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Winter 2014 • Lowell Pritchard on risk and uncertainty in environmental economics
Winter 2014 • Lee Lane on clashing worldviews, green politics, and a path forward
Spring 2014 •
Ronald Bailey on whether modern societies and free economies are antithetical to the flourishing of the natural world
Winter/Spring 2013 • Noemie Emery considers the good, the bad, and the ugly of horseracing
Fall 2012 • Rand Simberg on the legal framework needed to settle the final frontier
Summer 2012 • Joseph V. Kennedy on how the public and private sectors pay for R&D
Spring 2012 • Adam J. White on roads, rails, canals, and the politics of nation-building
Spring 2012 • Ari N. Schulman on patient exploitation and the bad case for human tissue markets
Winter 2009 • David Gratzer on how government ruins medicineNext
March 25, 2009 •
After months of delay, Treasury Secretary Tim Geithner finally unveiled the Obama administration’s plan for jump-starting a marketplace for “troubled” real estate-backed assets held by banks.
As noted in an editorial in Tuesday’s Wall Street Journal, a more direct, Resolution Trust Corporation-type facility, if initiated months ago as some had advocated, would have worked better, faster, and with more transparency for taxpayers than what Geithner is now planning. But we are where we are, and this plan is much better than no plan. It is long past time to remove the uncertainty hanging over the markets.
And, to be fair, the Geithner approach also seems to stand a reasonable chance of working, too. Some troubled assets should begin changing hands again fairly soon, thus pulling back the curtain on their true value, which should finally allow a bank “work out” to get underway in earnest. There’s no value at this point in Republicans pushing for an alternative approach. It is much better for the country to just get on with the plan that has been presented.
Still, it’s worth noting why the Geithner plan looks as it does. By all accounts, a primary motivation for its complex financial flows is the desire to avoid going back to Congress for funding and approval. Hence the use of FDIC reserves, loan guarantees, Fed money, and the last resources available from the $700 billion in TARP funding. This patchwork approach may work, but it also may leave the administration without any ability to deal with other contingencies—not a good position to be in with a crisis of this magnitude still unfolding.
Indeed, it’s a lamentable state of affairs when, in a true crisis, a Congress controlled by the same party as the president is not trusted by the administration to produce sound emergency legislation when it’s really needed. But that seems to be where we are. And the Obama team really has no one to blame but themselves for this particular box they now find themselves in. The constant drumbeat which has laid the entire blame for the turmoil on private-sector “greed” and “de-regulation” simply reinforces the worse instincts in a left-leaning Congress. What the public needs to hear from President Obama is that this crisis has complex origins, but it would not have occurred if there weren’t massive public-policy failures too, with many powerful Democrats and Republicans to blame, including himself. The flawed corporate structures of Fannie and Freddie which privatized gains and socialized losses. The excessively expansionary monetary policy earlier this decade. Long-standing tax policy which encourages ever larger mortgages. The flow of foreign reserves, driven by excessive U.S. consumption of imported goods, into U.S. credit markets. And the structural federal budget deficits that have fueled more consumption than our incomes could really support. Economists have been warning policymakers of the dangers of each of these policies for years—and far too few in positions of power ever lifted a finger to reduce the risks.
But it is almost too late now for the Obama team to change their tone and start treating the economic crisis with the intellectual seriousness it deserves. The damage has been done. Most members of Congress think they know why we are in this position, and it’s because profit-seeking firms, well, sought profits.
In this environment, the Obama team would be well advised to scuttle the idea of seeking new powers for the Treasury to seize non-bank institutions deemed too big to fail. If the Congress cannot be trusted to provide the financial resources needed in an emergency, can it be trusted to judiciously write a new law allowing the seizure of just about any private sector firm in the country? The same impulse that pushes members toward simplistic explanations for the crisis would surely lead them to support to ill-advised interventions we would regret for decades.
There needs to be a sober discussion of what kind of regulatory approach will prevent a recurrence of this disaster. But this is not the way to go about it. The Obama folks are playing with fire if they ask for sweeping seizure authority now, with this Congress and in this environment.
