In Canada there is a growing demand for human eggs for reproductive purposes and currently demand exceeds supply. This is not surprising, as egg production and retrieval is onerous. It requires considerable time, effort, and energy and carries with it significant physical and psychological risks. In very general terms, one cycle of egg production and retrieval involves an estimated total of 56 hours for interviews, counseling, and medical procedures. The screening carries risks of unanticipated findings with severe consequences for insurability. (...) The daily hormone injections can be painful and uncomfortable, causing cramping, abdominal pain, nausea, vomiting, bloating, mood changes, and irritability. (shrink)

In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but that there is another (...) autonomy-based objection to paid plasma donation that has not received sufficient attention. Namely, the stigma that surrounds exchanging plasma for payment makes it difficult to make an autonomous decision to engage in this activity. I suggest that this problem can be overcome in one of two ways; by banning payment for plasma, or by reducing the stigma surrounding this practice. I provide an indication of how we might work to achieve the latter, contending that this possibility should be taken seriously, due to the difficulties in achieving a sufficient supply of plasma without remuneration. (shrink)

L’article interroge la trajectoire psychique d’une patiente infertile qui réclame de choisir sa donneuse d’ovocytes elle-même, en ligne, comme cela peut se faire à l’étranger. L’hypothèse retenue consiste à interpréter sa démarche comme un contre-investissement de la position passive de réception qu’implique un don d’ovocytes au profit d’une logique d’emprise, de marchandisation et de dévalorisation de la donneuse d’ovocytes. Un fantasme sous-jacent nous paraît émerger de l’étude d’un cas clinique : « cracher sur la main qui me donne ». À (...) travers un panorama du don d’ovocytes aux États-Unis, l’auteur s’interroge également sur les limites de la rhétorique du don et de l’altruisme en matière de don de gamètes. Sa méthodologie du cas unique s’appuie sur une approche complémentariste qui fait appel à des données sociologiques et économiques. (shrink)

Social scientists have shown that scientific characterizations of the egg and the sperm are shaped by gender stereotypes and cultural values. How have such characterizations been transformed by a recent embrace of -omics, when studies of reproduction increasingly go beyond genomics to incorporate proteomics, transcriptomics, exposomics, and other -omics perspectives? Scientists studying reproduction and analyzing eggs, sperm, and embryos are in some ways reimagining the roles, identities, and functions of gametes as fundamentally shaped by other molecular entities and environments. Such (...) relational understandings of substances and processes, however, continue to operate through a teleology that often conscripts more nuanced -omics reflection into familiar genomic visions of sex and reproduction. While ideas of the gene as an alienable object may be unraveling, -omics efforts to go beyond the egg and the sperm are frequently constricted by an understanding of reproduction that remains tied to individualized bodies and by a genomically infused interpretation of the gamete as life itself. (shrink)

Identity crafts for migration and citizenship purposes require the assistance of brokerage actors that help secure documents, advise on self-presentations, and vouch for relevant credentials. While recognizing the contradictory roles these intermediaries play in both facilitating and controlling migration and the porous boundary between for-profit and non-profit actors, scholars have yet to explore what challenges these characteristics pose to the organization of a particular brokerage transaction. How do these intermediaries reconcile their roles as migration facilitators and surrogate gatekeepers? Does it (...) matter to present the transaction as driven by financial rewards or other loftier goals? How are the boundaries between different types of intermediaries enacted and contested? I explore these questions through the case of a religious organization that helps migrants establish their religious identities for asylum claims-making on religious grounds. Combining insights from the “relational work” approach with ethnographic research in Korean evangelical congregations in the U.S., I show how the template of gift giving allows the church to focus on making the faithful as God’s intermediary, instead of screening them as the state’s private deputy, and avoid an accusation that its trade with asylum-seekers turns the Christian persona into a quasi-commodity. The boundary between the church and commercial brokers, between gift giving and market exchange, however, is constantly contested and renegotiated through the interaction between the transaction parties. In conclusion, I discuss how the relational work approach can advance our comparative inquiry into the brokerage transactions facilitating the “profane” exchange of “sacred” identities for migration and citizenship purposes. (shrink)

