What is the relationship between the position that anonymous gamete donation is wrong (i.e. the anti-anonymity position) and the position that all gamete donation is wrong (i.e. the anti-donation position)? Some argue that people who accept the anti-anonymity position should also accept the anti-donation position on the grounds that the two positions share the same main arguments. But that’s not true. One argument in favor of anti-anonymity does not generate genuine dialectical pressure to accept (...) the anti-donation position. The other anti-anonymity arguments do generate dialectical pressure, but not in a way that pushes toward the anti-donation position. Instead, they push toward what we might call the ‘pro-known-donation’ position. So, either there is no dialectical pressure or, where there is, it doesn’t flow toward the anti-donation position. (shrink)

Over the years a number of countries have abolished anonymous gamete donation and shifted toward open-identity policies. Donor-conceived children are said to have a fundamental “right to know” the identity of their donor. In this article, we trace the arguments that underlie this claim and question its implications. We argue that, given the status attributed to the right to know one's gamete donor, it would be discriminatory not to extend this right to naturally conceived children with (...) misattributed paternity. One way to facilitate this would be through routine paternity testing at birth. While this proposal is likely to raise concerns about the conflicting interests and rights of other people involved, we show that similar concerns apply to the context of open-identity gamete donation. Unless one can identify a rational basis for treating the two groups differently, one's stance toward both cases should be the same. (shrink)

Over the years a number of countries have abolished anonymous gamete donation and shifted toward open-identity policies. Donor-conceived children are said to have a fundamental “right to know” the identity of their donor. In this article, we trace the arguments that underlie this claim and question its implications. We argue that, given the status attributed to the right to know one's gamete donor, it would be discriminatory not to extend this right to naturally conceived children with (...) misattributed paternity. One way to facilitate this would be through routine paternity testing at birth. While this proposal is likely to raise concerns about the conflicting interests and rights of other people involved, we show that similar concerns apply to the context of open-identity gamete donation. Unless one can identify a rational basis for treating the two groups differently, one's stance toward both cases should be the same. (shrink)

Gamete donation from third parties is controversial in China as it severs blood ties, which are considered of utmost importance in Confucian tradition. In recent years, infertile couples are increasingly demonstrating a preference for the use of gametes donated by family members to conceive children—known as “intra-family gamete donation.” The main advantage of intra-family gamete donation is that it maintains blood ties between children and both parents. To date there is no practice of intra-family (...) gamete donation in China. In this paper, we investigate intra-family adoption in China in order to illustrate that intra-family gamete donation is consistent with Confucian tradition regarding the importance of maintaining blood ties within the family. There are several specific ethical issues raised by intra-family gamete donation. It may, for example, result in consanguinity and the semblance of incest, lead to confused family relationships, and raise concerns about possible coercion of familial donors. Confucian tradition provides a new approach to understand and deal with these ethical issues in a way that Western tradition does not. As a result, we suggest intra-family gamete donation could be an acceptable solution to the problem of infertility in China. However, further discussion and open debates on the ethical issues raised by intra-family gamete donation are needed in China. (shrink)

In Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation (Oxford University Press, 2021), Daniel Groll argues why people who use donated sperm or eggs to have children ought to use a known donor. His main argument for this position is that a child conceived in this way will have a foreseeable, significant interest in acquiring genetic knowledge. However, Groll addresses issues that are of interest to anyone who thinks about the nature of families and parent‐child (...) relationships. For example, what obligations or responsibilities does a parent have to their child? What makes someone a parent? And what is the significance to one's identity of knowing about one's genetic origins? While a claim about access to genetic knowledge lies at the heart of Groll's book, he is all too aware of the social forces that influence people to care about their genetic origins. His prescriptions, ultimately, reflect this reality. (shrink)

In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes for use in in vitro fertilization. As sections of the AHR Act forbidding payment for gametes and permitting only reimbursement of receipted expenses gradually came into effect (...) in 2005, Canada did away with this anomaly. Medical practice and legal prohibitions in assisted human reproduction are now consistent with other areas of medicine where tissues and organs are taken from one person to benefit others: Altruistic donation, rather than selling and buying, will be the norm. (shrink)

