How choice for donors and donor conceived people keeps doors open
Bio-News had to shorten my response to Ben Saer (see previous blog) to fit their word count. Here's the original with a link to the slightly shorter one at the end.
Having just returned from the States, I thought at first it was the jet lag. The BioNews article I was reading couldn't possibly contain that many completely unsubstantiated assertions and assumptions and such a skewed view of what is and is not ethical in donor conception. But second reading when more compos mentis revealed that it did. It is hard to know where to start in addressing egg donation Dad-to-be Ben Saer's points…but I guess the first paragraph is as good as any. Here he applauds the decision made by the British Columbia Court of Appeal to overturn the decision made in the Olivia Pratten case giving retrospective access to donor records for donor conceived children. "Anonymity, guaranteed to the donor at the time of conception, was rightly respected" he asserts. In the next paragraph he regrets that such respect is not afforded to donors in the UK, completely failing to mention that current donors in this country donate under totally different conditions – ie. accepting that identifiability is part of the deal – and that retrospective access to donor records is not available in this country either. Nowhere in the world are donors forced to donate their eggs or sperm. In the UK it is by and large a completely free choice to do so, although some might argue that prevailing economic conditions and the recent raising of the 'compensation' levels for donation might introduce a coercive element. There have been concerns that women in poorer countries in Eastern Europe and elsewhere may also donate predominantly for economic reasons. But mostly it is a choice freely made.
Saer goes on to parrot the long-standing media myth that, 'The ending of donor anonymity in the UK cut supply overnight" without understanding that it was the attitudes and actions of many doctors that caused the shortage, not the change in law. Doctors put the fear of God into the donors they had at the time with nightmare scenarios of children turning up on their doorsteps. Predominantly male doctors assumed that no man would ever want to donate identifiably. In this way clinics ran down their practices and many decided not to carry on. It took two pioneering clinics to change the way that sperm donors were recruited – and the type of donor they targeted – for it to be shown that it was perfectly possible to recruit men who were willing to take on the responsibility of being identifiable. There had always been a shortage of egg donors and it has similarly been a reluctance on the part of clinics to put resources into recruitment that continued this situation until fairly recently. The National Gamete Donation Trust is quite clear that when awareness is raised of the need for egg donors, then suitable women willing to be identifiable, do come forward. Many clinics in the UK now have a surfeit of egg donors! Which raises the question of why Saer and his wife chose to go abroad, presumably to the Czech clinic he is now promoting as part of his business. Was it because they could not find a donor in the UK or was it because they were seeking an anonymous donor? His antipathy generally to state intervention in assisted reproduction leads me to assume the latter. All this starts to make me think that donors, for Saer, are simply a means to an end – someone who gives up 'cells' they don't need in order to help create a child for someone else. But no, a couple of paragraphs later we have, "Donors are heroes. Without them, donor-conceived children would not exist. Yet the rights of donors have been oddly marginalised by the debate." This seems to be assuming that the 'right' that any donor in their right mind would be desiring is anonymity. As I said before, donors do not have to donate. They choose to do so under the conditions that prevail in this country at this time. That is, being willing to be identifiable to young people they have helped to create from 18 onwards. There is even some evidence from research that some donors from pre 2005 and even pre 1991 days, would have been happy to be identified but the law at that time did not allow for that.
Saer goes on to criticise the Nuffield Bio-Ethics report not only for not recommending a review of donor anonymity but also for the encouragement of donors to re-register as identifiable saying, "Hectoring them to come forward is intrusive and probably illegal". There are of course no plans to hector donors in any way. It does seem reasonable, however, to have a high profile campaign pointing out how valuable it could be to some donor conceived people if they did re-register, but only if they choose to do so. It could be entirely counter productive if donors who wished to remain anonymous were 'outed' or pressured in any way. It seems to me that donors who take on the responsibilities associated with identifiability are the real heroes here.
Which brings us to the needs of the children, who in Saer's world don't appear to be offered any choices at all. In what feels like a veiled reference to the Donor Conception Network Saer accuses "countless websites, some with charitable status" of asserting that donor conceived children face an identity crisis later in life (if they do not know the identity of their donor). DCN has never claimed this – and indeed all the children of the founders, including Walter's and mine, are highly unlikely to ever have identifying or even much non-identifying information because they were conceived before the 1991 HFE Act. These young adults are doing well and have not suffered identity crises. But there are many donor conceived people who do feel that knowledge about their donor would help them understand themselves in a more profound way. Even if they have no wish to actually contact the donor, most donor conceived young people have a curiosity about the person or persons who contributed to their existence. Those conceived in the UK since 2005 will have a choice about what level of information to have. They, and those conceived since 1991, are able to be in touch by mutual consent with others conceived via the same donor if they choose to do so. These choices are not available to children conceived in the Czech Republic and elsewhere where anonymity prevails. Saer naively assumes that "good parenting will alleviate most emotional difficulties", and this is a position I have some sympathy with as many parents and parents-to-be in DC Network hope at some level that early telling (which Saer approves of) and good parenting will somehow curb curiosity. Particularly before actually becoming parents, recipients of donor gametes often worry that their child might reject the non-genetic parent. Experience, however, has shown that many young people live with the curiosity without being obsessed by it and children do not reject either of their parents (at least not because of donor conception). Good parenting is of course supportive and protective in many ways, but it does not resolve the desire of some teenagers and adults to know more about the person who helped create them.
Young adults, like our daughter, who were conceived prior to 1991 know that the culture was different then, that we, their parents, had no choices offered to us with regard to donors and that donor anonymity was the only possible option. Nowadays, with the change in culture towards openness and transparency in all areas and the availability of identifiable UK donors, prospective parents who exercise their choice to go abroad for anonymity need to understand what this means for their child in a modern context.
Saer says that he does not question the paramouncy of putting children first enshrined in the 1989 Children Act but it is hard to square this with his deliberate choice to have an anonymous donor. There is no 'statutory access for all" or "mandatory revealing of the donor's identity", as asserted in Saer's article, simply an option for a young person to pursue if this is what they choose to do. Surely this is the only ethical and genuinely respectful position.