[Cross-posted at the Corner]
May 12, 2008 •
Donna Dickenson is one of Britain’s leading experts on medical ethics. As professor of medical ethics and humanities at Birkbeck College in London, Dickenson has written on a variety of topics, including death and dying, assisted reproductive technology, the patenting of the human genome, and women’s health. In 2006, she became the first woman to win the prestigious Spinoza Lens prize for her contribution to the public debate on ethics.
Professor Dickenson’s latest book is Body Shopping: The Economy Fuelled By Flesh and Blood, a look at the rapidly growing trade in the human body. She kindly agreed to discuss her new work in an interview with Conceptions. Those in New York can see Prof. Dickenson in the flesh during her book tour on June 18-19. (For more details, see her website, www.donnadickenson.net.)
[Interview conducted, edited, and hyperlinked by Cheryl Miller.]
What is “body shopping”?
DD: I use the term "body shopping" to refer to the way in which human tissue, genes, gametes and organs are becoming consumer items like any other.
In your recent op-ed in the London Times, you write that the "'God vs. science' has become a dangerous distraction." How so? What kind of debate should we be having?
DD: In the Sunday Times article, I argued that the vituperative slanging match into which our debate on the Human Fertilisation and Embryology Bill has descended is diverting attention from serious ethical, economic and political issues about the widespread commercialisation of biotechnology. Debate has centred almost exclusively on "human admixed embryos," created from an enucleated cow or rabbit egg and a human somatic (body) cell, with religious figures lining up against this development and scientists insisting it's necessary for somatic cell nuclear transfer stem cell research. But there are many other important issues centring on the activities of biotechnology firms, such as the clinically dubious "product" offered by private umbilical cord blood banks, or the defensive patenting of human genes with an adverse effect on patient care. The 'God versus science' cliché, however, means that even a secular bioethicist like me risks being branded either a 'Luddite' or a 'God-botherer' for daring to pose ethical questions about scientific developments and their commercialisation.
The medical research community has long argued that ceding any ownership rights over tissue to donors will lead to patients buying and selling their own body parts. Should we own our own bodies? And if not, who should?
DD: It's quite odd for the medical research community to make this argument, when they see nothing wrong with commercial firms buying and selling intangible property rights in genetic sequences, or stem cell lines derived from donors of somatic cells and oocytes. The law has been equally contradictory: traditionally the common law viewed tissue taken from the body as res nullius, no one's thing, and therefore refused to allow patients like John Moore to exercise any rights over cell lines made from their tissue. If res nullius is taken to its logical conclusion, however, it should mean that no one, including researchers, universities and biotech firms, has any rights over cell lines of other forms of tissue either. But I don't actually advocate that we should own our bodies unreservedly: instead I favour more communal systems, such as the PXE model in which patient groups and biotech firms share rights over gene patents.
If we do “own” our own bodies, why aren’t we entitled to sell off an egg or kidney if we so choose?
DD: As I say, I don't believe that we do own our bodies straightforwardly, although I do think that in cases where considerable labour has been expended--first and foremost, egg donation, which has been estimated to require up to 60 hours' labour--the donor should have some rights on a Lockean basis of having 'mixed one's labour'. Even if we did own our bodies, ownership rights in our common law are generally seen as a 'bundle of sticks', from which certain forms of control are chosen appropriate to the need in hand. You might have a right to donate your tissue but not to sell it, for example, as these are separate sticks in the bundle.
Many have argued that without payment, there would be a shortage of sperm and egg donors--as there is of kidney donors. If we use altruism as a principle for all tissue donation, how can we avoid a shortage of available gametes, or determine a fair way of rationing available resources?
DD: This seems to me to be a rather narrow outlook. Only the United States, so far as I know, operates a full-fledged system of egg and sperm sale, but other countries manage perfectly well with a more altruistic system. European countries generally pay expenses only, although the amount varies quite widely--but nothing like the exaggerated amounts paid for 'desirable' eggs in the US, up to $100,000 per cycle from blonde, tall, musical and athletic young women. Where there are shortages of eggs and sperm in European systems, they have more typically been caused by changes in regulations about donor anonymity than by any failure of altruism.
In your book, you note the different ways in which egg donation and sperm donation are treated under the law. You observe, "The assault on freedom is only noticed when it begins to apply to men." Are women more vulnerable to biotech predation? How so?
