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Your thoughts about donor conception, conditionality and adoption

20 May 2013

By Sandy Starr

Appeared in BioNews 705

Following on from last week's article (see BioNews 684), we now turn to the final questions of the 'When It Takes More Than Two' poll - about whether gamete donors should be allowed to place conditions on who receives their donation, and whether those who are considering having children via donor conception should be encouraged to adopt instead.

The placing of conditions by a donor, specifying recipients who can or cannot be treated with their donated sperm or eggs (for example a sperm donor specifying that his sperm should not be used by a lesbian), is currently permitted in the UK. However, there is arguably a tension between this fact and the provisions of UK equality law. Indeed, at a meeting in 2011 the Human Fertilisation and Embryology Authority (HFEA) considered whether to continue permitting conditionality, in light of the latest equality legislation. The HFEA decided to permit conditionality, but there was dissension from authority members - this is a controversial subject.

Our poll asked 'Should egg and sperm donors be allowed to place conditions on who receives their donation?'. Two-thirds (67 percent) of the people who responded to this question thought that donors should not be allowed to place conditions on who receives their donation, and one-third (33 percent) thought that donors should be allowed to.

Those respondents who thought donors should be allowed to place conditions were asked a follow-up question - 'On what grounds should donors be permitted to prevent people from receiving their donation?' - with four options to choose from, and the additional possibility of suggesting reasons of their own. These options were not mutually exclusive, which meant that people could choose more than one option if they so wished.

The most popular condition that people thought it should be possible to place upon donation, named by two-thirds (66 percent) of those who thought such conditionality should be allowed, was the age of the recipient. The next most popular option, named by half (50 percent) of those who thought such conditionality should be allowed, was the recipient's sexuality. The final two options that could be chosen were religion (selected by 45 percent) and race/ethnicity (selected by 40 percent).

In addition to this, 37 percent of those who thought conditionality should be allowed took the opportunity provide their own suggestions of conditions that they thought donors should be able to place. Many diverse suggestions were given, but certain common themes emerged. The most popular suggestion was that donors should be able to place any conditions they wish upon their donation. In the words of one respondent, 'donors should be able to discriminate in the same way any person discriminates when choosing the person they want to have children with'. In the words of another: 'They are creating another person and have the right to have as much input as they so choose. [...] Perhaps if more conditions were permitted, more donors would feel comfortable donating'.

Some respondents saw conditionality as a mechanism for ensuring that the donor is identifiable (their identity made available, on request, to people conceived with their donation once they turn 18) or even known (their identity known to the recipient from the outset). Responses included 'any condition should be allowed if the donation is not allowed to be anonymous', 'as an egg donor I would only donate to a couple known to me', 'they should be permitted to restrict their donation to particular individuals or couples', and 'wanting contact - ie, known donor'.

Further to this, some respondents saw conditionality as a means for the donor to ensure that children conceived from their donation are told about their donor-conceived origins (or conversely, as a means for the donor to ensure that children are not told). Responses included 'should be able to specify if child of donor conception receives details about who you are', and 'whether resulting children will be told of their origins or not'.

Several respondents thought conditionality could be used to avoid a mismatch between the opinions and values of the donor and the recipient, with some thinking this was particularly important now that donor anonymity has been removed. Some respondents implied that people with bigoted or otherwise prejudiced views shouldn't be permitted to receive donated eggs or sperm at all - 'the child must grow in a family with few prejudices as possible' and 'I wouldn't want my biological child being brought up by racists, sexists, homophobes, etc'. Other saw this more dispassionately, as being about compatibility - 'children should never find out that the parents are abhorrent to the donor', 'if the donor has an intense dislike for some religious, ethnicity or sexual orientations then it would not be appropriate for recipient to be from that group', 'think about future contact between donor who is homophobic and lesbian couple who have received the donation'.

Some of the conditions suggested related to the prospective family structure and number of existing children. Some specified 'relationship status', 'single lifestyle' or 'not in a stable relationship', some went further and specified 'marital status', and there were several variations on 'restrict to only opposite sex married couples' (with one respondent keen to point out 'I wish to make it clear that I am not homophobic but believe that children deserve two parents of opposite sex'). Regarding the number of children, some respondents thought the recipient's 'number of current children' was a legitimate condition, while others were keen that the donor be able to 'limit number of children created by donation.'

Many of the conditions suggested were connected with the moral standing and worth of the recipient, and the welfare of the donor-conceived child. Some people posed these things in broad terms -'whether or not the recipients would make good parents', 'capability to be "good enough parents" if this can be ascertained', 'anything that could prevent the potential child from living a "good" life' - prompting the question of how such subjective qualities could ever be fairly or formally defined.

Other suggested conditions related to 'education'. 'income', 'social class', 'socioeconomic status', 'standard of living', and various permutations of drug and alcohol (ab)use. Several respondents suggested the health of the recipient should be a permissible condition, including 'disability (mental and/or physical)', and there were several variations on 'shortened life expectancy of recipient'. There were also a number of respondents who thought the recipient's criminal record was a legitimate basis for placing conditions, with some responses specifying types of crime - 'sex offenders' and 'violence'.

The last question in the poll - 'Should people who are considering having children via donor conception be encouraged to adopt instead?' - echoes a question that is almost always to be found in online comment threads following a news story about donor conception. Those who receive or provide fertility treatment often express exasperation with this question, on the grounds that it misconstrues or disparages their needs, desires, experiences and constraints. But since the question's popularity is enduring, and since several people suggested it be included, we thought its inclusion in the poll was appropriate.

