(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.