It is theoretically possible, with two mice, each carrying the genetic code of a human being in their modified reproductive organs, to suction the gametes from each mouse and create a “test tube” human being, just as we bring ova and sperm together today through in vitro fertilization, or IVF.

Is This Your Mother?

Therefore, it’s not a far stretch to propose that mice with these modified genetic structures be allowed to mate, and create a human embryo within the uterus of a mouse. Sound far-fetched? Think again.

The question we find ourselves faced with, in these remarkable scenarios of biotechnology, is this: Just because we can, should we? If we can learn to grow human kidneys in pigs, or human livers in sheep, should we proceed down that path in medicine? 80,000 people need a kidney, and a third might die waiting for a donor. If we could grow kidneys in pigs, people would live. On the other hand, we might bring a porcine virus into the human population that could sweep like the plague through dense population centers, and nullify any benefit that swine-bred kidney brought us. Sound far-fetched? It’s not.

Where do we draw the line in the determination of what’s right, moral, loving, and compassionate . . .  and what’s too dangerous to attempt? Twenty years ago, no one might have considered bearing a child to create the blood and donor tissues for a sister in dire medical need. Nevertheless, author Jodi Picoult’s novels about families, relationships and love have captured the imagination of many with her novel and movie My Sister’s Keeper, a story about a child conceived for the explicit purpose of helping save the life of a dying sister. That it does not seem remarkable we can do this thing, this conception of one child for the saving of another, says much about how far we’ve slid down this slippery slope of biological ethics.

Infertile? No problem. There are many options available to the couple seeking a child, and I applaud the desire of men and women to bring children into the world. Children are a gift from God. But where do we cross the line of enjoying God’s gift, and controlling the outcome to meet our needs? I would not deny any IVF family the joy of bringing their children into the world, but how far is too far? Is it appropriate to shop for a donor egg, a donor sperm, then a surrogate mother, and finally a wet-nurse to feed the child? We’re there, folks. It’s happening today. At some point, our technical abilities outstrip our ethics and then we find ourselves in dangerous moral territory.

From National Geographic's "Womb Animals"

Readers will gawk at this blog, in wonder that I propose we have moved too far too fast. But before you critique my “condemnation of progress,” do a little survey on the Internet. Shop for a donor egg, surfing through the many sites that offer you a broad choice of ethnicity, physical features and intelligence, with gametes for sale from beautiful women all over the globe. Check out the numerous sites where men offer to fly to the woman and inseminate her for a fixed price, men who brag that they “enjoy the experience more than the end result.” Shop for a surrogate mother, willing to carry your child for a fee. Where do we cross the line of altruism, and cross into Aldous Huxley’s Brave New World? I propose that we crossed that line long ago.

I commend medicine and biotechnology for the advances that have saved so many lives. But I’ve come to a realization that some advances may better be left in Pandora’s Box than released without careful prior consideration of their impact. It’s important for us to search out God’s will in this new world of medicine that we’ve encountered, and with each new tool we find in the biotechnology toolkit, ask the fundamental question: “Just because we can, should we?”

Better to ask, and prepare, than to dash into an uncertain future with no moral compass and no plan.

When I write about women selling their bodies, most readers immediately jump to conclusions about prostitution, or the sex slave trade of young girls trafficked out of central Europe and Asia. Yet few people consider the other trafficking, the exploitation that takes place on college campuses and in third world countries every day. Women selling their eggs for cash, lured by promises of “generous compensation,” a greedy wolf wrapped in the “sheep’s clothing” of altruism.
Egg donation. It’s anything but donation. Harvesting women’s eggs for money is part of a $6.5 billion dollar fertility industry that targets young women, particularly those who are tall, attractive and physically fit. Women with high IQs and a desire to assist another woman to conceive a child. Women exploited by an industry that tells them too little about research that is too sparse and a procedure that can cost them their own fertility—or their lives.

Harvesting a woman's egg through the abdominal wall

The Center for Bioethics and Culture Network (www.cbc-network.org) in San Ramon, CA has recently produced an excellent documentary entitled Eggsploitation that speaks to this issue, one highlighted in my upcoming novel Nobody’s Child. Poor women and cash strapped co-eds drive their bodies into hyper-stimulated ovulations, producing a bountiful crop of genetic material for money. “Selling your body” takes on a new wrinkle in an unregulated industry desperate for human eggs. Women donors—and their sperm-selling male friends—have ushered in a new global market in gametes: DNA for sale.

