What Does It Mean That A Child is “Yours?”: Thinking About ART Mistakes

Here’s a thought-provoking piece from The Guardian, UK.   It ties back to some of my earlier thoughts about ART mistakes. (The most recent string was occasioned by the “wrong embryo” case featured on the Today show not so long ago.)  

As the article notes, while uncertainty about paternity has been around forever, uncertainty about maternity is a new problem.   Time was a woman gave birth and we knew she was the mother.   Now?  She may not be legally recognized as the mother of the child (because in a jurisdiction that enforces surrogacy agreements a woman who gives birth is not necessarily a mother).   And she may be legally recognized, but she may not be genetically related to the child.   In this brave new world, women as well as men may now need to ask ”Is this child mine?”   

This question–is the child mine-is a fascinating one.   To say that this thing or that thing is mine is to claim possession.   Children, of course, are not possessions, nor can they be possessed.   As it is used in this article (and in the Michael Jackson’s Billie Jean) the question is really one about genetic lineage–was my genetic material used to create this child

So Maybe Being A Parent IS All About Sex?

Under the laws of many states (including Washington) and in the Uniform Parentage Act the parental status of some men turns on the precise means by which the crucial sperm entered the mother’s body:  If sperm is introduced via intercourse than the man is a father while if it is introduced any other way, he is not.   I have commented in the past  that this seems a very odd place to draw a line. 

People of differing views might well share this opinion.   If you think genetics is the  crucial determinant of parental status, then the man is a father no matter how the sperm is delivered.  If you think intent is critical, then the man may or may not be a father–engaging in intercourse is no guarantee of intent to parent.   If you tend towards function (as I typically do) then the man may or may not be a father, but it has little to do with the actual delivery of the sperm.   And so on through the tests I’ve discussed.   

Even when I might disagree in substance (as I do with the genetics-is-fatherhood stance) I find it sensible that sex/no sex is not where a line is drawn.  

Mistakes in ART–What’s the Remedy?

I’ve written on at least two earlier occasions about the consequences of mistakes in ART.   (If you want to go back, the posts are here and here.)  I’m suspect I have also let some of the “mistake” stories go by, too.   But there’ are stories of two incidents  circulating in the British press, and I thought I’d revisit the topic.    

I’ll start where I started before–mistakes are bound to happen in all human endeavors and ART is no exception.  But of course, as ART is more widely used, there will be more mistakes.   (Not necessarily a higher percentage of mistakes, but a constant percentage means a rising number of mistakes as the number of instances of ART rises.)  

Lesbians Ideal Egg-Sharers?

I just cannot resist doing a short post on this, seeing as it does tie back to my post from earlier today.  

Here’s the deal.   Some ART clinics offer egg-sharing.  I believe these clinics are all in the UK, but I’m not sure about this. 

The idea is that if I go in for ART (I assume mainly for IVF) and offer to share some of my eggs, then I get a cut-rate on my own treatment.  (As you can see from the linked article, it’s a very substantial savings.)   The clinic then offers those eggs to another client of theirs who needs eggs.   Especially where egg donors are not paid (as in the UK)  this helps ensure a supply of eggs.  (There’s an egg shortage in the UK, just as there is a sperm shortage.) 

The Business of ART in a Down Market

I’ve been collecting all this little bits and pieces about the impact of the economic downturn on aspects of childbearing generally and ART in particular.  There’s nothing surprising here, really, but still I thought I’d cluster them together.

Let’s start on the supply side.   I noted before that the supply of sperm and eggs is up.   In an essentially unrestrained market like the US, this makes perfect sense.   People need money.  Some people who were not willing to sell sperm or eggs a year ago are now willing to do so.  It’s not that the price they recieve has risen, it’s that they need the money more.  (Indeed, it seems to me that if the supply of donors is increasing, the price paid to donors ought to go down.)

Perhaps it is worth noting that even as the US is experiencing an expanding supply of gametes, the UK is in the midst of a sperm shortage.   (That’s the backdrop for the post a couple of days ago.)

Brave New World Coming Our Way?

Many of the posts on this blog have discussed ART (that’s Assisted Reproductive Technology and you can check out the tag).   ART creates more than its share of perplexing problems–everything from the parentage of children born to women who are not genetically related to them to the collection of sperm from men who have died.

In fact, the main ART techniques discussed have been around for a while–collecting sperm and eggs, freezing sperm (something they’ve been able to do for quite a while) and eggs (not so long, but creating similar questions), in vitro fertilization (IVF) (which is fertilizing eggs outside of the body and then transferring them to a woman’s womb).

I’ve seen a couple of stories recently about developing techniques that open a new range of questions.  So, for example, they can now do ovary transplants, at least in some circumstances.   

