A long time ago I wrote about the severe sperm shortage Canada is experiencing. This is one aspect of the larger picture of how ART is managed in Canada which I’ve written about recently for other reasons–mostly the case brought by Olivia Pratten that is pending British Columbia.
Anyway, here’s a news story about a report documenting the Canadian sperm shortage. (While the report itself is somewhat controversial, I think the news story is accurate.) If the report is anywhere near right, the dimensions of the shortage are astonishing—60 altruistic (i.e. unpaid) donors and 5500 potential patients (their word) who’d like to use donor sperm.
There are a couple of other things that are striking, too. A substantial part of the demand is from single women or lesbian couples. (That really isn’t surprising if you think about it. Beyond the obvious explanation (heterosexual couples have a source of sperm handy) there’s ICSI, which I’ve discussed before.)
Then there’s this quote:
Patients here obtain more than 90% of semen from the United States, and the federal government appears to turn a blind eye to the fact they buy it from mostly for-profit sperm banks — a criminal offence in this country.
This is the globalization problem exemplified. Just a little bit to the south of the vast majority of the Canadian population you’ll find one of the most robust ART markets in the world–right here in the US. It’s not hard to see why prosecutors in Canada aren’t rushing to prosecute those who purchase sperm from US (or other country) sperm banks located around the world. But short of prosecution, what do you do about this?
And then there’s the report’s recommendation–which is not (as I had expected) to ditch the ban on payment. Rather it is to create a more systematic campaign in support of altruistic donations. The analogy drawn by the author is to blood donations. It’s fascinating to me that even this recommendation is controversial. (See this commentary, for instance. ) That suggests that the general discourse in Canada is very far removed from that found in the US.
In the end, there are a series of issues raised here, and it is important to me to try to untangle them. I’ll try and list the main questions below, though this is always subject to amendment/revision.
1. Should there be payment for providing sperm for use by a third party? I’m inclined to care less about whether we characterize money as payment for sperm or compensation for expenses, but you might see that as a sub-question. Here you might find arguments about commodification and perhaps autonomy/choice.
2. Should altruistic donation (which really would be donation) be encouraged? You can see some reasons for opposing it in the commentary I linked to. I’m generally unsympathetic to this point of view, which is probably not surprising to you. It strikes me that the arguments offered are generally heteronormative–which is to say, they assert that people ought to partner up in heterosexual couples and have their kids early and if you don’t do that you are on your own.
3. The more extreme version of 2 might be whether use of third-party gametes–no matter how you get them–is allowed.
4. If you allow use of third-party gametes, what is the legal status of the gamete provider? What information is made available to whom? When and how is that done? This is where the Pratten questions go.
What’s important to note is that you can to some degree mix-and-match answers here. Thus, you could say that the child conceived via third-party gametes should have a right to information about the gamete provider and that it is good to encourage altruistic donation. Or you could say you don’t approve of exchanges for money, but in the event of altruistic donation, anonymity is okay. Or you could be completely opposed to the use of third-party gametes, in which case you might say anyone conceived via use of them has a right to know their donor, but really, that’s not a big issue–because there shouldn’t be any such children. And so on.
It’s easy to conflate and conjoin these issues in discussions and I don’t think that advances understanding, so I just wanted to take this opportunity to try to unbundle them.