DD: That point doesn't arise from my discussion of egg or sperm donation; rather, in the last chapter, I argue that we all have 'feminised' bodies now insofar as all bodies are increasingly assumed to be open-access. The tremendous publicity given to the patenting of the human genome--one in five genes are now patented, affecting both sexes equally--contrasts with the very minimal publicity given to the demand for women's eggs in 'therapeutic cloning'--in some cases under conditions which may welll have been coercive, as in the Hwang Woo Suk scandal. Female tissue is still more valuable, but both sexes are vulnerable to 'body shopping'.
You have warned that women who donate their eggs for stem cell research could be at risk from life-threatening side effects. Do you think egg-harvesting and stem cell technologies will become more effective and safe in the future, and would that dispel some of your present concerns?
DD: We are seeing good scientific evidence that low-dosage ovarian stimulation regimes produce just as good overall results in IVF as high-dose ones, even though fewer eggs are 'harvested'. But research in somatic cell nuclear transfer research still requires very high numbers of eggs because the technology is very wasteful (Hwang used over 2,200 eggs to create precisely zero stem cell lines). I am more hopeful about the possibility that SCNT [somatic cell nuclear transfer] will be bypassed altogether, if induced pluripotent stem cell lines do indeed fulfil their promise, since that technique doesn't require human or animal eggs. Last week, by contrast, the upper house of the Western Australian parliament voted against a bill to allow SCNT research on scientific grounds, that the technology had failed to deliver on its earlier promise and the ethical issues around taking eggs from women were too overwhelming. This can be seen as a victory for the attempts made by activists and academics such as Marcy Darnovsky, Sarah Sexton, Diane Beeson, Cathy Waldby and myself to ensure that the risks to women became better known.
Critics argue against organ selling and surrogacy on the grounds that the poor are more likely to be sellers, and that the procedures in question are risky. Yet we allow people to take on dangerous jobs. Further, many argue that serving as a surrogate or selling an organ is their best available option. One Indian surrogate explained her decision thus: "This is not exploitation. Crushing glass for 15 hours a day is exploitation." Are organ selling and surrogacy somehow different from other "exploitative" work?
DD: Freedom of choice is not a knock-down argument. Even where we allow people to 'choose' dangerous jobs, we retain health and safety laws to limit the risk. But few such protections exist for commercial surrogates, particularly in the developing world. In addition, we need to look at the massive difference between what the surrogate is paid--even if it seems a lot to a poor Indian woman--and the profits of the commercial agency arranging the transaction. One US agency, for example, pays surrogates $25,000 but charges $100,000. Most of that $75,000 difference is pure profit. Unless you really think the agency has contributed three times as much of the 'value' of the baby as the birth mother, you would have to classify that as exploitation because the rightful contributor of the value has been shortchanged.
How can we work towards finding treatments for serious diseases without commodifying our bodies? What policies can lawmakers adopt to protect people from exploitation without impeding medical progress?
DD: We will be much more likely to find treatments for serious diseases if we can rectify the grossest abuses of body shopping. The biotechnology industry has been allowed to claim that it is the greatest promoter of medical progress, when in many cases it is arguably the greatest hindrance. That's particularly true where defensive gene patents or restrictive licensing agreements block researchers from developing alternative, better or cheaper cures. A single company, Myriad Genetics has patented the BRCA1 and BRCA2 genes involved in some breast cancers, meaning that in the United States (though not in Europe) a clinical diagnostic test for those genes can only be afforded by those who can pay the fee. Lawmakers and judges need to be much more sceptical about the abuses of genetic patenting in particular; this process has begun in Europe but is still largely ineffective in the United States.
One chapter in your new book is subtitled "Resistance is not futile." But the rise of medical tourism would seem to make legislating an impossible task. If all you need is a passport to buy an egg or find a surrogate mother, how can we effectively regulate biotechnology?
DD: The globalisation of the biotechnology industry does indeed made regulation more difficult, but it's not impossible. In Europe there is now a tissue directive binding on all EC countries, which makes egg sale for IVF illegal. Some European countries, particularly Germany, prohibit their citizens from buying surrogacy or eggs abroad, as well as on German soil. Similar laws exist in some countries in relation to sex tourism, especially with minors, so where the political will is there, a way can be found.