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The emergence of new empirical evidence and ethical debate about families created by assisted reproduction has called into question the current regulatory frameworks that govern reproductive donation in many countries. In this multidisciplinary book, social scientists, ethicists and lawyers offer fresh perspectives on the current challenges facing the regulation of reproductive donation and suggest possible ways forward. They address questions such as: what might people want to know about the circumstances of their conception? Should we limit the number of children donors can produce? Is it wrong to pay donors or to reward them with cut-price fertility treatments? Is overseas surrogacy exploitative of women from poor communities? Combining the latest empirical research with analysis of ethics, policy and legislation, the book focuses on the regulation of gamete and embryo donation and surrogacy at a time when more people are considering assisted reproduction and when new techniques and policies are underway.
Lesbian women and gay men become parents via a number of routes depending on national regulatory legislation, access to health care and the implementation of social policies affecting parenting. Obtaining gametes or embryos from a third party is not always an issue. Both men and women can have conceived children within heterosexual relationships; can adopt where it is legal; and can become the same-sex partner of someone who has a child conceived within a heterosexual relationship, and are therefore considered a co-parent or step-parent. Reproductive donation is involved when lesbians become mothers using sperm, eggs or embryos (the latter two usually only if the woman is infertile) from a donor who is anonymous, known or open-identity. Recent legislative changes in the UK now allow both women of a couple to be named on their child’s birth certificate. Lesbians and gay men can donate eggs and sperm, respectively, to lesbian or straight women and conceive a child with the intention of having or not having a parenting role. For a gay man to become a parent using reproductive donation he needs both a surrogate and a source of eggs (or possibly embryos), which may or may not be donated by the surrogate.
In this chapter we discuss some of the ethical debates surrounding same-sex parenting, which we define as gay or lesbian couples becoming joint parents using gametes or embryos from a third party. We are not considering issues for those of other sexual orientations. Our discussion is confined to the context of countries where same-sex relations are legal and where lesbian women and gay men have at least some access to parenthood through donation. The legal and social implications for same-sex parenting outside of this context, as well as lesbian and gay (L&G) rights more generally, are beyond the scope of this chapter.
In families in which parents conceived using donated sperm or donated eggs, only one parent will be the genetic parent of the child: the mother in the case of sperm donation and the father in the case of egg donation. Parents can choose to tell or not to tell their child about their donor conception. In families in which parents choose not to tell, children will grow up unaware that the person that they think of as their mother or father is not, in fact, their genetic parent. Furthermore, families in which children were conceived using an anonymous donor will likely never be able to know detailed or identifying information about their donor. In countries where donor anonymity has ended and donor-conceived adults are able to access information about their donor, it is still the case that if someone does not know they were donor conceived they will have no reason to access information about their donor. Therefore, is it in the child’s best interests to be told about their donor conception?
This chapter outlines empirical research and ethical reasoning to discuss whether disclosure of donor origins is in a child’s best interests. Our discussion considers deontological (duty-based) and consequentialist (outcome-based) ethics in relation to disclosure. We hold that the question of whether to disclose can best be answered by reviewing at least three types of considerations for each child: (1) medical welfare; (2) family welfare; and (3) rights. These considerations build on the established empirical evidence presented in the first half of this chapter. Our intention is to clarify reasons why telling or not telling may be the best decision.
The long-standing ethical and policy debate about whether gamete donors should remain anonymous or be identifiable has been conducted with very limited empirical evidence about the implications of open-identity donation for those involved. While there is a growing consensus that the use of identifiable donors is preferable to the secrecy that has traditionally surrounded gamete donation, there is uncertainty around the consequences of policy decisions to remove donor anonymity, particularly regarding potential outcomes should donor offspring wish to meet their donor or other families created using their donor’s gametes. Open-identity donation is now available and is sometimes mandatory in several countries around the world, although it will be some years before the social effects of this regulatory change are realized. In the UK, for example, the entitlement of individuals conceived using donated gametes from 1 April 2005 onwards to receive identifying information about their donor at age 18 will not come into effect until 2023.
There are various types of identifiable donors. Clinics may use ‘identity-release’ donors whose identifying information is accessible once the child conceived with their gametes reaches a specified age; information may or may not be available to parents before this time. Alternatively, in instances where children have been conceived using anonymously donated gametes, the donor may choose to revoke their anonymity and make their identity known at a later stage. Lastly, the donor’s identity may be known from the time of the child’s conception, as is the case when prospective parents ask friends or relatives to donate their gametes, a practice that appears to be on the increase since the removal of donor anonymity. This chapter is primarily concerned with the first two types of open-identity donation, that is identity-release donation and formerly anonymous donation, and will focus on donations that occur within the context of the clinic (for a discussion of intra-familial donation, see Vayena and Golombok, Chapter 10).
Reproductive donation is the most contentious area of assisted reproduction. Even within Europe there are wide variations in what is permitted in each country. This multidisciplinary book takes a fresh look at the practices of egg, sperm and embryo donation and surrogacy, bringing together ethical analysis and empirical research. New evidence is offered on aspects of assisted reproduction and the families these create, including non-traditional types. One of the key issues addressed is should children be told of their donor origin? If they do learn the identity of their donor, what kinds of relationships may be forged between families, the donor and other donor sibling families? Should donation involve a gift relationship? Is intra-familial donation too close for comfort? How should we understand the growing trend for 'reproductive tourism'? This lively and informed discussion offers new insights into reproductive donation and the resulting donor families.