I have friends who’ve been blessed to conceive through In Vitro Fertilization (IVF). I’m not here to bash their experience and their gift of children. However, I agree with the ethicist quoted in the CBC documentary Eggsploitation who stated that women become little more than walking egg factories as part of this chilling social experiment in the harvest and sale of anonymous gametes. Whether stem cell research, cloning studies, or in-vitro fertilization, the fertility industry and medical research are completely dependent on a woman’s egg. When a market is allowed to emerge that pays for DNA, there will be women desperate for money who turn to their own genetic material as a source of cash. Then the trouble begins.

I was a poor college student at Rice University in 1973, living near Houston’s Baylor Medical Center. An intriguing flyer on a campus wall promised $25 a visit for healthy students willing to be research subjects in drug trials. A roomate urged me to give it a try. “Easy money,” he promised. I did, and I never went back, reeling with dizziness from the strange drug I took in an unmarked office. 37 years later, I wonder at that experience, curious what long-term impact the drug may have had on me. Probably none, but women who donate eggs can’t always say the same. Ovarian cancer, stroke, breast cancer, Ovarian Hyper-Stimulation Syndrome, cervical cancer, inflamed or scarred ovaries—or the nastiest twist of fate—infertility . . . all are potential results of egg donation, spurred by an industry that demands large harvests from its donors in return for “generous compensation.”

Fertility drugs boost a woman's egg supply for harvest

Stroke, cancer, or infertility. Is it worth it? The egg donor industry exploits women; those who lose in the deal will drift into a nameless void, their loss of life or health grim statistics that rarely track back to the industry that bought their eggs. The purchase of human ova exploits women around the world, an untold number of them suffering lifelong repercussions in silence. Is it worth it? Are we ready to embrace the genetic industries and anonymous fertility of Huxley’s Brave New World as our model for the 21^st century?

I hope not. You can’t undo a harm.

I laughed aloud, surprised that Tom had been so honest about his fear. Nevertheless, he expressed a concern that I hear from at least one reader every day. “Surely it’s not that dangerous,” others insist, desperate to avoid confronting the unsettling facts about what biotechnology has thrust upon us.

We live in an unstable future. It’s time to acknowledge that reality and embrace a slippery footing on this rapidly moving boat that we call medical technology. Or, using another metaphor, it’s time to admit that we’ve slipped the seal off Pandora’s jar and begun to drink of unexpected evils that we’ve released on the world.

It was not a box. Pandora of mythology was given a jar—not a box—along with a stern warning that she was not to open the vessel under any circumstances. Curious about the gift and not dissuaded by the warnings, she slipped the lid off for just a moment . . . and unspeakable evils escaped to plague mankind. In a flash, she jammed the lid back on, sealing Hope inside. There’s a metaphor for you—a world filled with evil, and Hope of all things, sealed up where we can’t get at it.

Tom, my good friend who disavows biological thrillers, understands what he’s up against. I admire him for that. He’d have wisely left the cap on the jar if he found it at Pandora’s house. But what about the rest of us, those who don’t realize that the developments that look so promising in medicine might have some unexpected—and undesired—consequences? Technology is providing us amazing abilities to extend life, to cure disease, to improve human performance, and to overcome human frailties of all kinds. Why would anyone object to that?

Read along with me in the coming months, and we’ll unpack that question in myriad ways. Indeed, why object to advances in medicine and technology? I’ll approach this subject, in my weekly bioethics blog One More Step, exploring the core question “Just because we can . . . should we?” Just because we can grow organs and body parts in animals, is it a good idea? I have a cow’s ligament in my thigh, friends have pig heart valves in their chest, and a neighbor’s daughter depends on insulin grown by bacteria. But have we gone too far when we’re capable of growing human ovaries and human testes in mice? What happens if those mice mate?
If I could sell you a pill that would guarantee you’d make a 36 on the ACT or ace the MCAT exam for medical school, would you pay me a hundred thousand dollars for that pill? Would it be fair to those students who could not afford the magic tablet? Or, if you’re near death waiting on an organ, what’s a kidney worth? Is it wrong to sell your eggs if you’re a young woman desperate for cash? It’s your body, after all.

First female DNA sequence. From www.sciencedaily.com

It’s an inconvenient truth, to paraphrase a recent movie, that we’re immersed in a world of remarkable technological achievement that pounds like a jackhammer, chipping away at the foundation of ethics built on millennia of wisdom and faith. Despite the amazing good of many biotechnology and medical breakthroughs, actions have unintended consequences. In my weekly bioethics blog I’ll explore both sides of questions about technology and their unanticipated penalties. “Just because we can . . . should we?”

That’s the question that keeps me awake at night, inventing new book plots . . . and it might just be why my friend Tom stays away from biological thrillers.