Procreative Freedoms Using Donated Gametes

Procreative Freedoms Using Donated Gametes A Parental Virtue Ethics Perspective

Damian Adams B.Biotech (Hons)

Procreative Freedoms (Australia)

When, with whom and how – inalienable human freedom, but not a biological right.Donor Conception (DC) allowed infertile people the freedom to procreate.DC framework – ability to produce a child via a third party that is not prohibited by law (eligibility requirements and means).

Current Procreative Freedoms

Parent’s freedom to decide does not end with DC - clinic, state/territory or country? - choice of donor? - tell or not tell and if so when?Some literature suggests potential harms to children.Do parent’s ethically and morally have these increased freedoms due to potential harms?

Child Welfare Paramountcy

Oz legislation (some states) and guidelines (national) describe the child’s welfare as paramount.Constraints on natural procreation is unethical, DC is artificial construct involving 3rd party(s).States have general duty of care to children under existing law.Potential to cause harm requires careful consideration.

3 Parental Virtues and NAVENeo-Aristotelian Virtue Ethics

Rosalind McDougall used NAVE to create 3 Parental Virtues.(2007)NAVE = Virtuous character and flourishing of the human being.3 PVs and child welfare paramountcy principle don’t preclude flourishing of parents - conflict, child takes precedence.

McDougall’s 3 Parental VirtuesParaphrased

1. Acceptingness – parent will accept the child for whoever or whatever the child represents.2. Committedness – parent undertakes responsibility to actively parent the child and to be there for the child.3. Future-Agent-Focus – principle that the child will become an adult and agent of own free will, - not adversely interfere with current & future opportunities (value structured – virtuous).

Applying 3 PVs to DC Outcomes

McDougall’s premise is that the framework is to be used to determine if a virtuous parent would do something and not if it harms.BUT a virtuous parent in aiming to be virtuous would assess harms in making decisions allows 3 PVs use in analysis.Committedness – given the effort and cost a parent enters into, assume that this PV is passed.Offspring outcomes assessed against remaining 2 PVs.

Deception of Origins

Current practice = identity release > 18 years.Previous practice = anonymous donors.Up to parents to disclose, majority do not.Origins of a person central to who they are. Deception potentially creates a psychologically harmful environment.No harm, no foul – if not told then no harm, but denies respect.This is how offspring wish to be treated, majority wish to know the truth about their origins (70-90%).

Deception of Origins

Deception of origins fails the acceptingness test - not comfortable with non-biological - fail to accept what the child represents (reminder of infertility).Simplistically truthfulness and openness represent virtuous character rather than deception and lies.

Kinship Separation

Not only donor, but siblings, grandparents etc.For some this is extremely traumatic and the majority wish to know other family members, not just donor.Due to current practice (ID release > 18), forced kinship separation fails the acceptingness of the complete child. But NO fault of parent.

Loss of Identity

Loss of kinship = loss of heritage and identity.Adolescence is a crucial time for ID formation.Absence of one or both biological parents removes the mirror – looks, personality, behaviour. Some studies suggest over 40% behaviour inherited – substantial mirror missing.Majority of teenage offspring want a picture of donor and non-identifying info (vocation, interests, children).

Loss of Identity

Identity loss harm assessment – fails acceptingness and future-agent-focus, no parental fault. Alternative approach – if parents let child’s ID freely develop (ie tell the child early) and not willfully force an identity construct  are accepting of child and not influencing future-agent-focus.

Late Discovery

Disclosure in adulthood often associated with extreme circumstances.Leads to distrust of parents, confusion, deceit and possibly anger.ID construct becomes destroyed and new information is difficult to assimilate.By not disclosing for a significant portion of child’s life, the parent fails: Acceptingness and F-A-F (failure may be viewed as temp.)

Incomplete Medical Histories

All offspring have incomplete medical histories: 1) no knowledge of donor’s history 2) info is outdated.Adversely effects early diagnosis, screening of hereditary diseases and lifestyle choices.Already cases whereby this has affected offspring.Some argue non-disclosure does no harm psycho-socially, but what about physical health?

Incomplete Medical Histories

Parents are being deprived of the ability to provide up to date medical histories.Fails the future-agent-focus test - child’s ability to flourish is potentially hampered.No fault of the parent.

Direct Physical Harms

Pre-eclampsia is increased in DC, extremely hazardous to child and mother.Frozen gametes increases DNA fragn and damage which can persist in the embryo.Damage is mediated by oxidative stress which has been linked to childhood cancers.

Direct Physical Harms

Single base changes in DNA associated with increased incidences of autism and schizophrenia.Physical harms fails future-agent-focus test.

Consanguineous Relationships

Illegal in Australia under Federal Marriage Act.Offspring that are deceived of origins are unaware of potential siblings.Aware offspring denied full knowledge of all siblings, other donation, natural children.Genetic sexual attraction, those separated at birth have been attracted and formed relationships when reunited.Similar likes (inherited) can lead to mingling in similar circles increasing chances of crossing paths.

Consanguineous Relationships

Knowledge of kinship reduces the number of potential relationships,  counter to F-A-F (reduced possibilities).Another component of F-A-F = ensure child develops into future moral agent with virtues (law-abiding citizen).On balance LAC outweighs the small increase of future possible relationships. Possibility to form consanguineous relationships fails F-A-F test.

Reconceptualising the Paradigm

Currently the paradigm restricts parental choices  reduction in parental ability to be virtuous.Practice needs to be altered to give parents increased choice and ability to fulfill 3PV’s.Changes to a child-centric paradigm that may initially be viewed as restrictive to adult’s procreative freedoms actually improves parental virtuosness.