In the event, of those who responded to this question 37 percent thought that people who are considering having children via donor conception should be encouraged to adopt instead. The remainder, 63 percent - a clear majority - disagreed.

What do these poll results tell us? At the Progress Educational Trust (PET), we are perhaps overfamiliar with the views held by the various groups, stakeholders and factions in discussions of donor conception. Responses to this poll have reminded us that some of the most fundamental questions relating to donor conception - anonymity, disclosure, conditionality and the option of adoption - are still unresolved. Even when we poll a self-selecting audience of BioNews readers, we find that their opinions on some aspects of donor conception are poles apart.

PET would like to thank everyone who responded to and suggested questions for the poll. The 'When It Takes More Than Two' project was supported by the Wellcome Trust.

SOURCES & REFERENCES

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

02 June 2014 - by Petra Nordqvist 
How do genes and genetic relationships actually matter in the messy and complex world of everyday life? The event 'Do genes matter? Donor conception and family life' discussed genetic connections and family life from the legal, sociological and scientific points of view...
12 May 2014 - by Sarah Norcross 
I don't often put my hand up to review books when they pop through the letterbox. Normally, after the pleasure of opening the parcel and inhaling the scent of fresh book, I quickly put it on someone else's desk...
12 August 2013 - by Daniel Malynn 
Joan Bakewell presents the case of Rosemary, a 36-year-old woman with Ehlers-Danlos syndrome undergoing IVF...
29 July 2013 - by Sarah Norcross 
Given that the Progress Educational Trust (PET) has just completed a project on gamete donation I was more than intrigued about this debate, but was left disappointed...

13 May 2013 - by Sandy Starr 
The Progress Educational Trust (PET)'s project 'When It Takes More Than Two', supported by the Wellcome Trust, sought to clarify public and professional understanding of donor conception by focusing on the different parties involved...
22 April 2013 - by James Brooks 
A podcast produced as part of the When It Takes More Than Two project organised by the Progress Educational Trust...
04 March 2013 - by Cait McDonagh 
Another full house for the final event of Progress Educational Trust's 'When it Takes More Than Two' series. This time attendees were invited to consider gamete donation from the perspective of the donor conceived...
18 July 2011 - by Sandy Starr 
The UK's fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), has made its first set of decisions following the outcome of its recent consultation on sperm and egg donation, known as the Donation Review...

HAVE YOUR SAY
Conditionality and Donation (redwonder - Updated on 23/05/2013)
A body part belongs to the body it came from even when its cut off and given to someone else.  My lung in another person's body will always be my lung and not theirs after all they would not need mine if they had their own.  My lung will cease to aid in my breathing function and will begin supporting another individual's body in staying alive.  I could not ask for it back without killing them so I'm kind of stuck with the decision I made.  But if another lung became available for that person to use and I was willing to pay for the operation it would not be that unreasonable to ask for mine back.  In theory I could give up a lung or a kidney as a lonor until one was available for them from a cadavor and It would still be a generous offer and would keep them alive.  Now I could not force a person to undergo surgery if they did not want to but maybe there could be some monitary damages for not giving me my lung back when they could have had another one installed but chose not to.  This extreme example is unlikely but it illustrates the nature of a person's body, their cells are theirs and we have to leave it up to people to be in charge of their own bodies lest we start thinking we actually own other people and their parts.
How gametes are different from lungs and blood (redwonder - Updated on 23/05/2013)
Unlike a blood donation and unlike a kidney donation gametes never stop operating to support the reproductive function of the donor.  The donated kidney will filter toxins to keep another body alive, donated blood will keep another person alive long enough to produce their own blood.  The donated gamete never helps a sterile or infertile recipient reproduce, it helps the donor reproduce so that a customer of the clinic can take and raise the donors child without the donor's involvement.  Assisted reproductive therapy that involves a donor always requires assisting the donor in reproducing and people should be allowed to determine who they will and won't reproduce with and since they are also signing agreements to essentially abandon their offspring for others to take and raise as their own it is not unreasonable to suggest that people might have some caveats as to how they want their child to be raised.  If they want their child raised in their faith it's not unreasonable.  In fact you have to wonder how anyone could simply want to check the people out before allowing them to raise their offspring.  

Forget for a moment that it's their own offspring they are letting other people raise because many people here might count the blood ties as worthless.  If the donor were handed a strange and unrelated infant and told they have a day to find this infant a permanent home what criteria would they use to determine who to send that strange infant home with?  Would they hand the infant to anyone who paid the clinic for a baby without doing a back ground check?  Who would do such a thing?  Donors seem to on the surface - what is so unreasonable about them getting to say who gets to raise the baby they will be responsible for creating?

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CROSSING FRONTIERS

Public Conference
London
8 December 2017

Speakers include

Professor Azim Surani

Professor Magdalena Zernicka-Goetz

Professor Robin Lovell-Badge

Sally Cheshire

Professor Guido Pennings

Katherine Littler

Professor Allan Pacey

Dr Sue Avery

Professor Richard Anderson

Dr Elizabeth Garner

Dr Andy Greenfield

Dr Anna Smajdor

Dr Henry Malter

Vivienne Parry

Dr Helen O'Neill

Dr César Palacios-González

Philippa Taylor

Fiona Fox

Sarah Norcross

Sandy Starr


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