Ethical reflections about the anonymity in gamete donation

Abstract

In the article “Effects of ancestry databases on donor anonymity”, Pennings (2019) brings up several controversial aspects about the anonymity (or its elimination) in the donation of gametes: the effects on the psychology of the children born by donation, what seek their genetic parents or their genetic siblings, as well as the effects on the psychology of donors regarding their genetic children and intentional families. However, I think that this article generates more profound reflections. The first reflection refers to the principles on which gamete donation techniques have been constructed. Have the psychosocial well-being of the minor been taken into account? Pennings describes the need to clarify this point, given that there are no clear indicators on the negative effects, but neither positive (Golombock et al., 2017). The result is that we are not sure of the consequences on the psychology of the child conceived by donors (De Melo et al., 2018). Certainly, the requirement of anonymity sends a message of privacy to donors and recipients, but they forget the main protagonist in this issue, the child, whose interests have not been consulted. These interests emerge with child's growth, so it would be unfair to hide them. This ignorance of the reality of gamete donations generates, as Pennigs says, uncertain futures about non-autonomous human beings. A second issue is added to this dilemma: the possibility that couples accessing the anonymous donation of gametes choose the physical, even ethnic, traits of their children to achieve a certain resemblance to the intentional parents (Maung, 2019). This social non-acceptance of children who are not similar to their parents leads us to the second reflection. Couples who use gamete donation try to pass as “normal” their child, avoiding the need to reveal the truth about their origin. The acceptance of the child by the parents may be conditioned to the acceptance of the public, which would be a new injustice, since they reduce the value of the potential child to their traits. The evaluation of the child as a whole constitutes the virtue of parental acceptance, which is unconditional, beyond ethnicity, gender or abilities (Legge and Fitzgerald, 2016). In the field of adoption, where there is no genetic link, the lack of similarity is assumed, externalized and not problematized (Casonato and Habersaat, 2015), but in assisted reproduction the dynamics of acceptance are hardly recognized, as demonstrates the obsession with phenotypic similarity (Wyverkens et al., 2017), which leads to the cross-border search for the desired gametes (Neri et al., 2016). The third reflection is a consequence of the two previous ones: is there an intrinsic right to know the truth about one's origin? This is something that worries parents who hide the origin of the child, although nowadays that concealment is utopian, due to modern tracking techniques (Harper et al., 2016). I think it is a deeper problem than the strict custody of the data, because information that every human being has the right to know is hidden, creating frustration or “genealogical bewilderment”. This frustration explains the changes in the laws of Sweden, the Netherlands, Finland, the United Kingdom and Portugal. All of them defend the moral right to know the origins of themselves and their identity (Ravistky, 2017). I think that the assessment of the American Society of Reproductive Medicine is illustrative to approach the problem with realism: the donation of gametes is not a simple transfer of material, but a complex exchange of emotions and psychological needs that affect the donor, the family of the donor, the recipient and the offspring (ASRM, 2014). Studies of a greater temporal spectrum are needed to understand the consequences of the disclosure (or not) of the origin in the identity and the existential dimension of the child conceived by donation, since the child is the most vulnerable member in these interventions.