Drawing on the views of donors and recipients about anonymity in a country that is experiencing a transition towards non-anonymous gamete donation mandated by the Constitutional Court, we explore how the intersection between rights-based approaches and an empirical framework enhances recommendations for ethical policy and healthcare. Between July 2017 and April 2018, 69 donors and 147 recipients, recruited at the Portuguese Public Bank of Gametes, participated in this cross-sectional study. Position towards anonymity was assessed through an open-ended (...) question in a self-report questionnaire, which was subject to content analysis. Preference for an anonymous donation regime was mentioned by 82.6% of donors and 89.8% of recipients; and all those with children. Instead of the rights-based reasoning used by the Constitutional Court, donors highlighted concerns over future relationships and recipients focused on socioethical values linked with the safeguard of safety, privacy and confidentiality. The remaining participants advocated the choice between anonymity or non-anonymity, invoking respect for their autonomy. The complex, diverse ethical views and reasoning of donors and recipients expand a traditionally dichotomous discussion. Their perspectives challenge the transition towards non-anonymity and international guidelines, raising awareness to the need for their involvement in the design of policies to enable choice according to their values and preferences, and of psychosocial counselling responsive to their socioethical concerns and sensitive to their parental status. Empirical frameworks complement rights-based approaches to uphold justice, fairness and equal respect, and to incorporate utility, beneficence and non-maleficence in policymaking and healthcare in the transition towards non-anonymity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Anonymous Versus Open Donation and Queerness as Political:Comments on Groll's Conceiving PeopleAmanda Roth (bio)1. IntroductionIn this commentary on Daniel Groll's 2021 book Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation, I examine a number of the book's major themes, especially around the idea that donor-conceived children have a significant interest in genetic knowledge and therefore, donor-conceiving parents are morally required to use (...) an open donor.1 I point to some concerns about Groll's case for this view and, in doing so, highlight the way in which taking up an LGBTQ+ perspective complicates and undermines the case against anonymous donation. The major theme of my comments is that the open versus anonymous decision is not merely an ethical decision, but a political one.My comments are organized around a few of the book's major themes, so I'll begin with laying out the most relevant themes in some detail. I then take up four points to consider in more depth. In so doing, I'll be drawing on my own scholarly perspective on issues of nontraditional reproduction, which is informed by my own social positionality in relation to family matters; this means that I (not so subtly) bring a queer perspective to the discussion of Groll's book. The through-line of my comments is this: While I agree with and appreciate much of Groll's approach, I want to stress the sense in which gamete donation is not just an ethical issue, but a political one, given its implication in bionormativity (and heteronormativity). I wonder if a deeper acknowledgment of the political nature of the issues might lead to moral conclusions that are different from those that Groll comes to, even assuming similar ethical values as starting points.2. Groll's major claims(1) Claim 1: Disclosure to donor-conceived offspring—in the usual case at least—is morally required given the intimacy argument: [End Page 166]The intimacy argument suggests that keeping "the secret" about donor conception involves intentional deception and undermines the proper intimacy of parent-child relationships (Groll 2021, 36–49).(2) Claim 2: Anonymous donor conception is (generally) morally impermissible because of the significant interest view.Donor-conceiving parents can reasonably foresee that their children will likely develop a significant interest in genetic knowledge. Significant interests "matte[r] quite a lot to the person who has [them]," "tak[e] up a space … in a person's mental economy" and/or "pla[y] a structuring role in a person's life and self-conception" (Groll 2021, 62–3). But not all donor-conceived people take such an interest in genetic information, and this information is not necessary for identity construction or psychological wellbeing (Groll 2021, 58, 61).2 Rather, multiple routes to self-identity exist, the genetic route being one among the options. Moreover, one needn't experience any loss in not taking this route; however, for those who take it up, genetic knowledge is objectively valuable and nonfungible (Groll 2021, 81–9). This is because genetic knowledge is uniquely relevant to the identity-related question "Who am I?" (Groll 2021, 112–3).3Groll argues that donor-conceiving parents should assume that their child will form such an interest because this is empirically a "good bet." Further, significant interests—at least when they are worthwhile (that is, not trivial and not morally objectionable)—are connected to one's wellbeing by the wellbeing principle: In satisfying a non-instrumental significant worthwhile interest, one's life goes better (Groll 2021, 62). It follows, then, that parents ought to choose open donors since (to simplify) parents are obligated to promote their children's wellbeing (ibid).4Counter to what one might expect, Groll does not take his ethical case against anonymous donor conception to justify prohibition of the practice. This is because wronging children in this way is within the realm of (unethical) choices we allow parents to make without societal interference.5 Moreover, to aim regulation at anonymous donor conception could reinforce bionormativity and target already marginalized families for special negative attention (Groll 2021, chapter 8).(3) "Claim" 3: Groll's own personal... (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (...) (OGMS) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

Currently in the United Kingdom, anyone donating gametes has the status of an open-identity donor. This means that, at the age of 18, persons conceived with gametes donated since April 1, 2005 have a right to access certain pieces of identifying information about their donor. However, in early 2015, the UK Parliament approved new regulations that make mitochondrial donors anonymous. Both mitochondrial donation and gamete donation are similar in the basic sense that they involve the contribution (...) of gamete materials to create future persons. Given this similarity, this paper presumes that both types of donor should be treated the same and made open-identity under the law, unless there is a convincing argument for treating them differently. I argue that none of the existing arguments that have been made so far in favor of mitochondrial donor anonymity are convincing and mitochondrial donors should therefore be treated as open-identity donors under UK law. (shrink)