The Wrong Sperm

A month or so ago I wrote about a wrong embryo case in Japan.   Here’s news of a case in the same general genre (ART mistakes) from the UK.    The story is pretty simple and I’m not sure how much there is to say about it.   The reporting seems a tad more interesting.

Three couples were using IVF at the same London hospital.   It appears that these were different sex couples and for each couple the plan was to use sperm from the man and an egg from the woman, to create an embryo, and then to transfer the embryo into the woman’s uterus.   The problem, for each of these three couples, was that they used the wrong sperm.

Now in this instance the mistake was caught within hours–it’s not clear to me that fertilization had even occurred.   This is quite a bit different from the case in Japan where the embryo was transferred and pregnancy resulted.   As soon as the mistakes were discovered, the sperm and eggs were discarded.   

Lesbian Mothers in New York–The Good News

A couple of posts back I alluded to good news/bad news out of New York.   I did the bad news first, and now it is time to come back and note the good news.   You can read the court opinion here or you can read a news account or you can, as usual, read Professor Art Leonard’s excellent blog account.  I recommend you have a look at the actual opinion–it’s both thorough and pragmatic.

This case does not begin with two lesbian mothers in conflict.  Instead it transpires when there is a pleasing unity of purpose between the two moms.  That’s a critical point I will return to.

Ingrid is a Dutch citizen.   Mona is Somali/Yemeni.  The women live together in New York City.  They have been together for 11 years and married in the Netherlands in 2004.

They wanted to have a child.   Mona donated an egg, which was fertilized using donor sperm.   The resulting embryo was then transferred to Ingrid’s uterus.   Sebastian was born January 27, 2008. Ingrid alone was listed on the birth certificate.

Now, there’s ever so many theories on which you could argue that Mona is a parent.   (You can read about a lot of them elsewhere on the blog.  Use the tags or do a search–I will not put in all those links right now.)   And the judge here (since it is in Surrogate Court, she’s called a Surrogate and her name is Kristin Booth Glen) does an admirable job of surveying many of them, reasonably enough those applicable in New York.   For example, Mona provided 1/2 the DNA used to create the child.  This gives her a genetic link, which is often (most typically for men) enough to claim parental status.  

Taking Sperm After Death

I read this story this morning and I’ve been trying to figure out what I think about it since then.  I’m still not sure.

A young man died tragically after being assaulted on the street.   His mother arranged to donate his organs.   At the same time, she wanted to collect his sperm so that she could use it at a later time to create grandchildren.   She is quoted as saying “I want him to live on,” Evans said. “I want to keep a piece of him.”  In addition, according to the mother, the young man had wanted to have children.   She sought and obtained a court order allowing her to have the sperm collected.

I wrote about a somewhat similar circumstance not so long ago.   In that case the man had already donated the sperm and the court declined to allow his parents to use it.   That post in turn will take you back to yet another instance of a similar problem.   Each is a slightly different variation, but I think all raise the same larger questions.  How do we relate to the stuff from which children are created?

Consider this:   The mother of this young man is undoubtedly doing a good deed when she donates his organs.   I gather that she has the right to consent to do this.  And I imagine that if she had anothcer child, say, who needed one of the organs, we would allow her to direct the organ to that child.  (While I think this is so, could I be wrong about that?)   Would it be different if she wanted to donate his sperm to someone else who needed it?  

UK Lesbian Moms on Birth Certificates

Here’s a UK story that lines up nicely with an earlier post I did about NY.   As a result of a law enacted last fall (you can read a few comments about the legislative debate here) lesbian couples will now have several new paths to joint parenthood in the UK.  Though the headline here is about birth certificates, in fact the changes go deeper than that.

I’m not entirely sure I’ve got all the details right, but the thing that seems most clear is this: If a woman in a civil partnership gives birth after using ART (this would include IVF and donor insemination) then her partner’s name goes on the birth certificate.  Even more important, her partner is the legal parent of the child, just as the husband of a woman who gives birth would be.    Given that the UK is a single country without separate sovereign states, this would place the partner in a fairly secure legal position.   (It’s not clear to me what another country might make of the certificate, of course.)

Further, it appears that even if the two women are not a parties to a civil partnership, as long as both women sign the necessary consent forms (some of which at least are required before doing any ART), then both women are legal parents.  And of course get their names on the birth certificate.

This is particularly interesting because while the two women could be a lesbian couple, it does not appear that any specific relationship is required.  Thus it could be any two women who agreed to raise a child together–as long as they are not blood relatives.   That’s an unusual provision, to say the least.   The signing of the consent forms the basis of parenthood.