Consent of the Sperm Provider

(This is following on my initial discussion of consent from yesterday–you might wish to start there.)  

As I move from a general view of consent to more context-specific considerations I thought I’d start by thinking about a man who is providing sperm (in exchange for money) to a sperm bank.   I don’t think there is any sense in which this is a medical procedure, and thus, the issues of informed consent that arise in treatment settings aren’t pertinent.    That ought to make it simpler. 

Indeed, this might be a situation in which we wouldn’t ordinarily even think in terms of consent.   It’s more like an business transaction–a simple contract:  I will sell you Y widgets in exchange for X dollars.   Do we agree?    I can use the word “consent” (I consent to give you widgets and in exchange you consent to give me dollars) but that hardly seems to advance the inquiry.  

I suppose the question here is whether there is something special about the sperm transaction that might lead us to say some safeguards are needed before the parties strike the deal.   Are there things that we should make sure the sperm donor knows/thinks about/considers?   

 Notice that this isn’t what we commonly do in business transactions.  Even if I am selling my dearly beloved collection of whatever-it-is that can never be replaced, we assume that I’ve thought it through and I am free to sell it. After all, I’m a grown-up.    No one stands over me making sure I have thought carefully about making an irrevocable decision.  (I think this is different in the context of medical decision making because there is information the ordinary patient doesn’t have.   Hence informed consent.)   

So back to the sperm bank:  Is there some reason to have some variety of informed consent here?  Should there be some special inquiry about whether the sperm provider understands what he is doing?   Should special information be provided? 

I suppose out the outset I should say that I doubt this would have much meaning, even if I thought it was desirable.   Around a year ago I gave a presentation to my faculty based on some of my work.  In the give-and-take that followed, one of my colleagues allowed as how she could imagine that her son (in his college years) might think that providing sperm to a sperm bank was a simple way to make a little pocket change.   I’m sure many twenty-year-old men would say the same.  

I don’t think it seemed nearly so simply to my colleague, however, and as the mother of a teenage boy myself, I can see how different it might look.   Relatedly, I’ve read several accounts recently of men who provided sperm for sperm banks in their youth and now wonder whether there are offspring out there created with that sperm.   This seems in some ways entirely predictable–surely we have all reflected on choices that we made when we were young, sometimes wishing we could make them be different, sometimes wondering what might have been.    

Perhaps this means we should consider some special disclosures about the possibilities of regret and second-thoughts.   Yet I fear that those sorts of disclosures would have little meaning to the young.   There’s something about the nature of youth…    

Still, you could require some sort of mandatory disclosure be made to all sperm donors–something that would inform them of the regrets they might someday experience.   (I don’t by any means believe that all men experience regret, by the way.)     I suppose the question would be what would be disclosed.     That’s a topic I might consider separately. 

There is an echo for me here of the debate around mandatory information that must be provided before a woman can choose to have an abortion.  It seems quite clear to me that much of this information is provided for the express purpose of preventing the woman from choosing abortion.   I see the same potential here–one could design the information not to inform, but to deter.   

In the end I’m quite skeptical about the real possibility of any meaningful informed consent here.    But there’s an interesting side note:   it seems that when sperm providers have to agree that any children conceived will one day be able to contact them, fewer young men are willing to provide sperm.  Providers are more likely to be older, more likely to have children of their own.    It seems quite likely that these older men have a greater appreciation for what they are doing.

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9 responses to “Consent of the Sperm Provider

  1. I agree with you (I think). As long as these young men are crystal clear on the biological scientific medical facts of the matter; which I actually think most vendors are, crystal clear on those biological facts even without any informed consent forms from the clinic. Sperm providers/vendors are the cream of the crop intellectually (excuse me I could not resist) most of the banks I’ve researched fir reunions do not take sperm from boys in the first four years of college. There is a huge population of Med students. The legal ramifications according to state law should be made clear to them and they should be told that there is no way for anyone to ensure that their children might not come knocking on their door some day or the doors of other close relatives with a DNA test in hand. They should know the facts as plainly as possible and if they wish to proceed they won’t be able to say “I thought they put some other guys DNA in my sperm, I did not know that there would be children actually related to me out there” or “nobody told me they could find me” “nobody told me how many children I’d conceive in my own home town”that’s a big one that impacts other members of their immediate family not just them and their kids. or “nobody told me it would be so hard for me to find my kids if I change my mind” Just the facts free of judgement that’s what they should be given. And men providing sperm for their own use should have a WAY different form.