I consider the question of what moral obligations prospective parents owe to their future children. It is taken as an almost axiomatic premise of a wide range of philosophical arguments that prospective parents have a moral obligation to take such steps as ensuring their own financial stability or waiting until they are emotionally mature before conceiving. This is because it is assumed that parents have a moral obligation to lay the groundwork for their children's lives to go well. While at (...) first glance such a premise seems benign, I will argue that when it is applied to arguments in assisted reproductive technology, as it is in Julian Savulescu's procreative beneficence argument or as it is in Daniel Groll's recent argument for open gamete donation, we see problems with this premise. Problems in Groll's argument also become apparent when it is scrutinized in connection with this premise. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation by Daniel GrollMelissa MoschellaGROLL, Daniel. Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation. New York: Oxford University Press, 2021. 256 pp. Cloth, $74.00In Conceiving People, Daniel Groll argues that, generally speaking, those intending to conceive with the help of donor gametes have a moral obligation to use an open (...) donor rather than an anonymous one. This obligation is grounded on the likelihood that their children will have a significant future interest in acquiring genetic knowledge, defined as "knowledge of who one's genetic progenitors are." Groll labels this view the significant interest view, which he argues for largely on empirical grounds.Before beginning his defense of the significant interest view, Groll dedicates chapter 2 to arguing that parents who conceive with the help of donor gametes should not keep this a secret from their children. His position on this point reflects the current consensus on the subject, but he offers a novel argument for it, based on the claim that keeping "the secret" in itself harms the parent–child relationship by inherently compromising the intimacy proper to that relationship.Chapter 3 presents the significant interest view in greater detail, distinguishing it from two other approaches: (1) the "Profound Prudential Good view," taken from the work of David Velleman, according to which "genetic knowledge is a profound prudential good and people who lack it will have tremendous trouble figuring out who they are," and (2) the view that "people have a right to genetic knowledge." Unlike these competing approaches, Groll's view "does not directly depend on claims about the value of genetic knowledge" but is based primarily on the fact that "many donor-conceived people are subjectively interested in having genetic knowledge," combined with the claim that parents have an obligation to promote their children's well-being by satisfying their worthwhile significant subjective interests. Because Groll's argument depends on the worth and significance of genetic knowledge, it is vulnerable to what he calls the "sideshow objection"—that is, that the significant interest view is just a sideshow, and the worth of genetic knowledge is what actually does the important normative work. At the same time, Groll's view that the interest in genetic knowledge is worthwhile and significant also leaves him open to the "bionormativity objection," according to which the interest in genetic knowledge "is morally problematic in virtue of evincing and entrenching a kind of bionormative prejudice" that sees the biological family as a normative ideal. [End Page 141]Responding to these two objections is the task of chapters 4 and 5. Chapter 4 argues that genetic knowledge is an objective but "prudentially optional good," meaning that "its value is not fungible, but a life that lacks it is not thereby impoverished." This distinguishes Groll's view from the profound prudential good view, which he characterizes as a form of "genetic chauvinism." Groll argues that genetic knowledge is valuable because it can provide insight into personal identity by answering questions about how I came to be and who I am like, but that the genetic knowledge is not the only or best way to answer these questions (thus explaining why it is optional, and why the significant interest view is not just a sideshow).Chapter 5 addresses the "bionormativity objection," which includes both "heteronormativity" (privileging families headed by a mother and father) and "biogenetic normativity" (privileging genetically related families). Groll ultimately responds to this objection by arguing that, even if (as Groll believes) our current society overemphasizes the importance of genetic relationships, "the interest in genetic knowledge is rationally intelligible quite apart from the bionormative social milieu that surrounds it."Chapters 6 through 8 present the implications of the preceding argument. Chapter 6 argues that the reasons to use an open donor are generally conclusive, because most reasons parents might have to use an anonymous donor do not outweigh the child's significant interest in obtaining genetic knowledge. Chapter 7 considers the responsibilities of gamete donors, arguing that gamete donation is not morally objectionable because it is permissible for donors to transfer prospective parenthood responsibilities... (shrink)

This article examines the absence of biological relatedness in couples where the use of a third-party gamete donor casts doubt on the notion of conventional kinship. The authors observe that individuals who have used technology to create a family remediate relatedness through a dehistoricized idea of kinship in which the traditional concept is replaced with the concept of chance. The article also examines how inherited value is replaced by strategies that redefine the ways in which donor gamete parents (...) can pass their values on to their children. This examination is accomplished by looking at how couples who used donated gametes articulate the ways in which familial relatedness is left open to chance. (shrink)

Brussen, Kerri Anne Children born through gamete donation can be genetically linked to one or neither parent. This article examines the practice of gamete donation, seeking to establish if there is cause for concern.

Unlike surrogacy and cloning, reproduction via gamete donation is widely assumed to be morally unproblematic. Recently, a number of authors have argued that this assumption is mistaken: gamete donors, they claim, have parental responsibilities that they typically treat too lightly. In this paper I argue that the ‘parental neglect’ case against gamete donation fails. I begin by examining and rejecting the view that gamete donors have parental responsibilities; I claim that none of the current (...) accounts of parenthood provides good reason for ascribing parenthood to gamete donors. I then argue that even if gamete donors do have parental responsibilities for ‘their’ children, it is not clear that they treat these responsibilities too lightly. I conclude the paper by examining the wider question of just what kind of responsibilities gamete donors might have towards the children that they have a role in creating. (shrink)

A growing number of jurisdictions hold that gamete donors must be identifiable to the children born with their eggs or sperm, on grounds that being able to know about one's genetic origins is a fundamental moral right. But the argument for that belief has not yet been adequately made.