This article examines valuation and payment practices of psychoanalysts in Buenos Aires, Argentina. Psychoanalysts do not use explicit sliding scales but rather reach an agreement about fees in conversation with the patient. This negotiation is conducted with some principles of gift-giving, where parties try to give more, rather than through competitive bargaining (an inverted bazaar). Drawing on the sociology of money, morals and markets, and valuation studies literatures, I distinguish four factors to explain this: 1) Some formally produced prices as (...) well as market mechanisms shape benchmarks for fees, but the peculiar service psychologists offer (which makes quality judgments hard), the way patients and therapists are matched, and the lack of public information about prices allow for high flexibility in price-setting; these are structural factors that remain unsaid in the conversation on fees. 2) A professional narrative that highlights a responsibility towards patients that should not be contaminated by economic interest. 3) Psychoanalysts’ elaborations on the meanings of the payment, which should reflect the uniqueness of each patient and the bond analyst-patient and symbolize the patient’s commitment to treatment, involving a cost and a loss beyond the economic. 4) The prevalence of cash, face-to-face payment without intermediaries, which helps desacralize the analyst and disentangle the session from the rest of the economic life of the analyst, but impedes evading moralization of the transaction. Payments in psychoanalysis are delicate arrangements, and analysts often stress about valuation and payments. They have to be careful to ensure this flexibility results in morally acceptable transactions. (shrink)

This article employs the concept of respectability and the discursive representation of gender equality policies to discuss how surrogacy is represented in Nordic parliamentary debates and policy documents. The article’s objective is to study how respectability, problems and equality are represented and discursively and rhetorically produced through a comparative study of Finnish and Norwegian political discourses on domestic unpaid surrogacy and cross-border commercial surrogacy. The article uses rhetorical and discursive analysis to analyse the Finnish and Norwegian Parliaments’ bills, members’ initiatives (...) and proceedings from 2002 to 2018. Finland’s policy on surrogacy has evolved from an unregulated and permissive approach towards a more restrictive one, with discourses focusing on medicalisation, equality, altruism and safety concerning domestic surrogacy and problems and risks concerning cross-border surrogacy. Norway’s policy on surrogacy has been restrictive consistently, with discourses focusing on surrogacy as a transnational social problem involving exploitation of women and children, and biocentrism. Analysing surrogacy regulation in Nordic welfare states, the author concludes that policies and parliamentary debates in both countries have expressed expectations for inclusive health policies and social security for families. Cross-border surrogacy is characterised as an unwanted consequence of globalisation and marketisation of reproduction. Surrogate mothers’ respectability is constructed through rhetoric on differences in terms of nationality, class and binary representations of female caring and instrumentalism. (shrink)

Progressing beyond the given has been a key modern tendency. Yet modern societies are currently facing the problem of how to put limits on progress, expansion, and growth, live within them, and preserve (rather than transcend) the present. Drawing on economic sociology scholarship on valuation and morality in economic life, this article develops and applies the term economization to analyze the enactment of limits on progress. The question of end-of-life care—when to stop medical efforts to prolong life, postpone death, and (...) advance the scientific frontier—serves as an illustrative empirical case that sheds light on limit-setting in general. My analysis of this case combines historical, ethnographic, and in-depth interview data on US palliative care clinicians, who specialize in making life-and-death decisions in acute care hospitals. (shrink)

Decades of public investment in molecular technologies and data integration techniques have fueled promises of precision medicine (PM) as a novel, targeted, and data-driven approach that takes into...

In both social science and medicine, research on reproduction generally focuses on women. In this article, we examine how men’s reproductive contributions are understood. We develop an analytic framework that brings together Cynthia Daniels’ conceptualization of reproductive masculinity with a staged view of reproduction, where the stages include the period before conception, conception, gestation, and birth. Drawing on data from two medical sites that are oriented to the period before pregnancy, we examine how gendered knowledge about reproduction produces different reproductive (...) equations in different stages of the reproductive process. We conclude with a new research agenda that emerges from rethinking the role of men and masculinity in reproduction. (shrink)

