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2. Donor Anonymity

Thus, gamete donors are selected or deselected by reference the extent to which their physical and sometimes social and psychological characteristics match those of recipient parents. As Braverman and Frith note, the aim of this practice is often:. There may however, be aims other than secrecy and concealment. Such selection may thus be performed with several aims in mind. Of these two categories, a desire for matching is generally thought to be less morally problematic than a desire for design , since desires for familial resemblance, secrecy within limits , and to avoid offence are often considered relatively benign.

This is not, however, to say that no critical work has been done on this topic as shall be seen in subsection 3. Design-based motivations for selection, however, have been the subject of a great deal more debate. For, although in the context of gamete donor selection there are no embryos or fetuses involved, nor genetic manipulation performed, there has been much focus on questions of:.

The desire to have a child free from disability and disease is often considered the least contentious ground for gamete donor selection. Robertson ; Glover et al. Robertson sums up this view well when he states:. The desire not to have a child with serious defects is not itself immoral, and actions to avoid such a reproductive outcome should be respected as an important aspect of procreative liberty.

The question then is what means to achieve that goal are acceptable… Preconception selection by voluntary selection of mates or gametes raises the fewest problems… Concern with the genetic fitness of a mate may not be romantic but it is rational if one is concerned about the health of spouse and offspring. Mate selection should thus be left to the individual. Similarly, the selection of a gamete donor should be left to the couple that needs this service.

Some go further, arguing that donor selection for the purpose of disability-avoidance is not merely permissible but, in certain circumstances, obligatory see, for example: Discussions regarding this matter have tended to focus less on gamete donor selection and more on the selection of embryos and fetuses through pre-implantation and pre-natal genetic diagnosis. However, as Holm and Bennett and Williams note, arguments suggesting a moral obligation to select against disability in these contexts apply to gamete donor selection too.

Indeed, that this is the case can be seen clearly in the negative media reaction and public outrage directed towards a deaf couple who, after deliberately conceiving a deaf child in the early s via the use of a 5 th generation deaf sperm donor, were vilified by the tabloid media and condemned by the US National Association of the Deaf.

For interesting and insightful commentaries on this case see Savulescu ; Spriggs ; Fahmy It can also be seen in the fact that many countries require that clinics screen out potential donors for heritable diseases prior to their inclusion on the donor register. HFE Act , s. Yet on what grounds might such an obligation be based? Arguments falling into this category thus focus on person-affecting reasons, picking out the harms or limits to opportunity associated with certain disabilities as providing good reason to select against donors with traits liable to result in such harms and limits to opportunity.

Such an approach is intuitive. However, given the conclusions of the Non-Identity Problem see entry on the non-identity problem , many question the logic of appeals to the interests of the child created in all but cases of the most severe disabilities. For, as it is generally held that a life with a disease or disability is better than no life at all, and selection decisions alter who it is that comes to exist rather than the prospects of determinate future persons, a focus on the interests of future children cannot ground such an obligation Bennett ; Parfit ; Parker ; Robertson Others suggest that although the objects of our procreative efforts may not be harmed by being born with a disability prospective parents may nevertheless have good moral reason to select against disability in their offspring on the basis of other considerations.

See entry on eugenics for a more detailed treatment and criticisms of different arguments in support of an obligation to select against disability. Such arguments have been criticized by many who suggest that parental obligations to their offspring cannot be so strong as to ground an obligation to select against disability Williams ; that. Yet, whilst such authors tend to suggest that there cannot be an obligation to select against disability, they also suggest that prospective parents should be at liberty to do so. Among a number of authors associated with the disability rights movement however, a different claim is made.

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For, such authors suggest that not only can there be no moral obligation to select against disability, parental preferences to screen out disabled donors are morally problematic for two reasons. The first regards the messages that such preferences send about and towards persons living with disabilities, ones which may be seen as discriminatory and offensive: The second is that the desire to select against disabling genetic traits is based on misinformation regarding both the severity and true nature of disability.


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Regarding the true nature of disability, it is claimed that contrary to the views of many, who hold that disability is inherently disadvantageous, many and, for those who take an extreme approach, all of the harms associated with disability are socially constructed. Thus, it is suggested that as disability is often not a feature intrinsic to those who suffer it, to attempt to prevent disability by preventing the existence of persons with inabilities is very much akin to attempts to prevent sexism or racism by preventing the births of black people and women: Taken to extremes, however, social constructivism is often viewed as irredeemably flawed by the academic community and a great number of able bodied and disabled persons alike.

Robert Kitcher expresses this well when he notes that if we take a wholly social constructivist view. Had gamete donor selection been well known in the s when discussion raged concerning whether trans-racial adoption practices constituted a step in the right direction towards the social ideal of colour-blindness, a form of racial and cultural genocide, or something in between the two, one might have expected to see similar discussions regarding donor selection.

This however has not been the case and instead, the philosophical literature on race-based selection has tended to focus on the question of whether selection of race-based characteristics is appropriate at all. For the most part this focus is due to contemporary debates regarding the question of whether the concept of race is philosophically and scientifically defensible. Thus, work suggesting the removal of racial identifiers on donor catalogues seems to owe a great deal to authors such as K. Anthony Appiah , and Naomi Zack , who both deny that race is a coherent concept and recommend discarding it entirely see entry on race.

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Fogg-Davis , for example, suggests that both the practice of reproducing race through assisted reproduction and selecting donors on the basis of different race-linked characteristics are problematic as they raise two major linked ethical issues:. She suggests that those who use racial classification to inform donor selection decisions are saying that. Harris too questions the legitimacy of the desire to match donors to recipient parents on the basis of race-linked characteristics such as skin tone, and hair and eye colour.