The vast majority of gamete donations worldwide are made anonymously, and in some countries, including Spain, France, and Denmark, the anonymity of donors is explicitly protected by law. Nonetheless, a growing number of countries have called into question the morality of such practices and are enacting laws allowing children access to identifying information about their gamete donor. A significant reason for the growing legislative support for nonanonymous gamete donations is the belief that donor‐conceived children have a fundamental (...) moral right to know their genetic origins and that the right should be legally protected. A variety of factors, such as the increasing number of children born by means of gamete donation, advances in genetic science and technology that make it easy to discover the identity of a person's genetic parents, and the widespread belief that genetic information is important for protecting people's health, have made this alleged right quite salient, even leading some to challenge the ethical appropriateness of gamete donation practices altogether. Often, however, this right is assumed rather than explicitly justified. The purpose of this paper is to call into question the ethical justifications that are often thought to ground a right to know one's genetic origins.Proponents of a right to know this information usually argue that such a right protects at least three vital interests: the interest of donor‐conceived people in having strong family relationships, their health interests, and their interest in forming a healthy identity. These different interests might be protected by different aspects of the right to know one's genetic origins: knowing one's mode of conception, accessing medically relevant information, and accessing identifying information about one's genetic parents. I will discuss each of these interests and explore whether and how they might be set back by an individual's lack of access to information about his or her genetic parentage. I will also evaluate whether donor anonymity policies are, as many of their opponents argue, morally impermissible because they fail to protect these important interests. (shrink)

PurposeThis paper presents an ethnographic study of gamete donation in Latvia. The aim of the study is to describe and analyse the practice of applying responsibility in gamete donation cases from the perspective of anthropology and ethics.MethodsWe performed thirty semi-structured interviews with laypeople and five focus group discussions among adolescents. The third source of data was media analysis: 57 articles discussing assisted reproduction in Latvian electronic popular media as well as internet discussions among ART participants. The (...) data were processed using Atlas.ti.ResultsThe data showed that the situation of ART responsibility is formulated through defining one’s relationship to the gametes, to the nation and the relationship between parent and child.ConclusionsThe practice of gamete donation does not create new responsibilities but uses already existing relations in a situation marked by new knowledge. Relationships among ART users, donors and physicians often result in an imbalance of responsibility sharing. The framework of relational ethics is one possible way to change the practice of balancing and sharing responsibility in ART applications. (shrink)

The Significant Interest view entails that even if there were no medical reasons to have access to genetic knowledge, there would still be reason for prospective parents to use an identity-release donor as opposed to an anonymous donor. This view does not depend on either the idea that genetic knowledge is profoundly prudentially important or that donor-conceived people have a right to genetic knowledge. Rather, it turns on general claims about parents’ obligations to help promote their children’s well-being and the (...) connection between a person’s well-being and the satisfaction of what I call their “worthwhile significant subjective interests.” To put this view simply, the fact that a donor-conceived person—who knows she is donor-conceived—is likely to be very interested in acquiring genetic knowledge gives prospective parents a weighty reason to use an identity-release donor. This is because parents should promote their children’s well-being through the satisfaction of their children’s worthwhile significant interests. (shrink)

In France, since the approval of the first bioethics laws in 1994, the principle of the anonymity of sperm donors has prevailed. This choice is regularly challenged, namely by children who have been conceived under these conditions and have now reached adulthood. In this paper, we will briefly describe the reasons that led practitioners of assisted reproduction to endorse the anonymity principle in 1994. Secondly, we will elaborate on the reasons why this principle is becoming so controversial today. Finally, we (...) shall examine two possible outcomes of the debate, highlighting their respective legitimacy as well as their consequences, as far as the rights of children, the notion of the family, and medical practice are concerned. (shrink)

Sophisticated arguments advanced by Harry Silverstein, David Boonin, and Jeff McMahan attempt to show that being responsible for an individual's existence need not result in an obligation to ensure that the needs of that individual are satisfied. While these arguments take place within the abortion debate, by extension they threaten causal accounts of procreative responsibility more generally. In this article, I defend causal accounts of procreative responsibility by showing that these arguments do not succeed, but without thereby undermining the permissibility (...) of abortion. Further, while being causally involved in the existence of a person is not sufficient for acquiring procreative responsibilities, I argue that there is an especially strong case for ascribing such responsibilities to gamete donors. (shrink)

Purpose This paper presents an ethnographic study of gamete donation in Latvia. The aim of the study is to describe and analyse the practice of applying responsibility in gamete donation cases from the perspective of anthropology and ethics. Methods We performed thirty semi-structured interviews with laypeople and five focus group discussions among adolescents. The third source of data was media analysis: 57 articles discussing assisted reproduction in Latvian electronic popular media as well as internet discussions among (...) ART participants. The data were processed using Atlas.ti. Results The data showed that the situation of ART responsibility is formulated through defining one’s relationship to the gametes, to the nation and the relationship between parent and child. Conclusions The practice of gamete donation does not create new responsibilities but uses already existing relations in a situation marked by new knowledge. Relationships among ART users, donors and physicians often result in an imbalance of responsibility sharing. The framework of relational ethics is one possible way to change the practice of balancing and sharing responsibility in ART applications. (shrink)

