I let you buy kidneys, you let me buy eggs!

The issue of organ trade is now splashing all over the news in Singapore. Three things strike me about it: the timing, the way it is being reasoned and the grounds on which it is being argued.

Let us begin on the timing. Few months ago, Singapore showed its will to become a leading nation in biotechnology and concretely in Stem cell research, more particularly, embryonic stem cell research. We have reasons to believe that because in the short span of few weeks, it called the public to react on two medical procedures that were being proposed: compensating women for donating eggs and creating cybrids. Both proposals had the same purpose: the artificial fabrication of human embryos for the purpose of research.

The only available human eggs or embryos are those left behind by the IVF industry. When women don’t want the spare embryos to be implanted, they have the choice of “donating” them for research. However, this supply is way too short for any meaningful research.

Activating cow’s eggs with human DNA is one option (cybrids) to solve this problem; the other is increasing the pool of donated eggs. The first presents serious ethical problems while the second, a very practical one. Women won’t simply volunteer to undergo a surgical procedure, however minor, just for the sake of science. How to increase women’s altruism? Simple. Offer money for their eggs. Problem? It is illegal in Singapore. Solution? Change the law so that it is no longer illegal and Singapore has already shown its clear will to walk this path.

The reason why the selling of human eggs is illegal in Singapore and many other countries is because there is a firm intuition that the selling of part of one’s own body amounts to “commodifying” the body. What does this mean? It simply means that the body, which is not a commodity, becomes treated as a commodity the moment we put a price on it.

By changing the law so that the selling of human eggs is allowed, warrants a licit question : Do we change the law because we no longer believe that selling parts of our body is commodifying the body or because we believe that this commodification is worth being pursued for the sake of a higher good? To my knowledge, that question still remains to be answered. To say that it is not commodifying the body, would imply that we believed the wrong belief in the past. To say that we can commodify the body for a higher good, raises the question of what good could we be talking about that makes commodifying the body worth pursuing. Would scientific research be that good? Very arguable.

Months has past, and a timely episode has occured. Some were caught buying kidneys to be transplanted. Buying kidneys, just like selling eggs, is illegal for the same reason. But kidneys are not eggs. Kidneys may save the life of a patient whose only hope is a kidney transplant. Now the ethical issue has changed its disguise.

Now it has taken on a human face. Now it is not about cold scientist in white gawns and ethicist waving abstract principles of commodification. Now it is about Peter, about my neighbour or about my family member.

Now the ethical problem takes on a new formulation: Should we allow people to die because of a principle? If we maintain the principle, people might die as a result of cadaveric kidney shortage; if we kill the principle, however, we might be ready to go down the slippery slope of admitting that body parts may be assigned a price. And if this works for human kidneys, it may also work for human eggs.

Perhaps what Singapore is saying is, “I let you buy kidneys, you let me buy eggs.” Or perhaps it is all just a timely coincidence.