Fathers anonymous: beyond the best interests of the sperm donor.
Current AID practices are based primarily on consideration of protecting the interests of practitioners and donors rather than recipients and children. The most likely reason for this is found in exaggerated fears of legal pitfalls. It is suggested that policy in this area should be dictated by maximizing the best interests of the resulting children. The evidence from the Curie-Cohen survey is that current practices are dangerous to children and must be modified. Specifically, consideration should be given to the following: 1. Removing AID from the practice of medicine and placing it in the hands of genetic counselors or other nonmedical personnel (alternatively, a routine genetic consultation could be added for each couple who request AID); 2. Development of uniform standards for donor selection, including national screening criteria; 3. A requirement that practitioners of AID keep permanent records on all donors that they can match with recipients; I would prefer this to become common practice in the profession, but legislation requiring filing with a governmental agency may be necessary; 4. As a corollary, mixing of sperm would be an unacceptable practice; and the number of pregnancies per donor would be limited; 5. Establishment of national standards regarding AID by professional organizations with input from the public; 6. Research on the psychological development of children who have been conceived by AID and their families. Dr. S.J. Behrman concludes his editorial on the Curie-Cohen survey by questioning the "uneven and evasive" attitude of the law in regard to AID, and recommending immediate legislative action: The time has come--in fact, is long overdue--when legislatures must set standards for artificial insemination by donors, declare the legitimacy of the children, and protect the liability of all directly involved with this procedure. A better public policy on this question is clearly needed. I have suggested that agreement with the need for "a better public policy" is not synonymous with immediate legislation. The problem with AID is that there are many unresolved problems with AID, and few of them are legal. There is no social or professional agreement on indications, selection of donors, screening of donors, mixing of donor sperm, or keeping records on sperm donations. Where there is agreement, such as in requiring the signature of the donor's wife on a "consent" form, the reasons for such agreement are unclear. It is time to stop thinking about uniform legislation and start thinking about the development of professional standards. Obsessive concern with self-protection must give way to concern for the child.
Annas
G J
GJ
Department of Socio-Medical Sciences and Community Medicine, Boston University School of Medicine, USA.
D005053:Eugenics; D005260:Female; D006801:Humans; D007316:Insemination, Artificial, Heterologous / Q000191:economics / Q000331:legislation & jurisprudence / Q000523:psychology*; D008297:Male; D008499:Medical Records; D010819:Physician's Role