The United States has become an ideal marketplace for those seeking selective technologies that are illegal, inaccessible, or unavailable in their own countries. Specifically, technologies such as commercial egg donation, preimplantation genetic diagnosis, and sex selection are prohibited or highly regulated in many nations, but remain legal and largely unregulated in the United States. Based on in-depth interviews with US fertility industry providers, including physicians and egg donor and surrogate brokers, this article analyzes how the ideologies of genetic determinism and (...) consumer choice are embedded in the industry. These are transformed into competitive advantages that may appeal to foreign nationals unable to acquire the technologies, services, and reproductive materials to which they feel entitled. Regardless of providers’ particular attitudes regarding the uses of selective technologies, their overall practice reinforces intended parents’ desires to have some control over their potential children’s appearance, temperament, abilities, and behavior. Despite other nations’ laws and policies, ideologies supportive of the use of selective technologies do not, obviously, end at the US borders, and the globalization of communications, media, and transportation technologies enable their spread. (shrink)

Engaging with the work of C. Wright Mills and Eve Sedgwick, in this article I theorize how homoerotic relations facilitate the flow of global capital into risky market economies. Drawing on interview data with more than 60 financial professionals managing foreign investments in Vietnam, I examine the co-constitution of gender and global capital by identifying three categories of deal brokers. System maintainers are men and women who accept that women’s bodies are necessary for male homosocial bonding between political and economic (...) elites. System transformers are men and women who disrupt the status quo and develop alternative ways of deal brokering outside of erotic spaces. System defectors are those break the triangle altogether and work to create new markets. (shrink)

In this article, I discuss cross-border egg provision by young South African women as a form of traveling biolabor that is critically about embodiment, and aspirations for mobility and cosmopolitanism. The frame of biolabor challenges the frames of altruism/commodification, and choice/coercion, and instead highlights the desires of egg providers, fundamental to the creation and maintenance of the global fertility market. When biolabor crosses borders as traveling biolabor, the analysis can focus on the specificities of inequalities embedded within such reproductive mobility. (...) Traveling or mobility is often a privileged decision and connotes freedom and cultural capital. Yet, when applied to young white egg providers from South Africa, this traveling biolabor relies on a particular kind of biopolitics wherein the reproductive potential of ova/egg is fundamental in facilitating women’s cross-border mobility. I divide the findings sections into three key themes—“cosmopolitan competency,” “alternatives to maternity,” and “productive pain”—to argue that, on the one hand, from recruitment of traveling egg providers to their management, this biolabor is built on the young women’s aspirations for cosmopolitanism. Traveling biolabor becomes a way to escape the normative expectations of their families and the national project of the volksmoeder. On the other hand, the pursuit of these aspirations is critically contingent on management successfully reframing the embodied pain of egg provision as well as the biolaborer’s own maternity. Laborers’ desires and management disciplining tactics converge to sustain the global fertility market. (shrink)

In this article, we examine the ways gendered frames shift to make room for societal changes while maintaining existing pillars of systemic gender inequality. Utilizing the case of U.S. media representations of transgender people who reproduce, we analyze how media outlets make room for increasing societal recognition of transgender people and maintain cisnormative and repronormative traditions and beliefs in the process. Specifically, we outline how these media outlets accomplish both outcomes in two ways. First, they reinforce cisgender-based repronormativity via conceptualizations (...) of transgender reproduction as new and occurring in contrast to normative, cisgender reproduction. Second, they create a transnormative reproductive subject, which establishes a new socially sanctioned script for what it means to be transgender and what types of transgender experience may be recognized or accepted in mainstream society. In conclusion, we draw out implications for understanding how social authorities may shift existing gender frames to make room for changes in society while at the same time maintaining normative beliefs. These normative beliefs continue to facilitate societal patterns of gender inequality within such new frames. (shrink)