    • I’m not sure what biological facts they need to be clear on–that the sperm can (and probably will) be used in an attempt to cause pregnancy? I cannot imagine that many providers are unaware of this. (I also cannot help but think of the contrast between the situation of the sperm provider at a bank and the situation of a man having unprotected sex with a woman.)

      I’m a bit wary about having the sperm banks inform the providers about the law. For one thing, law changes. Think about the Pratten case–banks could have told men that the law at that time protected their privacy but now the law may change. The other thing is that I’m not entirely confident that the law will be the same no matter where the sperm is used. In particular, I’d like to avoid having banks give men false confidence in the anonymity of their donations.

      • I know I’ve read donor release forms that actually say that the law changes and there is no guarantee…etc. Ok then the law should state what the law is at the time of donation, they have no parental authority etc. Its really to protect the doctor from a law suit, and that’s ok.

  2. perhaps the medical model is the wrong model to apply to sperm donors. Maybe a legal model is more appropriate? After all, they do sign legal forms.
    Does the idea of informed consent exist in the legal profession?

    • Sometimes particular waivers of rights have to be knowing–which means a person has to be informed of the rights before waiving them. (Think Miranda–you have the right to remain silent…but you can choose to talk.) I suppose that is akin to informed consent. But it’s fairly unusual in law and I’m not sure how it would work here. You can, I suppose, think of all agreements (contracts) as part of the legal model.

      I cannot quite see a system where every prospective sperm provider would have to consult with a lawyer–that’s the sort of requirement that (in my view) would be interposed simply to make the whole thing more expensive and less practical. Perhaps more centrally, I’m not sure what I want a lawyer (or anyone else) to be telling him.

  3. Here is the form that the DSR mailed to all sperm banks, clinics and doctors- with hopes that they would agree to hand it out to all prospective donors. It is not hard to understand why not one agreed to do so. If they adequately informed their donors, they would have a lot less donors willing to donate.

    ARE YOU THINKING OF DONATING SPERM?
    Your medical history, past, present and future….
    Would you be willing to provide ongoing current medical information with respect to yourself and your immediate family?
    As a donor, it is important to consider the ongoing ramifications for any children conceived who share your DNA. If you donate sperm this year, the sperm may be sold for many years into the future and potential mothers may keep that sperm for many years after purchase, often to try to provide their children with full biological siblings.
    Should you or a member of your immediate biological family develop a health or medical issue following your initial completion of the donor interview, it would be essential that you provide this information to the sperm bank and post the information (anonymously if you’d like) on the Donor Sibling Registry http://www.donorsiblingregistry.com, an online database and community that enables donors, recipients, and offspring to make mutual consent contact and share information. For many years after your original donation children who share your DNA may develop medical and health concerns that can only be answered with your updated information.
    It is also important to note that the accuracy of the medical and health history you provide to the sperm bank is crucial to the potential parents reviewing that information. Certain conditions carry genetic components that are not readily tested for and your accurate information is vital.

    If you have children of your own, or plan to…..
    Have you considered the possibility that in this small world your children may encounter biological half-siblings?
    At the present time, sperm banks do not keep, nor are they required to keep, any record of live births resulting from any specific donor. What this means for the children born with your DNA is that they may be many in numbers (there are currently many donors known to have more than 30, 50 and even 100 biological children as a result of their sperm donations). The children you have now or may have in the future may meet your biological children born from your donations. Honesty is essential. Before you donate, consider your willingness to be forthright with your children.

    Are you planning on donating anonymously?
    If you are planning on being an “anonymous donor” it is important to understand that because of advances in DNA testing and internet search engines, the likelihood of your remaining “anonymous” in the future is growing smaller. Have you considered what your reaction will be if you are “found” by your biological children in the future? The children born from your donation may be curious and will want to search out their genetic “roots”. As noted above, many donors have more than 20, 30 or even 100 biological children. Have you considered the possibility that you will be contacted in the future, even if your donation is anonymous? How would you respond if, one day in the future, you were asked to meet with your genetic offspring and his or her parents? You will need to think about the fact that this could be potentially disruptive to any family that you may have formed n the traditional manner.
    With this in mind, would you consider being an “open donor” now? This means that your biological offspring will be able to contact you when they turn eighteen (18) years of age.

