Posthumous sperm donation and donor-conceived peoples' rights

Recent media coverage of recommendations published in The Journal of Medical Ethics regarding non-directed posthumous sperm donation highlights the ready ease with which donor-conceived people are marginalised in policy decisions about donor conception. Instead of taking fear-based, constraint-focused decisions that disenfranchise stakeholders, let's work to establish a just society that approaches donor conception without fear - a community that supports win-win policies.

According to coverage by the BBC and in the Guardian, Dr Joshua Parker, from Wythenshawe Hospital, Manchester, and Dr Nathan Hodson, from the University of Leicester, recommend that UK men be allowed to specify their sperm for posthumous donation in the UK in a manner like organ donation. The researchers argue that such an approach will address the shortage of UK donor sperm that prompts many intended parents to go abroad. Further, their solution addresses a fear possibly experienced by intended parents that their donor-conceived children may form a relationship with the donor or donor-siblings. Finally, while not explicitly stated, their recommendation also seems to address donor's possible fears about being pursued for child support.

I imagine the researchers feel they provide an exciting solution to the problem they intend to solve. Unfortunately, their framing of the problem is too narrow. Parker and Hodson's recommendation would strip donor-conceived people of the ability to contact their donor or exercise their rights to know their biological origins.

Compounding their attack on donor-conceived people, prominent media coverage from the BBC implied support for removing regulations by drawing several wrong-headed conclusions.

• 'There is a growing shortage of donations around the country because of strict regulations.' This is a bold assertion. Sperm donation involves medical samples that need testing to ensure the health of the recipient. By creating human life, sperm donation involves the rights of the persons so conceived, including a right to know one's origins. But absent evidence in BBC coverage creates the impression that these regulations create a shortage.

• 'In 2014, a national sperm bank serving the UK opened in Birmingham with a government grant of £77,000. Less than two years later, the bank had closed its doors and stopped recruiting donors. Only nine signed up after its launch, with one of those later dropping out.' Strangely, this report carefully avoids the logical critique, that the effort was woefully underfunded. Instead, notice the next sentence....

• 'Since 2005, the law says that sperm donors in the UK must agree that any children born from their donations can contact them when they turn 18.' No explanation is provided for this fact, but the clear implication is that these regulations are to be blamed for the shortage.

Thus, the reader is encouraged to conclude that the government has over-regulated this space. To restore the supply, the argument follows, remove the medical protections and rights of donor-conceived people.

Because donor-conceived people can only claim their rights decades after they are conceived, and only if they are aware of the circumstances of their origin, intended parents, doctors and donors have all the power. All too often, these parties have conspired in lies and secrecy, claiming that expedience justifies sacrificing or denying the rights of the donor-conceived person, and that the fact of their existence should provoke sufficient gratitude on the part of the donor-conceived person as to merit forgiveness of those who made it possible.

At present, influenced by coverage such as the BBC's, the public appears to imagine a zero-sum game, pitting the yearnings of would-be parents (and their doctors) against seemingly hypothetical future concerns of donor-conceived people. Such twisted reasoning arises from a position of fear. And the anonymous donation industry feeds on fear, including:

• Intended parents' fears that often centre on complications from knowing the donor's identity including competition for the child's affection, possible interference in parenting, and making sense of new relationships (such as donor-siblings);

• Donors' fears that include being held financially or socially responsible for a child they helped create but did not plan to parent, and stigma around the act of donation.

As illustrated by this recommendation and the news coverage, in the fight for recognition of one's right to know one's origins, donor-conceived people and their allies must seek to reduce fear in order to build public sympathy. Unfortunately, donor-conceived people bear a disproportionate burden of work in this matter, as they are so easily cut-out of the decision processes, as described above.

Yet donor-conceived people can win the hearts of the public with compelling personal stories, humanising the issues, while advocating for policies that provide answers and assurances to the strongest fears of the parties in the room, parties whose decisions will be felt for lifetimes.

Let's work to reduce fear, rather than mine dead men's testicles.