The harvesting of data about people, organizations, and things and their transformation into a form of capital is often described as a process of “accumulation by dispossession,” a pervasive loss of rights buttressed by predatory practices and legal violence. Yet this argument does not square well with the fact that enrollment into digital systems is often experienced as a much more benign process: signing up for a “free” service, responding to a “friend’s” invitation, or being encouraged to “share” content. In (...) this paper, we focus on the centrality of gifting and reciprocity to the business model and cultural imagination of digital capitalism. Relying on historical narratives and in-depth interviews with the designers and critics of digital systems, we explain the cultural genesis of these “give-to-get” relationships and analyze the socio-technical channels that structure them in practice. We suggest that the economic relation that develops as a result of a digital gift offering not only masks the structural asymmetry between giver and gifted but also permits the creation of the new commodity of personal data, obfuscates its true value, and naturalizes its private appropriation. We call this unique regime “accumulation by gift.”. (shrink)

There is a growing consensus that the offer of a reasonable compensation for oocyte donation for reproductive treatment is acceptable if it does not compromise voluntary and altruistically motivated donation. However, how to translate this ‘reasonable compensation’ in practice remains unclear as compensation rates offered to oocyte donors between different European Union countries vary significantly. Clinics involved in oocyte donation, as well as those in other medical contexts, might be encouraged in calculating a more consistent and transparent compensation for donors (...) if the elements that constitute a reasonable compensation are explicated. In doing so, lessons can be learnt from living organ donation and medical research participation. Practices in which the elements of a reasonable compensation for the individuals involved have already been more defined in the literature. By means of analogical reasoning, we will outline the different components of a reasonable compensation and subsequently apply these to the context of oocyte donation. We will argue that oocyte donors should first of all be reasonably reimbursed direct expenses related to the donation, without standard remuneration of lost wages. Second, donating oocytes requests a serious time investment, therefore donors are entitled to suitable compensation for their time spent and efforts made. Finally, we will explain that a reasonable compensation consisting of these two components allows for altruism to remain the key value of oocyte donation for reproductive treatment. However, if we acknowledge that donors’ motives are more complex and often include reasons from self-interest, the reasonable compensation may be complemented with modest (non)monetary benefits. (shrink)

I connect commodification arguments to an empirical literature, present a mechanism by which commodification may occur, and show how this may restrict the range of goods and services that are subject to commodification, therefore having implications for the use of commodification arguments in political theory. Commodification arguments assert that some people’s trading a good or service can debase it for third parties. They consist of a normative premise, a theory of value, and an empirical premise, a mechanism whereby some people’s (...) market exchange affects how goods can be valued by others. Hence, their soundness depends on the existence of a suitable candidate mechanism for the empirical premise. The ‘motivation crowding effect’ has been cited as the empirical base of commodification. I show why the main explanations of motivation crowding – signaling and over-justification – do not provide mechanisms that could underpin the empirical premise. In doing this, I reveal some requirements on any candidate me... (shrink)

Abstract BACKGROUND: Anonymity remains the more common practice in gamete donations, but legislation prohibiting anonymity with a goal of protecting donor-conceived children's right to know their genetic origins is becoming more common. However, given the dearth of research investigating the function of anonymity for donors and recipients, it is unclear whether these policies will accomplish their goals. The aim of this study was to explore experiences with anonymity among oocyte donors and recipients who participated in an anonymous donor oocyte program (...) and to understand the ways in which anonymity functions for them. -/- METHODS: Semistructured interviews were conducted with 50 women: 28 oocyte donors and 22 recipients who were recruited from an academic center for reproductive medicine in the United States. -/- RESULTS: Donors and recipients view anonymity both as a mechanism to protect the interests of all parties (recipients, donors, and donor-conceived children) and as a point of conflict. Specifically, three key areas were identified where both donors and recipients saw anonymity as having an important role: relieving anxieties about family structures and obligations; protecting their interests and those of donor-conceived children (while acknowledging where interests conflict); and managing the future. -/- CONCLUSION: As gamete donation increasingly moves away from the practice of anonymity, examining why anonymity matters to stakeholders will be helpful in devising strategies to successfully implement identity-release options. (shrink)