Approximately 15% of couples are affected by infertility worldwide. Subsequently, the use of assisted reproductive technologies is becoming increasingly popular, including the use of donor eggs, sperm and embryos. Despite ongoing ethical debate surrounding gamete donation, this is now a widely accepted practice in Western countries. Assisted reproductive technology is becoming more commonly utilised within the Muslim population; however, gamete donation remains a relatively controversial and taboo topic within this religion. Interestingly, there are significant differences in (...) beliefs between Sunni and Shi’a Muslims. Whilst Sunni Islam absolutely forbids the use of third-party reproductive assistance, Shi’a Islam is somewhat more lenient towards this practice. Reproductive tourism has therefore become prevalent in Shi’a Middle Eastern countries that permit the use of donor gametes in assisted reproductive technologies; however, this continues to evoke a strong bioethical debate, particularly around sperm donation. With the increased influx of reproductive tourism, this is beginning to weaken the regional Sunni Islam ban on the use of donor technologies, questioning the morality of their current beliefs. Consideration of religious beliefs is also crucial for patient-centred care in UK patients treated by the National Health Service for fertility issues. Of note, there is a lack of non-Caucasian donors in the United Kingdom. Reproductive tourism is also becoming increasingly common in the United Kingdom and needs to be considered in terms of future patient management in delivering good obstetric care. (shrink)

Anonymous gamete donation continues to be practised in most jurisdictions around the world, but this practice has come under increased scrutiny. Thus, several countries now mandate that donors be identifiable to their genetic offspring. Critics contend that anonymous gamete donation harms the interests of donor-conceived individuals and that protection of these interests calls for legal prohibition of anonymous donations. Among the vital interests that critics claim are thwarted by anonymous donation are an interest in having (...) a strong family relationship, health interests, and an interest in forming a healthy identity. This article discusses each of these interests and examines what they could involve. The legislation in two countries is considered: Spain, which mandates anonymous gamete donation, and the UK, which prohibits such practice, to assess how these different legislations might or might not protect these vital interests. (shrink)

In (K)information, Maren Klotz presents a contemporary renegotiation of the values of privacy, information-sharing, and connectedness as they relate to the social, clinical, and regulatory management of kinship information.

According to the causal theory of parenthood, people incur parental obligations by causing children to exist. Proponents of the causal theory often argue that gamete donors have special obligations to their genetic offspring. In response, many defenders of current gamete donation practices would reject the causal theory. In particular, they may invoke the ‘too many parents problem’: many people who causally contribute to the existence of children – for instance, fertility doctors – do not thereby incur parental (...) obligations. This article argues that the conclusions commonly drawn by causal theorists, and by their critics, are premature. Causal theorists have a promising response to the too many parents problem. This response, however, defuses the moral concern that many causal theorists have raised about gamete donation. A similar point, it is argued, applies to Rivka Weinberg’s ‘Hazmat Theory’. -/- . (shrink)

Procreation with donor gametes is widespread and commonly accepted, but it involves ethical questions about the child's best interest. Understanding the historical structures of the moral discussion of gamete donation may contribute to reflecting on the child's best interest. This is why I have analysed the debate on gamete donation in the Netherlands, and this analysis has uncovered some striking discontinuities. Notions of the child's best interest have undergone a radical swing. In the past, it was (...) considered acceptable to conceal the truth about the child's biological origin, but in the past two decades the general opinion has changed to the common belief that this information should be shared with the child. This changed notion of the child's best interest will be analysed using a framework encompassing three views of the child, which derive from the debate on children's rights. These three views each provide a different interpretation of the child's moral and political status. I conclude that the changed notion of the child's best interest results from a view of the child that focuses on autonomy and citizenship, and which frames the child's interests according to its legal status. I comment on this view and I champion an alternative one, namely ‘the embedded child’. This is a relational view based on care ethics that goes beyond what can be articulated in law, and that will help to establish a more balanced interpretation of the child's best interest at the practice and policy levels of gamete donation. (shrink)

The dominant philosophical view of gamete donation as morally permissible rests on two premises: parental obligations are triggered primarily by playing a causal role in procreation, not by genetic ties, and those obligations are transferable—that is, they are obligations to make adequate provision for the child’s needs, not necessarily to raise the child oneself. Thus while gamete donors are indeed agent causes of the children that their donation helps to bring into existence, most think that donors’ (...) obligations are discharged insofar as they know that competent others intend to care for those children. In this article, I call into question this dominant view by challenging both of its premises. Challenging the first premise, I argue that genetic parenthood is what primarily triggers parental obligations. Challenging the second premise, I claim that those obligations are non-transferable—i.e., that they are obligations not simply to ensure that someone will raise one’s genetic child, but to raise that child oneself . The implication of my argument is that gamete donation is inherently wrong insofar as it involves acquiring non-transferable obligations that one has no intention of fulfilling. (shrink)

An important argument against removing donor anonymity is that such state-mandated policies might validate bionormative attitudes about the importance of genetic relatedness in families. Bionormative attitudes can be unjustly disparaging and harmful to a wide range of families including donor-conceived, adopted, and single-parent families. However, studies show that the majority of donor-conceived individuals want donor anonymity removed. This paper explores the question of how to weigh these desires for knowing the donor—which may be grounded in biased and bionormative assumptions—against the (...) competing concern that removing donor anonymity perpetuates attitudes that may be harmful. (shrink)

