What Else Do We Lose If We Lose Anonymity?

This is a continuation of the last post, which is itself part of a much longer series of posts about the use of third-party gametes.   There’s a lot about this general subject on the blog, but if you just want to start with the recent string, you could start here.

I’m afraid that where I left off yesterday isn’t the most interesting aspect of this discussion (at least, not in my view) but I figure I should try to follow through with what I said.   In the last post I suggested that perhaps it was time to move away from anonymity.  One question to consider, then, is what that would mean for the supply of gametes.   Would people provide gametes if they understood 1) that they would not be legal parents but 2) that at a time in the future (18 years or more) a person conceived with those gametes might contact them.

Clearly the answer is that some people would.   Why is it clear?  Because many sperm banks provide what The Sperm Bank of California call “identity-release” donors.   (It’s also clear that some (and perhaps as this article suggests, most) purchasers prefer anonymous providers.   But we’re in the land of compromise here where not everyone gets what they want.)

I’m well aware that there have been many claims that the abolition of anonymity has lead to sperm donor shortages in the UK and other places.   But as that post I just linked to makes clear, I don’t entirely believe in this explanation for what may very well be a sperm shortage.   There are actually other explanations.

I’m also reminded here of the research and writing of Rene Almeling, an author about whose work I’ve written a fair bit in the quite recent past.    There may not be direct connections here, but I am reminded, for example, that the way we pitch the process to men considering providing sperm may determine the nature of the pool that responds.   (This hardly seems debatable–different sorts of advertising surely appeal to different sorts of people.)   You can see this, I think, with in the story about the London Sperm bank that I wrote about a little while ago. 

The other thing I’d add into the calculus is a basic law of supply and demand.   And with that in mind, I think all this adds up to two points for me.

First, the people who are willing to be gamete providers in a system where offspring could have access to contact information for the providers will not be exactly the same set of people as those who are willing to be gamete providers with a promise of anonymity.   Because it isn’t an identical set of people, you might find them in different places, you might appeal to them with different ads and so on.   It also seems possible to me that this different set of people will help solve some other problems faced by the ART industry–in particular the number of offspring for male providers.   (I’ll come back to this in another post.)

Second, the worse case scenario I can see is that you’d have to pay a bit more for gametes.   This goes back to the basic laws of supply/demand.   As far as I can tell, all the countries where there is a sperm shortage (and that’s the gamete shortage you here about) are countries where payment to providers is severely restricted.   By contrast, in the US, which is pretty much a free market, I’ve never heard tell of a shortage.

I don’t mean to suggest that the role of money in this whole process is unimportant.  There have been concerns raised about overpaying egg providers–and I’ve written about that.   Doubtless there is more to say.   But I don’t actually see that there needs to be any real concern about a gamete shortage if we are willing to pay a bit more.   I hope to discuss some of the concerns about payment and what is called “coercion” in the near future.

 

 

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13 responses to “What Else Do We Lose If We Lose Anonymity?

  1. “coercion” a term all to familiar sadly to the adoption world.

    If people who want gametes are not given the option of anonymous donors they will choose to suck it up and get over themselves.

    Anonymous only really protects the provider from one side talking to the other side and finding out what the truth actually is. With the donor sibling registry showing mega number of half siblings that cat’s out now.

    • I’m not sure I understand your reference to coercion in the adoption world. Can you elaborate?

      I find some of the uses of the word “coercion” in discussions of medical experimentation perplexing. If there’s a promising drug that might cure a disease, it needs to be tested on people at some point before it can be marketed. You need people to volunteer for that experiment. Once they used prisoners–even unwitting prisoners. Now they tend to compensate subjects. But people worry about offering just the right amount of money. Too much money and it becomes what they call “coercive.”

      To me this is an odd use of the word. If someone is starving and must feed their children then that person is very vulnerable. If you offer $100 to them to participate in the experiment they may take it. That might be a bad thing because maybe it’s really too dangerous. If instead you offer them $500 you have the same problem. Is the $500 more coercive somehow? It will be more tempting to more people for sure. People who won’t do it for $100 will do it for $500, but there are also the original people who would have done it for the $100. Actually, it seems to me they are better off with the $500 because either way they are doing this dangerous thing, they are just getting paid more for it. In any event, what is problematic, it seems to me, isn’t the money offered but rather there original impoverished state.

      I’m sorry–I’ve rambled off on your comment. I’d like to know more about where coercion comes up in adoption.

  2. My era coercion was blatant. Today it is more subtle and the spin makes it less obvious. I am just going to download a bunch of thoughts and you can ask more about whatever if you are interested.

    Starting off the minute they talk to an agency they are deemed Birthmothers. The profiles of the potential parents are carefully designed and I will leave it at that.

    Pre-birth matching – pro’s and con’s to it, but when the mother is told the couple had two failed adoptions and this is their last shot, is treated as the bravest, best person in the world for such a selfless choice, at times is housed with the prospective parents or at least moved away from her support system and courted by the prospective parents until birth the emotional coercion is obvious coupled with expenses. Prospective parents pay mega expenses, mother is encouraged to make a hospital plan where at least the potential mother is with her during L&D and cuts the cord and is the first to hold the baby, the adoption worker is there as soon as legally possible for the mother to sign rights, it goes on and on.