Gamete donation offers a unique opportunity to compare men and women's relationships to reproductive decision-making, unlike other reproductive processes, which typically involve women's bodies much more asymmetrically. I address medical and reproductive decision-making by examining how a gamete donor's partner may be involved in the donation process. Some countries explicitly involve a donor's partner by legally requiring spousal consent for donation, but this is not the case for the U.S. In the absence of any formal regulation, what are the expectations (...) for involving a donor's partner? Through a content analysis of materials from donation programs across the U.S., I examine how donation programs configure the partner's role. Overall, I find that there are quite different expectations for partner involvement in egg versus sperm donation. Such differences, I argue, both stem from and reinforce existing issues navigating boundaries between intimate relationships and women's medical and reproductive autonomy. (shrink)

Recent cases involving biosamples taken from indigenous tribes and newborn babies reveal the emptiness of informed consent. This venerable doctrine often functions as a charade, a collective fiction which thinly masks the uncomfortable fact that the subjects of human research are not actually afforded full information regarding the types of research that may be contemplated, nor do they provide meaningful consent. But if informed consent fails to provide adequate protection to the donors of biological materials, why not turn to principles (...) of property law? Property is power, yet current law permits everyone except for those who donate biological materials to possess property rights. The reluctance to invoke property probably stems from fears of resurrecting slavery and the commodification of human beings. But ironically, avoidance of property transforms the subjects of human research into objects that can be owned only by others, resulting in new forms of oppression and exploitation. Human research subjects are autonomous individuals who should not only possess the power to contribute their biological materials, but also the right to help control the course of research, and to share in the resulting benefits or profits. Conferring body property might enable research subjects to regain power and a measure of self-sovereignty. (shrink)

Background: The availability of assisted reproductive technologies (ARTs) in the medical marketplace complicates our understanding of reproductive public policy in the United States. Political debates over ARTs often are based on fundamental moral principles of life, reproduction, and kinship, similar to other reproductive policies in the United States. However, ARTs are an important moneymaking private enterprise for the U.S. biotechnology industry. This project investigates how the U.S. states regulate these unique and challenging technologies as either moral policies or economic policies. (...) Methods: This study employs ordinary least squares (OLS) regression to estimate the significance of morality and economic policy variables on ART policies at the state level, noting associations between state-level political, economic, and gender variables on restrictive and permissive state-level ART policies. Results: Economic variables (reflecting the biotechnology industry) and advocacy for access to ART on behalf of infertility patients increase the chances of states passing policies that enable consumer use of ARTs. Additionally, individual ART policies are distinct from one another in the ways that morality variables increase the chances of ART regulations. Surprisingly, the role of religious adherence among state residents varied in positive and negative relationships with individual policy passage. Conclusions: In general, these results support the hypothesis that ART laws are associated with economic as well as moral concerns of the states—ARTs lie at the intersection of issues of life and reproduction and of scientific innovation and health. What is most striking about these results is that they do not follow patterns seen in the legislation of abortion, contraception, and sexuality in general—those reproductive policies that are considered “morality policy.” Similarly, economic variables are not consistently significant in the expected direction. (shrink)

This article develops an analytical framework to study the role of narratives in markets and argues that there is a relationship between the structure and composition of narratives produced by market actors and market dynamics. With respect to theory, the article bridges the perspectives that study markets as cultures and as fields and draws from the organizational studies approach to the analysis of narratives. Two empirical cases of the crises narratives in the emerging contemporary art markets of Russia and India (...) illustrate the use of the framework. The analysis is based on in-depth interviews with artists and art dealers as well as observations in Moscow, Saint Petersburg, New Delhi, and Mumbai conducted between April 2012 and June 2013. The article shows that there is a widely shared crisis narrative with a coherent structure in the Indian art market. In contrast, fragmented and contested stories that lack narrative structure dominate in the Russian art market. The analysis of the first case highlights the narrative structure and shows the productive work it does in the Indian market—it provides a moral justification of existing market norms and produces a perspective for the future. The analysis of the second case focuses on the context of narrative production and connects the conflicting interpretations of the crisis in the Russian art market to contested hierarchies and persistent uncertainty. (shrink)

Mainstream breast cancer social movements such as that of Susan G. Komen have called on all women to race or fight for the cure for breast cancer. They suggest that the fight can be won by buying and wearing pink ribbons, taking part in races and walks, donating money, and participating in research. For some patients with breast cancer, research participation may involve non-diagnostic tumor biopsies. While this clinical research is performed in the hope of gaining new knowledge through the (...) removal and study of breast cancer tissue, these procedures have been heavily criticized because they offer little potential benefit to the patient providing the tissue (Helft and Daugherty 2006; Kimmelman et al. 2012;... (shrink)

