Transcript from panel discussion at the United Nations in New York City

Nigel M. de S. Cameron, President Institute on Biotechnology and the Human Future

The U.S. State Department recently hosted a panel discussion at the United Nations in New York City. Invited presenters included the Institute on Biotechnology and the Human Future's (IBHF) Nigel Cameron and two of our IBHF fellows, Judy Norsigian and Adrienne Asch. Following is a transcript of comments presented by Nigel Cameron.

There is no more important distinction than that between persons and property.

As we know, while in public pronouncements the world has set its face against the history of feudalism and slavery that it once took for granted, the ringing terms of the Universal Declaration of Human Rights must constantly be re-asserted in the face of threats ­ some of them overt, others insidious - to the dignity of the individual.

The fresh articulation of human rights and fundamental freedoms in the Universal Declaration on Bioethics and Human Rights adopted by the General Conference of UNESCO in October 2005 represented an important step in the application of these broad principles to the increasingly complex arena of medicine and the life sciences. One of the most notable statements in the Declaration is that of Article 12 on respect for cultural diversity and pluralism, which declares that while these principles are important and should be held in due regard, "such considerations are not to be invoked to infringe upon human dignity, human rights and fundamental freedoms."

We are all aware of concerns about abuses to human rights involving involuntary servitude and trafficking in persons, in which economic considerations have erased the distinction between persons and property. As medicine and the life sciences advance, in the context of the global economy, the pressure to treat the living human body as a source for economic gain will undoubtedly grow. In a world where there are huge economic disparities, the pressure is already mounting for the wealthy to maintain their health by purchasing tissue and organs that directly threaten the health of the less fortunate. This is one reason why the World Medical Association urged at its 52nd Assembly in 2000 that "[f]inancial incentives for providing or obtaining organs and tissues for transplantation ... should be prohibited" because of their inherently coercive character. There is known to be a growing market in organ transplants - especially involving kidneys - across national boundaries and largely between wealthy recipients in the West and donors in developing nations. As one famous bioethics essay put the question in its title, "If I were a rich man, could I buy a pancreas?"

The concern is not simply over financial pressures that have coercive effect. It has long been a principle widely agreed upon by physicians and experts in bioethics that the only moral basis on which parts of our bodies can be transplanted into the bodies of others is that of "donation." Indeed, in English the term "donation" has become synonymous with the process of transplantation, as if any exchange of body parts were truly an act of giving. The "donor" is still called a donor even if he or she has engaged in an act of selling, for valuable economic consideration. This weakening of the meaning of the term is to be regretted. But its continued use indicates the unease with which the human community regards the exchange of body parts and tissue if it is not in the context of the giving and receiving of a gift. This concern for the integrity of the body and the vital importance of protecting it from becoming a vehicle of economic exploitation have parallels with the general agreement that persons should not be free to sell themselves into slavery.

These broader concerns in respect to organ and tissue transplants are the context for growing alarm at the manner in which reproductive tissue has been treated as an exception, including oocytes whose retrieval carries practical health risks of the same kind as are involved in organ donation.

The selling of body parts is demeaning and places huge economic pressures on the poor. The developing trade in oocytes sold for profit is the latest example of such exploitation. And the demand is only going to increase, whether for purposes of research or reproduction, as we see the growing development of a global marketplace for science and healthcare. In the United States, where there is no federal law prohibiting the sale of oocytes, college newspapers regularly carry advertisements offering, at a minimum, $10,000 for the eggs of young women. This market is openly eugenic: sums several times higher have been offered to young women in exclusive schools whose eggs might be judged of "superior quality."

We are facing an issue of women's health and human dignity that transcends traditional divisions of "left" and "right," and especially spans women and men of goodwill who take divergent views on abortion. Indeed, as we face the ethical and policy issues raised by emerging technologies in the 21st century, we will increasingly find people of goodwill drawn together across traditional divides, confronting hard choices in which the dignity of the individual demands curbs on practices that assume an economic reduction of human nature and the human good. If we do not, we shall move steadily toward a situation in which raw economic power permits the wealthy few to extend their fertility and their health by literally purchasing the bodies of the poor.

It is, therefore, necessary for the international community, as a first step, to prevent the trafficking of oocytes across national borders. Such a move would remove one growing and especially egregious form of this developing trade, and should go hand in hand with encouraging member states to take domestic action to eliminate financial inducements from oocyte "donation," ensuring proper respect for persons, the defense of their rights, and fundamental freedoms against a new form of economic exploitation that has emerged as a threat to the health of women.