The Daily Mail recently reported that a 59-year-old woman is seeking to give birth to her own grandchild (see BioNews 792). The woman's daughter died from bowel cancer aged 23, but had some of her eggs harvested and frozen, prior to treatment. The mother claims that it was her daughter's 'dying wish' that she (the mother) should use the eggs to have her daughter's child.
The Daily Mail describes the case as 'unprecedented' and highlights the 'large risks' of such treatment. However, many aspects of this case are precedented. A British woman acted as a surrogate for her daughter in 2005.
Such arrangements are not illegal in the UK. Women aged 59 and over have given birth to children following fertility treatment in the UK and elsewhere (1). A British woman of 59 conceived naturally and gave birth to a healthy child in 1997. There are many, many cases of mothers bringing up their daughters' children. And there has been at least one case in the UK where access to a dead loved-one's gametes has been sought and granted despite the lack of consent (2).
Given all this, is there really anything uniquely problematic about this woman's claim? I consider three objections here: confusion over genetic relationships; the risks involved; the lack of formal consent given by the daughter.
Whose child would this be?
The appealingly alliterative Daily Mail headline focusses on the dead daughter. It is her child that might be born. Possessives - 'mine', 'yours' 'ours' - are a common way of indicating who a child 'belongs' to. But this terminology is rather puzzling. We don't own our children, yet we think we have rights to them and over them that are associated with - well - with what? Biology? Genes? Chromosomes?
With the advent of advanced reproductive technologies, we have to develop new understandings of the relationships between technologically-created children and the adults who bring them into being. Would this child be the woman's son/ daughter, or her grandson/ granddaughter? In the UK, the woman who gives birth to a child is the legal mother. Her husband, if she has one, is the legal father. The child need have no genetic link with either parent. If the woman in this case gave birth, it would legally be her child, and that of her husband.
Yet the Mail, and the woman herself, think otherwise, perhaps because the daughter's egg provides half the offspring's chromosomes. Parenthood on this view is genetically determined. Yet if 'ownership' is determined by chromosomal contribution, the headline might equally have read 'woman seeks to have sperm donor's child'. The 'dead daughter', like the sperm donor, provides only 50 percent of the chromosomes, no gestational input and no contribution to the child's care.
John Locke argued that parenthood should not be associated solely with biology: 'So little power does the bare act of begetting give a Man over his Issue, if all his Care ends there, and this be all the Title he hath to the Name and Authority of a father.' (3)
Locke's approach suggests that genetic relationships are not sufficient to entitle a person to call a child their 'own'. The 'dead daughter' referred to by the Mail might be thought of as 'begetting' her child posthumously, if the procedure goes ahead. But since, as Locke puts it, all her care ends there, the child is not hers or the sperm donor's, but belongs more properly to the people who do care for it.
But we live in societies that place extraordinary importance on genetic relationships. Were it not so, it seems unlikely that this woman would want to use her daughter's eggs. Genetic determinism in family relationships thus seems self-defeating: while giving a powerful impetus to conceive with a particular set of genes, it also suggests that certain fixed genetic boundaries are breached in doing so.
However, this woman is not alone in prioritising the importance of genetic ownership over other aspects of parenthood. The recent mitochondrial donation debate also perpetuates the idea that for a child to be 'mine' it must have my chromosomes, though - apparently - it may have anyone else's mitochondrial DNA.
The 'large risks' of treatment
Postmenopausal motherhood is often regarded as being excessively risky. However, pregnancy and childbirth carry risks whatever the mother's age. It is safer to use contraception rather than get pregnant, and to abort rather than continue a pregnancy to term.
The risks of postmenopausal motherhood specifically may therefore not seem much more daunting than those involved in pregnancy in general, especially where a person has a very powerful reason for wishing to have a particular child. Quibbling about the dangers of pregnancy for older women, while blithely encouraging younger women to undergo these risks therefore seems arbitrary and discriminatory.
For the child itself, the outlook is better in some ways than for a naturally-conceived child whose mother is over 35, as many mothers are these days.
Young women's eggs are less likely to carry genetic defects than those of older women. However if the daughter's cancer resulted from a genetic mutation, this might affect offspring conceived with her eggs. Even were this the case, though, it would be inconsistent to prevent the woman from using them on these grounds. Why? Because those who undertook to freeze her eggs were facilitating the passing on of those potentially faulty genes to offspring. Since they are the same genes that we are talking about here, we have no justification for becoming suddenly queasy about these risks just because the eggs are going to be gestated by a different person from the one originally envisaged.
At 59, the child's birth mother is likely to die earlier in the child's life course than would be the case if the mother was younger. Yet the daughter in this case was encouraged to pursue a course of action that would facilitate her becoming a mother despite, or rather because she had a potentially life-limiting illness.
Tragically, she died too soon to use the eggs. If she had conceived while still alive, her offspring would have risked losing their mother early in life. Again, it seems discriminatory to apply different reasoning to the 59-year-old woman, if her daughter's own limited lifespan would not have been grounds for a refusal.
A final point relates to the issue of consent. The daughter did not sign any formal agreement to allow her mother to use her eggs. Yet the case of Diane Blood demonstrated that lack of consent is not an unsurmountable barrier to the posthumous use of gametes. In some ways, the current situation is more promising than Mrs Blood's, since the eggs in question were at least retrieved with the daughter's consent. Mr Blood's sperm was extracted without his consent, but his wife was permitted to export and use it nevertheless.
If we are consistent in applying the reasoning in the examples described above to the case in question, the claim of the woman who wishes to give birth to her dead daughter's child may be considerably stronger than it would initially appear.