Why do so many people firmly believe that children should be like their parents, particularly in terms of their general colour and racial characteristics? Not only would such selection collude with prejudice, constituting an inappropriate response to a social problem, but it would likely also undermine attempts to change racist and homophobic social attitudes and practices.

Such cases raise a different kind of concern about whether selection, when performed in order to satisfy these kinds of preferences, encourages and facilitates the development of ethically troubling attitudes on the part of prospective parents. This concern has been expressed in various different ways. Those who take this view hold onto the traditional notion of the child as a gift and correspondingly suggest that parents ought to care, not about the traits that their children possess, but about developing a loving relationship with and raising whatever child they receive.

Others take a more Kantian line, suggesting that such these parents are wrongfully instrumentalising their children: They hold instead that other conceptions of parenthood can, provided they are not taken to extremes, be perfectly adaptive, and crucially, do not require parents to refrain from all attempts to shape the characteristics of their prospective children. Others question whether the virtues of the prospective parent are the same as those of an existing parent.

This is echoed by Wilkinson who, discussing a hypothetical example of two prospective parents who seek to ensure the birth of a blue eyed child and agree that they will put it up for adoption after birth should it not possess such characteristics, notes. Some suggest however that, although selection is not necessarily morally problematic, we should still be concerned that a selective mentality may be a precursor of conditional, as opposed to unconditional, love once the child is born, or to unrealistic expectations and feelings of entitlement.

Kass ; Sandel Should gamete providers be paid? If so, should such payments be limited to compensation possibly including compensation for time and inconvenience? Or is incentivising or rewarding providers also morally acceptable? In addition, supporters of payment cite justice gamete providers deserve to be rewarded and autonomy providers and recipients should be allowed to contract with each other as they see fit. Some of the arguments and issues concerning payment for gametes closely resemble ones arising in other areas such as organ sale, sex work, and commercial surrogacy see entries on exploitation , feminist perspectives on reproduction and the family , feminist perspectives on sex markets , parenthood and procreation , and the sale of human organs.

We deal with these briefly here before moving on to consider in greater detail some of the more distinctive issues raised by paying gamete providers. The focus here is on gametes for clinical use in human reproduction, rather than gametes for research purposes, although many of the same issues also arise in a research setting. In the case of sperm, the physical risks of donating are negligible, but concerns have been raised about psychosocial risks, especially if one man is permitted to generate numerous offspring.

What happens, for example, if a single sperm donor produces hundreds of children and a significant proportion of those contact him years later? One way of containing this risk would be to limit donor offspring numbers; another would be to allow donor anonymity, although that may be objectionable on other grounds see our earlier discussions of donor anonymity and donor offspring limits.

Producing hundreds of children is unlikely to be a problem for egg donors but, unlike sperm donors, these women do face non-negligible physical risks: As has been noted however it should be possible to neutralise this risk by enforcing donor offspring limits.

Another set of issues is the negative effect that payments, or payments above a certain level, are supposed to have on the quality of consent—a concern that is closely linked to worries about exploitation. Financial incentives, it is argued, encourage people to do things that they would not otherwise do, encourage them to do things that are harmful, and make their actions, consents, and decisions less likely to be autonomous and voluntary Resnick ; Steinbock ; Wilkinson These arguments are more often directed at paid egg donation than paid sperm donation, because the direct physical risks and the sums of money involved for eggs tend to be much greater.

Thus, people have been concerned that vulnerable young egg donors might be lured into the egg market and then exploited by clinics, egg banks, or recipients. These concerns structurally parallel ones that people often have about commercial surrogacy and sex work. For the present, we simply note that, while the possibility of defective consent and exploitation must be taken seriously in any system of paid gamete donation, there seems no reason in principle why paying for gametes must be exploitative, nor why it cannot be validly consented to.

Finally, we note here that there is a connection between remuneration arrangements and selection practices discussed above.

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In particular, one objection to allowing payment—or at least to the unfettered commercialisation of gametes—is that it may encourage a market in which particular traits can, for those willing to pay a high price, be aggressively selected for. The first of these is the welfare of the child created. What follows from this possibility, however, is unclear. To start with, there are empirical questions about how many donor-conceived people will feel this way and about how severe their negative feelings if any are. So, if this concern is going to ground an ethical argument against paying donors, a solid evidence base will be needed to underpin its empirical premises.

Another is that if donor-conceived children are communicated with appropriately, honestly, and sensitively, and at an early stage then any problems associated with donor motives will be minimal Nuffield Council on Bioethics What follows from this? First, we should note that this area is subject to the implications of the Non-Identity Problem Parfit Therefore, for standard reasons relating to the Non-identity Problem, they may not be harmed by the practice of payment—or at least not in the usual comparative harm-to-interests sense worse off than they would otherwise have been.

See entry on the non-identity problem.

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So, while there may still be a child welfare argument against payment, it must rely not on harm-avoidance but rather on impersonal welfare considerations. Given this, a lot hinges on whether payment is required to ensure an adequate supply of donor gametes.

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If it is not if, for example, the reasons for paying people are quite trivial ones, such as administrative convenience, or even allowing recipients more choice then the fact that payment will adversely affect donor welfare does looks like a good albeit prima facie reason to prefer altruistic donation. Imagine that we have a choice between creating a population of donor-conceived children using paid donors or a different but equally large population using altruistic donors.

It is supposed to follow from this that incentivising egg sharing other things being equal is less morally problematic than incentivising egg donation: This does seem like a sound prima facie reason to prefer egg sharing although several caveats must be noted. First, some special types of risk may apply to egg sharers: We send them handy tips and reminders; you see the support clock up. Get in Touch Pledge an Action.

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1. Organ Retrieval from the Dead

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