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Parental choice and child welfare

17 June 2003
Appeared in BioNews 212
Developments in assisted reproduction have opened up new choices for prospective parents over the past few years. IVF and donor insemination (DI) allow infertile individuals and couples to have the family that nature has denied them. But they also allow fertile people to make choices about when and how to have children - even what kinds of children they have.

At a conference in London yesterday, clinicians, lawyers and other interested parties came together to discuss the duties that practitioners of IVF and PGD (preimplantation genetic diagnosis ) owe to the children who might be born as a result of the treatment that they provide. Under UK law, practitioners are obliged to 'take account of the welfare of any child born as a result of treatment'. Although the regulatory body (the Human Fertilisation and Embryology Authority, HFEA) provides some extra details as to what kinds of questions clinics should ask of their patients, quite how the welfare of the future child should be 'taken into account' remains pretty unclear. The result is that individual clinics have completely different policies in place as to what kinds of patients they will accept onto their treatment programmes. For instance, some clinics accept lesbian couples and single women seeking donor insemination, whilst others generally turn down their request for treatment.

Some legal experts at the conference advised clinics with policies that bar particular groups of patients, such as lesbian couples or single women, to rethink those policies. Clinics with a blanket ban of this kind run the risk of legal actions from patients who have been refused treatment on the basis of, arguably, discriminatory judgements.

Aside from the legal issues, how does the welfare of the child obligation work in practice? Some practitioners are concerned that the welfare of the child obligation under the act is too vague to implement in any consistent fashion. Others feel that they are ill-equipped to make a meaningful judgement as to what would be in the best interests of a child born to a particular person or couple. But perhaps there are more fundamental problems with the welfare principle. Should doctors offering a clinical service to assist conception be making social judgements about the parenting skills of prospective parents?

The HFEA is planning to review the welfare of the child provisions in the act and its code of practice (which clinics must adhere to), so the debate is likely to step up a gear over the coming months. Progress Educational Trust's conference in London on 25 November 2003, Chosen Children, will also examine the issue of what impact reproductive choice is having on the resulting children and what policy changes should follow from that. If our chosen children are faring well in life, perhaps it's time that we allowed prospective parents more choice, rather than less.

SOURCES & REFERENCES
Chosen children
Progress Educational Trust |  25 November 2003
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