    The counselling is given by the agency who only makes money if there is a placement, and will leave you to see how the use of double speak and framing can convince a young inexperienced or struggling woman there is no choice except adoption. The lawyer is paid for by the potential adoptive parents and sometimes is the same lawyer. Mothers are told they are in control of the adoption leaving out until you sign the papers. Mothers are promised open adoptions that are only legally enforced in 26 (?) states, and even then they are not in the power situtation and most likely can’t afford a lawyer and the AP’s only need to use the best interests card.

    Some states allow signing 24 hours after birth with no revocation period. There are no – exceptions if the mother had a c-section or any of those normal considerations that she may not be competent within 24 hours. Some states do not require a minor to have parents told or at least have a GAL present. Some states do not mandate counselling and allow the mother to wave counselling and that is really easy to doublespeak them out of it.

    It takes a very ethical agency to look out for the non-paying clients best interests. The above are just some ways a mother can be subjected to coercion – does it always happen – no – but the slippery slope is primed and ready.

    As to medical coercion – the link takes you to an interesting but dry conversation on that if you are interested.

    http://plato.stanford.edu/entries/informed-consent/

    • Now I see what you mean–thanks. It seems to me that the things that make the practices you describe problematic are different from (and in my view much worse than) the practices that people point to with regard to egg/sperm providers. In that setting people are offered money–which they may need very badly–but you don’t have the impending time pressures that seem to really compound the situation you describe above.

      • Ending anonymity for not “donors” but for people with offspring, would be tremendously helpful in preventing people from being forced out of relationships with their offspring if their sperm or eggs or embryo’s are misappropriated. People who do not intend to raise their offspring or have any contact with them have to understand that there needs to be proof that they really did intend to let someone else raise their offspring before the law recognizes someone else as their offspring’s parent. Ending anonymity protects them and patients. It protects offspring as well. While accidents are not cooersion, they do force people in to a very serious situation. That should stop.

  3. Adopted ones that was so well put and very informative. Thank you. I had a hunch something fishy was going on with the people who earn a living by matching childless couples to mothers whose families are not helpful or supportive.

  4. Julie,

    Yet with egg donors you still have vulernable young women being offered at times extreme amounts of money which combined with escalating university debt perhaps is just as bad. Think back to your early twenties compared with your thought process today – if you were like most your thought process did not have the combined maturity and life experiences to completely understand the life-long rammifications of what you were doing. Sure some do and perhaps a higher percentage for those who attend university, but when you get down to the nuts and bolts most won’t have the maturity at the perferred age for egg donors, to understand the regrets that may come or believe any of the health risks will apply to them. When you dangle a carrot (money for eggs / open adoption – life will be grand for mothers without the real facts) people do things that with hindsight they will realize they should have known better.

    • I don’t mean to suggest that it is unproblematic, but it seems to me that the problems are different. A young and pregnant woman is facing a momentous change the time of which she cannot control. It’s also a change that bring with it a complicated emotional roller coaster.

      A woman considering selling her eggs may face time pressures–the rent could be due for instance–but it seems to me that these are of a different magnitude. (It’s also true that it’s often quite a while between deciding to sell your gametes and getting any money and so you’re not going to find someone doing it for the current month’s rent. More likely prostitution I’m sorry to say.)

      Further, many women considering the egg transaction aren’t facing that kind of deadline at all, though they may need the money. And if you consider the position of men selling sperm, I think it is different yet again, because the amount of money is lower. These are differences that matter to me.

      Your point about age and ability to comprehend the nature of the act involved is one of greater similarity and there is certainly something troubling there.

      • This is sort of a PS to my earlier response to your comment. I just want to add one very small point: I think the problem of potential regret from making a decision that had consequences you didn’t really comprehend, while a problem, is not one that involves coercion in any sense that I’d use the word. In this way it seems to me different from the situation you described of the young mother asked to give a child up for adoption. (I see there are similarities as well.)

  5. Julie – yes the problems are very different and the time crunch is completely different in that there is no due date when suddenly everything changes.

    I just think that it is important to recognise the maturity level of the “donors” that I think gets lost in the discussion typically between older individuals who forget what it is like to be young and foolish.

    • Fair enough. I think one of the interesting things about providers who agree to have their identities released is that they tend (I think) to be older. This makes intuitive sense to me. I also think being asked to think about the fact that eighteen year hence a child might contact you would make a potential provider think a little more concretely about what they are doing. (I also think the concrete thinking is probably more common among women, who are agreeing to undergo an invasive medical procedure than among men, but that’s a different point.) All of which is to say that I agree with you that the maturity levels (or lack thereof) are something that have to be considered quite seriously (by us older folks).

  6. The Law Reform Committee of the Victorian Parliament has recommended full retrospectivity. If this becomes law, then *all* donor-conceived people will have access to all donor information that is on record (including identifying):

    http://www.parliament.vic.gov.au/lawreform/article/1468

    • An important development. There’s a lot to read (I’ve been looking at it) and it, too, is probably worth featuring in a post.

      Retrospective relief can never be perfect, of course, because there will be instances where records weren’t kept and/or have been destroyed. But you can demand that whatever exists is made available and the going forward you can do a whole lot more than that.

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