer are what…an unconnected gift?

  53. I saw a program on television about this. They actually interviewed Indian surrogate mothers and asked if they had any bad feelings about this. All of them said no, that they were better off, one of the woman had been living in a shack and built a house large enough for her ten children. I agree that if these women came from upper middle class Indian backgrounds, they would never have become surrogates. But, realtiy is, they didn’t, and this was the quickest and easiest way they could help their families. I think outlawing this type of surrogacy would only hurt poor women, while making middle class white American feminists feel better about themselves.

  54. Rilka, your system offers disincentives for anyone to donate. Why donate when you can sell?

    Sabrina, did it occur to you that there is something seriously wrong if the “quickest and easiest” way for these women to feed their families is to take bargain-basement price money from Americans to put themselves through pregnancy and birth?

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