This morning I came across this document, which provides ethical guidance to ART (that’s assisted reproductive technology) professionals. (DI is is one facet of ART.) It was developed by the ASRM(American Society for Reproductive Medicine). While it doesn’t address the issue of anonymous donors, it is focused on the use of ART by people who will frequently be using anonymous donors.
It’s not particularly new (2006) but it is interesting to me the way the discussion is organized. As the title makes clear, this paper is addressed to the use of ART by lesbian, gay or unmarried people. The question posed is whether it is permissible to discriminate in the provision of ART–that is, to provide it to (heterosexual) married couples, but not to unmarried couples or single people.
Framing the question like this requires the justification of restriction rather than the justification of access. That’s consistent with an underlying assumption that we should all be treated equally unless there is a reason not to do so. I think often the approach taken is the opposite, with each constituency having to justify why it should have access to what is already available to married couples.
In considering the ethics of restricting access to ART, the authors here examine three interests–those of the people seeking to use the technology, those of any children that might be created because of use of the technology and the interests of the providing professional. Their ultimate conclusion is that there is no ethical justification for generalized discrimination in access to ART.
I’m undoubtedly a little less concerned with the interests of the providing professional than is the ASRM. And I recognize that there is probably an inherent bias in favor of more treatment for more people (and more money for the providers.) But apart from that I think they have identified the interests we ought to be concerned about.
I also appreciate the systemic nature of the analysis here. My own goal is to try to be transparent and systematic in working through these issues. And I notice they have others, some more recent. I’ll be looking at those in the next few days just to see what else they have to say.
To be clear, this is a different and independent question from that regarding donors. If one contended that the use of anonymous donors was impermissible generally, then presumably one would not discriminate between various people who might wish to use them. At the same time, the questions raised here arise whether you use known or unknown donors, at least in any regime where the donor is not a legal parent.
Also, as is discussed at some length in previous postsand comments, if the donor is to be recognized as a legal parent, it will generally alter the practice of ART dramatically. I suppose even then, though, the question of differential access to ART arises.