Assisted reproduction using donor gametes is a procedure that allows those who are unable to produce their own gametes to achieve gestational parenthood. Where conception is achieved using donor sperm, the child lacks a genetic link to the intended father. Where it is achieved using a donor egg, the child lacks a genetic link to the intended mother. To address this lack of genetic kinship, some fertility clinics engage in the practice of matching the ethnicity of the gamete donor (...) to that of the recipient parent. The intended result is for the child to have the phenotypic characteristics of the recipient parents. This paper examines the philosophical and ethical problems raised by the policy of ethnic matching in gamete donation. I consider arguments for the provision of ethnic matching based on maximising physical resemblance and fostering ethnic identity development. I then consider an argument against ethnic matching based on the charge of racialism. I conclude that while the practice of ethnic matching in gamete donation could promote positive ethnic identity development in donor-conceived children from historically subjugated ethnic minorities, it also risks endorsing the problematic societal attitudes and assumptions regarding ethnicity that enabled such subjugation in the first place. (shrink)

Background Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspectives of gamete donors and recipients about decision-making regarding research with EGDs are still under-researched, which precludes the development of policies and guidelines informed by evidence. This study seeks to explore the views (...) of donors and recipients about who should take part in consent processes for the use of EGDs in research. Methods From July 2017 to June 2018, 72 gamete donors and 175 recipients completed a self-report structured questionnaire at the Portuguese Public Bank of Gametes. Agreement with dual consent was defined as the belief that the use of EGDs in research should be consented by both donors and recipients. Results The majority of participants were willing to donate embryos for research. Almost half of the donors and half of the recipients considered that a dual consent procedure is desirable. This view was more frequent among employed recipients than among non-employed. Donors were less likely to believe that only recipients should be involved in giving consent for the use of EGDs in research and were more frequently favourable to the idea of exclusive donors’ consent. Conclusions Divergent views on dual consent among donors and recipients indicate the need to develop evidence-based and ethically sustainable policies and guidelines to protect well-being, autonomy and reproductive rights of both stakeholder groups. More empirical research and further theoretical normative analyses are needed to inform people-centred policy and guidelines for shared decision-making concerning the use of EGDs for research. (shrink)

The use of rights based arguments to justify claims that donor offspring should have access to information identifying their gamete donor has become increasingly widespread. In this paper, I do not intend to revisit the debate about the validity of such rights. Rather, the purpose is to examine the way that such alleged rights have been implemented by those legislatures that have allowed access to identifying information. I will argue that serious inconsistencies exist between the claim that donor offspring (...) have a right to know the identity of their gamete donor and the way such a right is currently met in practice. I hope to show that in systems where non‐anonymous donation is practised, an understanding of the proclaimed right of donor offspring to know their genetic identity is one composed of two different rights – the right to know the circumstances of their conception and the right to information identifying the gamete donor – can provide important insights into this important area of public policy. (shrink)

The growing scope of gamete donation and themanipulation of gametes makes it essential to developa coherent theory of the nature of gametes and theclaims which may be made in relation to them. Thenature of gametes is ambiguous, they blur thedistinctions between persons and property, but thecurrent legal framework which governs gamete donationand manipulation fails to address their status. Thisleaves unanswered fundamentally important questionsabout control of processes involving gametes andrights to use or control the gametes themselves andthe information (...) which they represent. These areclaims which are rooted in the concept ofproperty. A property based analysis highlights thethemes of autonomy, personhood and control which lieat the heart of the claims made in relation to gametesand an account based on the notion of property forpersonhood offers a more coherent justification forrecognising claims in gametes and mediating disputes. This perspective exposes the inadequacies andinconsistencies of the legal construction of gametesand the legal regulation of gamete donation. Thepresent legal framework has not sought to develop acoherent construction of gametes, but to constrain thepractices of the assisted reproductive technologies(including gamete donation) within a framework whichis presented as least damaging to the traditionalideologies of the creation of the family. (shrink)

Couples need to make their wishes explicit if we are to allow postmortem gamete donation.

Gamete donation offers a unique opportunity to compare men and women's relationships to reproductive decision-making, unlike other reproductive processes, which typically involve women's bodies much more asymmetrically. I address medical and reproductive decision-making by examining how a gamete donor's partner may be involved in the donation process. Some countries explicitly involve a donor's partner by legally requiring spousal consent for donation, but this is not the case for the U.S. In the absence of any formal (...) regulation, what are the expectations for involving a donor's partner? Through a content analysis of materials from donation programs across the U.S., I examine how donation programs configure the partner's role. Overall, I find that there are quite different expectations for partner involvement in egg versus sperm donation. Such differences, I argue, both stem from and reinforce existing issues navigating boundaries between intimate relationships and women's medical and reproductive autonomy. (shrink)

In this paper, I claim that live uterus donors ought to be considered for the possibility of compensation. I support my claim on the basis of comparable arguments which have already been applied to gamete donation, surrogacy, and other kinds of organ donation. However, I acknowledge that there are specificities associated with uterus donation, which make the issue of incentive and reward a harder ethical case relative to gamete donation, surrogacy, and other kinds of (...) organ donation. Ultimately, I contend that while reimbursement for the costs incurred by live uterus donors should be treated as a necessary ethical minimum, how much further we ought to remunerate uterus donations remains an open question. (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and (...) payment for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