    Please consider…
    Please consider how you might feel about your donation in the future. It is likely that more than one child will come to exist as a result of your donation. These children are genetically yours; in fact, they may one day have children of their own who will be your genetic grandchildren! Take a moment to imagine how donor offspring might feel. No doubt many will wonder about who they may look like, where they get their talents and personality traits from, and their genetic family history. Imagine your reaction if your genetic offspring needed a lifesaving bone marrow transplant and reached out to you-

    Please consider these issues carefully as you make your decision on whether or not to become a donor. Your actions today may have an incalculable effect on the future.

    Your donation is much more than a transaction with a sperm bank.

    © Donor Sibling Registry, 2007

    • Its no surprise that I of course agree with the content of the DSR handout but I do think the tone of it is to leading to be adopted as part of a clinic’s standard info packet for men looking to sell their sperm. I think the same basic facts must be presented but in a manner less like “have you considered?” and more like “Be advised that”. These men must understand the outside number of children that can be conceived from a single donation and they must understand the shelf life issue; I’m guessing but they could conceive 50 to 100 children with a single donation all in the same year or over a period of possibly 20 years? They also need to understand that donating puts themselves and other members of their immediate family at risk of sexual contact and possibly inbreeding with the children he’ll be conceiving anonymously – they need to understand that people do not always choose sexual partners in their own age group so the potential for his immediate family to have sexual contact with a neice nephew grandchild or cousin is not at all insignificant. He needs to understand that a member of his own immediate family may seek help with a fertility problem and purchase his sperm because people are looking to purchase the genes of someone with a family history similar to their own, religion, appearance, education etc. Its not inconceivable that his own sister, aunt or cousin might purchase his sperm if he is donating in the same area where his family lives. Information on donor profile sheets can be used to locate the donor in the future despite the fact that the clinic does not release the donors name or address. They need to be advised that it is not against the law for their children or for the purchaser to contact them or other members of their family if they are able to determine their identity from the information on the donor form.

      The donor profiles are quite complete actually and I’ve helped a couple of people find their fathers using the DSR. Its harder for the fathers to find their children though, I wish there was more to be done to improve their chances of finding them.

    • I’d like to separate out two different things here: One question is what are the concrete pieces of information that a man should have. A second is how should they be delivered.

      I’ll agree, for example, that man should probably be informed that improvements in technology make it more likely that they will not remain anonymous (assuming they are being offered that option.) But there are many ways to impart this information.

      As I read the form above, it seems to me it is designed to dissuade men from donating. In that sense it is akin to the informed consent requirements that I think are designed to prevent women from choosing to have an abortion. I don’ t mean to say that this is necessarily the actual intent of the drafter–only that to me it reads this way.

      As I said earlier, it’s also true that people sign all sorts of things without reading them. (I certainly do.) So if you really want people to know what’s in the form you might have to do something like read it to them. But that’s not our general practice with forms. What does it mean when we single out some things (like abortion or providing sperm) for that treatment when generally we figure it’s fine if people don’t read it?

  4. Julie I think Physicians or clinics have to take steps to limit their liability, certainly for malpractice where medical procedures are being performed – say a staph infection from dirty instruments used to perform an abortion. Also informed consent forms for medical procedures that could potentially go awry injuring the person physically should probably be entirely seperate from clarifying the rolls and responsibilities from what is essentially a contract to purchase a mans genes. I don’t think that in that instance the Doctor is a doctor they are a business person, and promising not to sell his vendor list is like any other business promising not to sell their mailing list. The clinic should advise the man selling his genes that the government requires them to retain certain records about the sale, for how many years and advise that if the government requires retailers to give those records to their customers they will have to comply – advise them that the records are private but that could change. I don’t see anything inflammatory about that. I do think the biology of it should be written and explained clearly that he and his immediate family will be at risk of unintended sexual contact with his offspring – its the nature of anonymity and the more offspring he has the greater the risk will be and that the clinic will not be liable for any damages that arise as a result of that incestuous contact. That I don’t think is leading.

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