There has been a great deal of discussion about the ethical implications of donating sperm and of the ways in which donated tissue is presented, selected, and sold for use in assisted reproduction. Debates have emerged within the academic sphere, from donor offspring and recipients, and in broader popular culture, including questions about the commodification of human tissue and the eugenic potential of selecting donors from particular demographic categories. However, the voices of donors themselves on this subject have been largely (...) silent. This paper draws on data from qualitative interviews with men who donated at a major Danish sperm bank between 2012 and 2013. It argues that many of them are indeed thinking through these complex issues. Donors’ approaches to ethical issues fell into two broad ‘types’: a pragmatic, individualistic approach which focused on more immediate personal consequences, and an ethically-driven approach in which donors considered the impact of donation on offspring and on a wider societal level. (shrink)

The idea of paying donors in order to make more human bodily material available for therapy, assisted reproduction, and biomedical research is notoriously controversial. However, while national and international donation policies largely oppose financial incentives they do not treat all parts of the body equally: incentives are allowed in connection to the provision of some parts but not others. Taking off from this observation, I discuss whether body parts differ as regards the ethical legitimacy of incentives and, if so, why. (...) I distinguish two approaches to this issue. On a ”principled” approach, some but not all body parts are inherently special in a way that proscribes payment. On a ”pragmatic” approach, the appropriateness of payment in relation to a specific part must be determined through an overall assessment of e.g. the implications of payment for the health and welfare of providers, recipients, and third parties, and the quality of providers’ consent. I argue that the first approach raises deep and potentially divisive questions about the good life, whereas the second approach invokes currently unsupported empirical assumptions and requires difficult balancing between different values and the interests of different people. This does not mean that any attempt to distinguish between body parts in regard to the appropriateness of payment necessarily fails. However, I conclude, any plausible such attempt should either articulate and defend a specific view of the good life, or gather relevant empirical evidence and apply defensible principles for weighing goods and interests. (shrink)

Oocyte donation raises conflicts of interest and commitment for physicians but little attention has been paid to how to reduce these conflicts in practice. Yet the growing popularity of assisted reproduction has increased the stakes of maintaining an adequate oocyte supply and minimizing conflicts. A growing body of professional guidelines, legal challenges to professional self-regulation, and empirical research on the practice of oocyte donation all call for renewed attention to the issue. As empirical findings better inform existing conflicts and their (...) potential harms, we can better attempt to reduce these conflicts. To that end, the article first describes the nature of conflicts in oocyte donation and relevant regulations and professional guidelines. We then describe studies on conflicts at four phases of oocyte donation: recruitment, screening, stimulation, and post-stimulation monitoring. Next we consider three models for conflict reduction in medicine generally: improved professional self-regulation, outright restriction like Stark anti-referral laws, or the use of conflict mediators, like in living organ donation. We ultimately conclude that improved professional self-regulation is a reasonable starting place for oocyte donation. (shrink)

A sociologist examines contemporary engagements of queer bodies and identities with fertility biomedicine. Drawing on social science, media culture, and the author’s own empirical research, three questions frame the analysis: 1. In what ways have queers on the gendered margins moved into the center and become implicated or central users of biomedicine’s fertility offerings? 2. In what ways is Fertility Inc. transformed by its own incorporation of various gendered and queered bodies and identities? And 3. What are the biosocial and (...) bioethical implications of expanded queer engagements and possibilities with Fertility Inc.? The author argues that “patient” activism through web 2.0 coupled with a largely unregulated free-market of assisted reproduction has included various queer identities as “parents-in-waiting.” Such inclusions raise a set of ethical tensions regarding how to be accountable to the many people implicated in this supply and demand industry. (shrink)

In this paper, we provide as accurate a picture as possible of transnational trade in human eggs involving Canadians. We explain the legal status in Canada, and call for reform in the regulation, of such trade.