Over the past years, a growing number of countries have legislated open-identity donation, in which donor-conceived offspring are given access to the donor’s identity once the child has reached maturity. It is held that donor anonymity creates identity problems for such children similar to the “genealogical bewilderment” described within the adoption context. The study of the social and psychological effects of open-identity donation is still very much in its infancy, but what has been left unquestioned is (...) whether offering access to the donor’s name and address is an adequate response to such effects. This study has two goals: First, we aim to provide a systematic review of the reasons why donor-conceived offspring want to know the identity of their sperm donor. Second, we examine to what extent the provision of donor-identifying information can satisfy the reasons mentioned. The most important motivations appear to be: to avoid medical risks and consanguineous relationships; to satisfy curiosity; to learn more about the self or to complete one’s identity; to learn more about what kind of person the donor is ; to form a relationship with the donor and/or his family; and to learn about one’s ancestry/genealogy. Our analysis shows that for nearly all of these reasons access to the donor’s identity is not necessary. In those cases where it is, moreover, donor identification is not sufficient. What is really needed is contact with the donor, rather than the mere provision of his name. (shrink)

Biomedicine has opened up new possibilities for parenthood. Once resigned to remaining childless or pursuing adoption, infertile couples can now pursue options such as gamete donation, in-vitro fer...

Feelings of guilt are human emotions that may arise if a person committed an action that contradicts basic moral mores or failed to commit an action that is considered moral according to their ethical standards and values. Psychological scholarship distinguishes between altruistic guilt (AG) and deontological guilt (DG). AG results from having caused harm to an innocent victim, either by acting or failing to act, whereas DG is caused by violating a moral principle. Although physicians may be expected to experience (...) frequent feelings of guilt in their demanding and intensive work, it is surprising to find that this issue has not been explored in the professional literature on medical ethics. To that end, we conducted a qualitative study that included personal in-depth interviews with Sunni Muslim gynaecologists. These doctors provide underground infertility care and perform religiously forbidden treatments involving sex selection and gamete donation. They opened their hearts and spoke about the emotionally taxing pangs of conscience they suffer. Analysing their narratives led us to characterize their feelings of guilt as DG. We discuss the causes for their plight and the way they cope with it, compare DG to the concept of moral distress, and call for future research on clinicians’ feelings of guilt and pangs of conscience. (shrink)

