I’m considering the topic of the sort of consent we might want in various stages of ART (and perhaps even more generally, in people becoming parents.) Anyway, for now I’ve focused specifically on the consent you might want to get from a man before he provides sperm. This is the second post on that topic.
Before heading out into new territory, I want to emphasize one point that I think is in the background of that last post. In general, we do not favor requiring particular forms of disclosure before people enter into commercial contracts. We assume that adults are competent to make their own choices and we leave them to it. People may make very foolish bargains, but they are free to do that.
Some folks have suggested that men providing sperm should be reminded of things like that they might come to regret their choice, or at least feel differently about it, ten or twenty years from now. If we don’t generally do this in a commercial setting, why do it with sperm providers?
I don’t think this really is like what happens with informed consent in the medical setting. The risks that are included in medical informed consent are ones that might not be readily apparent to patients. (At least, I think this is the case.) But the possibility of second thoughts is fairly obvious. Indeed, any time one makes a deal one may have regrets. That’s what “buyer’s remorse” is all about.
To the extent there is a difference I think it might be related to the way in which we think about parenthood. This human experience is at once mundane (by which I mean common-place) and mysterious. It also occupies a particularly sacred spot in our cultural landscape these days. Perhaps here we doubt our ability to make the same sort or rational and well-reasoned decisions we readily assume people make in other contexts and this makes us more wary?
And now for the new territory: There is another quite important difference between the ordinary situation in which you see informed consent and the sperm provider/bank transaction. In a medical setting the person seeking the consent is under an ethical obligation to have the patient’s interests in mind. But a sperm bank isn’t under that sort of ethical obligation vis-a-vis a sperm provider.
Indeed, given the high rejection rates for prospective sperm providers, I would guess many banks do not want to discourage men from trying to provide sperm. After all most, but not all, sperm banks are for-profit institutions and they need men to supply sperm. This creates a rather different dynamic when you think about the discussion that might occur around consent.
I do not mean to suggest that I generally mistrust the people who run sperm banks. I do not. (I realize some of you may not share my view here.) But even well-meaning representatives of sperm banks are going to be in a meaningfully different position than is someone with an professional and ethical obligation to protect the interest of the person from whom consent is sought.
Two last thoughts: First, perhaps I am wrong in asserting that there is no professional ethical obligation between sperm bank and sperm provider. If so, I trust someone will tell me.
Second, I think I’ve probably made the difference between the ordinary medical setting and the sperm bank seem larger than it is. Professional obligations notwithstanding, it seems to me that it may sometimes (frequently?) be the case that the person seeking medical consent also has a financial interest in the patient proceeding with treatment. This means you’d have a more similar situation than I’ve suggested exists in theory.