Introduction

Assisted reproduction (AR) has dramatically changed family formation in Western countries. It has opened access not only to couples battling infertility, but also single individuals and gay and lesbian couples. The United States (USA) and United Kingdom (UK) have taken sharply different regulatory paths regarding AR. While the UK has developed comprehensive regulatory guidance for AR providers based on the work of multidisciplinary commissions, the US legislative scheme is quite limited and fails to address many issues related to gamete donation. It primarily relies on a market model based on private ordering. This chapter investigates these contrasting legal frameworks regarding gamete donation and their ethical contexts. In conducting this evaluation, it must be kept in mind that both regulation and the absence of regulation express ethical perspectives (Pennings, 2004).

While both societies agree that patient autonomy is essential to fertility treatment, the UK seeks to protect the autonomy of all involved through clearly defined government legislation and guidance. It also trumps individual autonomy where it finds that societal values, such as human dignity, override the rights of individuals to make decisions regarding reproduction. The USA has, for the most part, left determinations regarding autonomy to the private sector – medical professionals, market providers and consumers. Most states have little or no regulation, so assisted reproductive choices are not restricted, but there is also less legal certainty regarding the rights of each participant in the process.