ART and, in particular, IVF and ICSI, are essentially a laboratory experiment, but which, due to its specificity, goes beyond the disciplinary boundaries, explicitly acquiring an ethical-axiological dimension in the interaction zone of the members of a particular community involved in child-bearing. At the same time, it is noted that the activity and choice of a way to solve problems with childbirth has a characteristic severity, due to the traditions and level of civil and social maturity of a country, due, (...) among other things, to the level and achievements of technical equipment in this industry of knowledge and practice. According to foreign studies, about half of all subfertile people in developed countries are trying to overcome their infertility with the help of medicine, and research data indicate that the proportion of such individuals is growing. The most difficult problems of reproduction are associated with low quality of oocytes or low ovarian reserve ; aspermia and deep teratozoospermia, can not give hope to a couple to have genetically related offspring. However, donor programs create additional opportunities for social motherhood / paternity. Donation of oocytes is found in ART programs at least 3 times more often than donation of spermatozoa. At the moment, donation of gametes and embryos raises a number of ethical, legal, medical and socio-psychological issues that require competent support from experts of a wide range of specialists, as well as competent, non-commercial, primarily due to the interaction between donors and recipients. The analysis of possible modifications of family and kinship ties is based on the idea of transforming social relations, in which assisted reproductive technologies play a fundamental role, building a system of “new kinship and new family.” By entering into the intimate process of the birth of life and acting as a regulator of the composition of participants in this process through the stimulation of responsibility to present and future relatives, reproductive technologies affect the initial moral requirements in the community, redefining universal values based on the specific situation. Scenarios of childbearing through ART with the involvement of additional participants are possible in the context of the legal field, but legally fixed anonymity of the donor leaves many unresolved issues related to the problems of hereditary diseases, genetic abnormalities and epigenetic changes; in addition, there is a problem associated with the possibility of unintentional incest, as well as the difficulties of the child’s self-identification and the closeness of his genealogy. Solutions to these issues are postponed until later, thereby initiating future dramatic situations, ethical conflicts and dilemmas with a poorly predictable positive outcome. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Significant Interests and the Right to KnowReuven Brandt (bio)1. IntroductionDaniel Groll's book Conceiving People (2021) attempts a novel and insightful defence of why individuals ought to choose open over anonymous gamete donation, barring any special circumstances. In broad strokes, the overall argument proceeds by defending three main claims: (1) that failing to disclose to children that they are donor-conceived is morally problematic, (2) that children who (...) are informed that they are donor-conceived (either intentionally by their social parents or otherwise) are likely to have a worthwhile, significant, subjective interest1 in having knowledge about their gamete donor(s), and (3) that parents have a duty to advance their children's worthwhile subjective significant interests. Groll's account departs from other criticisms of anonymous gamete donation in that it does not rest on the view that knowledge about one's genetic progenitors is essential to self-knowledge, identity formation, or other elements of wellbeing for creatures like us. The view thus attempts to avoid the pitfalls plaguing other criticisms of anonymous gamete donation, which tend to rely on controversial (and likely false) claims of genetic essentialism and/or genetic exceptionalism.Groll's thesis rests on the much more modest (and likely correct) claim that seeking information about one's genetic progenitors is one of many permissible, fruitful, and valuable routes to identity formation. According to Groll, it just so happens that a large portion of donor-conceived individuals aware of the absence of biological ties to one or more social parents choose this route to identity formation. And this empirical fact combined with plausible views about parents' obligations to promote their offspring's wellbeing gives prospective pro-creators strong reason to choose open donors over anonymous donors.Although many aspects of the picture Groll paints are attractive, I remain unconvinced that the overall argument succeeds. My criticism of the argument is multipronged. I am skeptical that failing to disclose to a child that they were donor-conceived and/or failing to disclose information to a child that they are [End Page 201] likely to find important violates the parental duty to build intimate relationships with one's offspring. This shifts the force of Groll's argument to the empirical claim that donor-conceived children are likely to have a significant subjective interest in knowing information about their biological relations. As I will show, the empirical evidence for this claim is not as strong as Groll presumes. In the absence of a deontic argument for disclosure, Groll must provide more robust empirical evidence that anonymous gamete donation is likely to result in off-spring with their weighty interests frustrated, or else argue that the risk is not worth taking. These are not fatal flaws but show that more empirical and normative work needs to be done to defend this line of argument.A more serious set of worries arise in response to Groll's claim that the interest that donor-conceived individuals have in genetic information is likely to be significant. Little is said about what constitutes a significant interest, except that interests fall along a linear spectrum and that the significance of an interest is a factor of "the space, so to speak, it takes up in a person's mental economy (do they think about it a lot?) and the extent to which they organize their lives around it" (2021, 63). My worries here are three-fold. First, it is unclear whether the empirical data support the claim that donor-conceived individuals are likely to have an interest in genetic knowledge that is significant in the sense that it occupies a large portion of their mental energy and is a locus around which they organize their lives. Second, there is scant discussion about whether an interest can become morally problematic (and so no longer worthwhile on Groll's account) if it is given too much weight. I will argue that a plausible reading of Groll's account requires that we treat overvalued interests as no longer worthwhile. Consequently, Groll's argument risks presuming the kind of genetic chauvinism—the view that genetic knowledge is essential to wellbeing—that he seeks to reject. Third, if... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Groll on Bionormativity and the Value of Genetic KnowledgeBradford Skow (bio)1. IntroductionShould people who plan to use donated sperm and/or eggs to conceive a child use an open donor who agrees ahead of time that any resulting children may be told who the donor is? In Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation (Groll 2021), Daniel Groll answers yes. He argues that (...) using an anonymous donor would be wrong. Groll does not discuss adoption in detail, but his ideas also support the claim that people who adopt a child should adopt from parents who agree ahead of time that their child may be told who their biological parents are. It is not OK to have a closed adoption, in which information about the child's biological parents that would otherwise be public (for example, information on their original birth certificate) is kept secret by the government, and where (in some cases) the biological parents are promised that their children will never learn who they are. I was adopted in a closed adoption and met my biological family when I was twenty, and I think Groll's answer to his main question is right. That, however, does not mean I agree with all of his reasons. Here I examine those reasons and sketch some places where I would depart from them.2. The argument in outlineThe basic outline of Groll's argument, in simple terms, is as follows.1. If a child's knowing who their genetic parents are will likely benefit them—that is, if it will make their life go better, or increase their wellbeing—and if this is foreseeable, then that is a reason for parents to make the child's learning this possible (at some "appropriate" time).2. That knowledge will likely benefit the child …3.. … and this is foreseeable. [End Page 182]4. This reason favoring parents making genetic knowledge possible is strong enough that, except in maybe very special circumstances, parents should make this knowledge possible.The first point is hard to dispute. If the second point is true, then the third point is also plausible, since it is foreseeable that a child born from gamete donation (or an adopted child) will likely try to learn who their genetic (or biological) parents are. These searches are common and widely known to occur. Most of the action, therefore, is in the second point. Why think that knowing who your genetic or biological parents are is likely to make your life go better? Here the path diverges into a wood.3. First try: getting what you want makes your life go betterThe simplest way to argue that knowing who your genetic parents are is a benefit is to note that many, if not most, people conceived through gamete donation (or adoption) will, at some point, want—intensely want—to know who their genetic (or biological) parents are. One can then appeal to the idea that getting what you want makes your life go better, other things being equal.1Groll does not like this justification. His objection is that it does not show "that there is anything resembling a deep connection between genetic knowledge and well-being" (Groll 2021, 65). On Groll's view, knowing who your genetic (biological) parents are is a benefit, but this is not simply because it is something you want to know. I might know ahead of time that my child will want to live in a red house, and they might therefore be better off if they get to, and I might do my best to make that possible; but the reason I have to make genetic knowledge available to them is much stronger and much weightier than my reason to help them live in the right colored house. (It may be that this is where the fourth point of the argument, about the strength of reasons, comes in.)So why is the reason to provide genetic knowledge stronger? Groll, I think, holds that some things are more worth wanting than others. Getting what you want may benefit you, but getting what you want when what you want is something... (shrink)