Your thoughts about donor conception, conditionality and adoption

Following on from last week's article (see BioNews 684), we now turn to the final questions of the 'When It Takes More Than Two' poll - about whether gamete donors should be allowed to place conditions on who receives their donation, and whether those who are considering having children via donor conception should be encouraged to adopt instead.

The placing of conditions by a donor, specifying recipients who can or cannot be treated with their donated sperm or eggs (for example a sperm donor specifying that his sperm should not be used by a lesbian), is currently permitted in the UK. However, there is arguably a tension between this fact and the provisions of UK equality law. Indeed, at a meeting in 2011 the Human Fertilisation and Embryology Authority (HFEA) considered whether to continue permitting conditionality, in light of the latest equality legislation. The HFEA decided to permit conditionality, but there was dissension from authority members - this is a controversial subject.

Our poll asked 'Should egg and sperm donors be allowed to place conditions on who receives their donation?'. Two-thirds (67 percent) of the people who responded to this question thought that donors should not be allowed to place conditions on who receives their donation, and one-third (33 percent) thought that donors should be allowed to.

Those respondents who thought donors should be allowed to place conditions were asked a follow-up question - 'On what grounds should donors be permitted to prevent people from receiving their donation?' - with four options to choose from, and the additional possibility of suggesting reasons of their own. These options were not mutually exclusive, which meant that people could choose more than one option if they so wished.

The most popular condition that people thought it should be possible to place upon donation, named by two-thirds (66 percent) of those who thought such conditionality should be allowed, was the age of the recipient. The next most popular option, named by half (50 percent) of those who thought such conditionality should be allowed, was the recipient's sexuality. The final two options that could be chosen were religion (selected by 45 percent) and race/ethnicity (selected by 40 percent).

In addition to this, 37 percent of those who thought conditionality should be allowed took the opportunity provide their own suggestions of conditions that they thought donors should be able to place. Many diverse suggestions were given, but certain common themes emerged. The most popular suggestion was that donors should be able to place any conditions they wish upon their donation. In the words of one respondent, 'donors should be able to discriminate in the same way any person discriminates when choosing the person they want to have children with'. In the words of another: 'They are creating another person and have the right to have as much input as they so choose. [...] Perhaps if more conditions were permitted, more donors would feel comfortable donating'.

Some respondents saw conditionality as a mechanism for ensuring that the donor is identifiable (their identity made available, on request, to people conceived with their donation once they turn 18) or even known (their identity known to the recipient from the outset). Responses included 'any condition should be allowed if the donation is not allowed to be anonymous', 'as an egg donor I would only donate to a couple known to me', 'they should be permitted to restrict their donation to particular individuals or couples', and 'wanting contact - ie, known donor'.

Further to this, some respondents saw conditionality as a means for the donor to ensure that children conceived from their donation are told about their donor-conceived origins (or conversely, as a means for the donor to ensure that children are not told). Responses included 'should be able to specify if child of donor conception receives details about who you are', and 'whether resulting children will be told of their origins or not'.

Several respondents thought conditionality could be used to avoid a mismatch between the opinions and values of the donor and the recipient, with some thinking this was particularly important now that donor anonymity has been removed. Some respondents implied that people with bigoted or otherwise prejudiced views shouldn't be permitted to receive donated eggs or sperm at all - 'the child must grow in a family with few prejudices as possible' and 'I wouldn't want my biological child being brought up by racists, sexists, homophobes, etc'. Other saw this more dispassionately, as being about compatibility - 'children should never find out that the parents are abhorrent to the donor', 'if the donor has an intense dislike for some religious, ethnicity or sexual orientations then it would not be appropriate for recipient to be from that group', 'think about future contact between donor who is homophobic and lesbian couple who have received the donation'.

Some of the conditions suggested related to the prospective family structure and number of existing children. Some specified 'relationship status', 'single lifestyle' or 'not in a stable relationship', some went further and specified 'marital status', and there were several variations on 'restrict to only opposite sex married couples' (with one respondent keen to point out 'I wish to make it clear that I am not homophobic but believe that children deserve two parents of opposite sex'). Regarding the number of children, some respondents thought the recipient's 'number of current children' was a legitimate condition, while others were keen that the donor be able to 'limit number of children created by donation.'

Many of the conditions suggested were connected with the moral standing and worth of the recipient, and the welfare of the donor-conceived child. Some people posed these things in broad terms -'whether or not the recipients would make good parents', 'capability to be "good enough parents" if this can be ascertained', 'anything that could prevent the potential child from living a "good" life' - prompting the question of how such subjective qualities could ever be fairly or formally defined.

Other suggested conditions related to 'education'. 'income', 'social class', 'socioeconomic status', 'standard of living', and various permutations of drug and alcohol (ab)use. Several respondents suggested the health of the recipient should be a permissible condition, including 'disability (mental and/or physical)', and there were several variations on 'shortened life expectancy of recipient'. There were also a number of respondents who thought the recipient's criminal record was a legitimate basis for placing conditions, with some responses specifying types of crime - 'sex offenders' and 'violence'.

The last question in the poll - 'Should people who are considering having children via donor conception be encouraged to adopt instead?' - echoes a question that is almost always to be found in online comment threads following a news story about donor conception. Those who receive or provide fertility treatment often express exasperation with this question, on the grounds that it misconstrues or disparages their needs, desires, experiences and constraints. But since the question's popularity is enduring, and since several people suggested it be included, we thought its inclusion in the poll was appropriate.

In the event, of those who responded to this question 37 percent thought that people who are considering having children via donor conception should be encouraged to adopt instead. The remainder, 63 percent - a clear majority - disagreed.

What do these poll results tell us? At the Progress Educational Trust (PET), we are perhaps overfamiliar with the views held by the various groups, stakeholders and factions in discussions of donor conception. Responses to this poll have reminded us that some of the most fundamental questions relating to donor conception - anonymity, disclosure, conditionality and the option of adoption - are still unresolved. Even when we poll a self-selecting audience of BioNews readers, we find that their opinions on some aspects of donor conception are poles apart.

PET would like to thank everyone who responded to and suggested questions for the poll. The 'When It Takes More Than Two' project was supported by the Wellcome Trust.