Category Archives: Industry regulation
Kathy Apple, MS, RN, FAAN, is CEO of the National Council of State Boards of Nursing and an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2006-2009). She received the Ben Shimberg Public Service Award from the Citizen’s Advocacy Center.
Human Capital Blog: Congratulations on receiving the Ben Shimberg Public Service Award from the Citizen’s Advocacy Center! What does the award mean for you and for your work at the National Council of State Boards of Nursing (NCSBN)?
Kathy Apple: It is quite an honor for both NCSBN and myself, as this recognition comes from an independent, objective organization that advocates for the public interest, effectiveness, and accountability of health care licensing bodies. It confirms that NCSBN is on the right track in supporting its members, the nurse licensing boards in the United States.
HCB: The award is named for a man who is considered the “father” of accountability in professional and occupational licensing. How are you carrying out his mission at NCSBN?
Apple: Dr. Shimberg was an expert on competency testing and challenged all licensing boards to ensure competence assessments meet the highest psychometric and ethical standards. He urged licensing boards to continuously examine how to improve testing procedures. Dr. Shimberg challenged licensing boards to improve communication to applicants and consumers, to keep data and accurate records on all board business, and be accountable for their own performance. He advocated for licensing boards to conduct research in all aspects of regulatory functions. He encouraged collaboration between and among licensing agencies. He challenged all regulators to have and follow their own code of ethics. Dr. Shimberg really was incredibly insightful and visionary regarding the role and work of licensing boards.
Human Capital Blog: “Sex Cells: The Medical Market for Eggs and Sperm” takes an in-depth look at the business, rather than the science, behind in vitro fertilization. It’s a fresh perspective on a controversial topic. How did you come to choose that as the subject of your studies?
Rene Almeling: As a 19-year-old undergraduate, I read an essay by Katha Pollitt on the Baby M surrogacy trial that took place in 1987. I became fascinated by the complex issues associated with the prospect of women selling reproductive services and wrote a senior thesis based on interviews I conducted with surrogate mothers. More than a decade later, this book is part of an ongoing attempt to sort through the questions raised by bodily commodification.
HCB: How big is this industry, in terms of both people involved and money? How many people does it touch?
Almeling: There are more than 400 fertility clinics in the United States, and they serve thousands of patients every year, making this a multi-billion dollar industry. However, the idea of selling bodily goods makes people very uncomfortable, so the euphemistic language of donation suffuses the market for eggs and sperm. Staffers at egg agencies and sperm banks consistently use this rhetoric, even as they make profits on the sale of sex cells. Egg and sperm donors use it, even as they earn thousands of dollars for their genetic material. And recipients of sex cells use it, even as they purchase eggs and sperm in the hopes of conceiving children.
HCB: Among your key findings is that gender and cultural norms significantly influence the way donor banks pitch to potential egg and sperm donors. Tell us about that.
Almeling: The market for sex cells is structured both by traditional economic forces, such as supply and demand, and also by cultural expectations of women and men that are associated with reproduction and the family. Fertility clinics frame paid egg donation as a gift, while they frame paid sperm donation as a job. These gendered organizational framings have profound implications for egg and sperm donors.