When I was in high school and college I was subject to a gazillion courses in bioethics. At the time, IVF was newish, egg donation was mostly theoretical, right-to-die folks were just starting to get noisy, the human genome was only just beginning to be mapped, etc. I spent countless hours in discussions with far more conservative peers, arguing mostly for a great deal of freedom for the uses of new medical technologies and research (including research using human embryos).
So imagine my surprise when my recent post at Strollerderby about a new for-profit offering at a fertility clinic, allowing parents to use PGD to determine a child's hair and eye color, was met with a big shrug. Most commenters seemed to feel that hey, it's a free market. And of course, IVF being a massive undertaking--only done by the medically in need, at great pain and suffering and expense--this procedure isn't going to be sought by many and thus will have very little impact on society.
Well of course. This procedure. At this moment. But that doesn't mean we should just accept it and move on. The fact that huge expense goes into developing something so--frankly--stupid as hair and eye color selection and it is offered in a free market to medical consumers is a travesty in my opinion. No it won't impact the gene pool (which fact plenty of people don't seem to understand and is another problem with the lack of discussion) and no, banning it won't automatically cause money to spent elsewhere.
But unlike Barack Obama, I'm a socialist--at least about a great many things. And it seems more than obvious to me that a free market approach to medicine has failed miserably in the United States. It's time to pull in the reins on the race to the ethical bottom (octuplets, anyone?) and the excessive gap between rich and poor people's access to medicine. Taking a good look at high-cost fertility treatment that forces people to mortgage their homes for a 5% shot at having a baby seems reasonable to me, when we re-evaluate how our society allocates spending.
And I am not talking about banning fertility treatment. It seems like in some corners, if you say "regulate" and "fertility treatment" anywhere within 100 words of each other, people jump to assume they will no longer be allowed to do those high-end procedures. I am hardly suggesting that. In fact, I think that any public health coverage should include fertility treatment--including IVF, including PGD when medically called for--which is considerably more than most private insurance plans do for us now. But if we are going to provide fertility coverage to everyone, we are going to need to make the expenses reasonable. Why not include in any new health plan, caps on pricing for treatments and drugs like many countries have now? Why not put a maximum on the profit a doctor can make with this stuff? How could regulating that kind of thing not help infertile people who need the treatment?
Look, I'm not interested in ever getting pregnant myself. But I'm happy to pony up some percentage of my tax money so that you folks who are interested and need help with it can get that help even if you aren't rich, without going into monumental debt. But I'm not paying so some fool doctor in LA can line his pockets with cash from people who know no better than to think it's a good idea to custom order a baby by looks. And I'd like to see the incentives to a doctor to offer that sort of thing drastically reduced--by, for example, making it illegal to charge anything extra for that kind of service. That would also reduce the R&D incentives to go finding those genes in the first place. The market is not a force of nature. Plenty of people outside the United States know this. It is time U.S. Americans realized it and started taking some responsibility for where the market goes next.
Let's focus on curing cancer, not filling the prep schools of tomorrow with customized kids.
