An interesting Washington Post article about the only state bill to attempt to outlaw donor anonymity (the comments in caps are mine):
RICHMOND -- A Republican lawmaker is sponsoring General Assembly legislation that would make Virginia the first state to prohibit anonymous sperm donations.
Delegate Robert G. Marshall, a Christian conservative from Prince William County, is sponsoring the House bill.
Mr. Marshall also is the General Assembly's foremost author of legislation to curb abortion and regulate birth-control methods. He said he filed the bill to protect donor-conceived children and that he feels for those who don't know the identity of their father.
Mr. Marshall said he recently saw a child wearing a T-shirt with the words: "My dad's name is Donor," then thought, "That's pathetic."
Australia and a few European countries [U.K., NORWAY, SWEDEN AND AUSTRIA] have banned anonymous sperm donations. In each country, donations have dwindled and the cost of fertility services has increased.[THIS IS ARGUABLE. SEE MY POST: http://itsshawnvandorsblogwow.blogspot.com/2009/05/should-there-be-state-or-federal.html FOR LINKS TO ARTICLES DISPROVING THIS POINT IN THE U.K. AND SWEDISH MARKETS].
Opponents warn about the same result in Virginia.
Katrina Clark grew up knowing only that her father was tall, blond and a third-year college student somewhere in Northern Virginia when he donated sperm.
Miss Clark, now 18 and a Gallaudet University student, is trying to persuade lawmakers to support legislation banning anonymous sperm and egg donations, so others won't grow up with the same questions she had.
"I just felt like something had been stripped away from me," she said.
Mr. Marshall's bill also would require women donating eggs to sign a disclosure detailing all known risks involved, whether from ovulation-stimulation drugs or harvesting the egg. Virginia law already requires that patients be told about the success rates and donor health before being treated.
More than 15,000 successful egg donations in the United States in 2004 resulted in about 6,000 births, according to the latest data available. Sperm donations and births resulting from them are much more numerous and much more difficult to track. No trade groups, medical associations or government agencies track either the donations or the number of births attributed to donor sperm.
The industry wasn't fully commercialized until the 1970s, and laws regulating it focus on testing, storing and administering the donations. Only recently has the discussion turned to the ethical repercussions.
Miss Clark's mother, Janie Price, of Newport News, was 30 and single but didn't want to wait any longer for a child when in 1988 she opted for artificial insemination.
"I talked myself into believing that if I loved her enough, it would be OK," she said. "What I didn't consider is that one's genetic component is very much a part of her identity. Why else would we spend so much money as adults researching our genealogy?"
Miss Clark said she grew up not thinking she was any different from her friends. That changed when she was 15 and saw a show about a woman who died of a genetic heart disease that she had no idea she was at risk of developing because she had been adopted.
"That's when it really hit me for the first time that something was missing," she said.
Miss Clark said she started the search for her father because she wanted answers about her medical past, not because she wanted a father figure.
She was one of the few lucky ones, finding her father on an online message board weeks later. After a few weeks of telephone and e-mail conversations, a DNA test confirmed what they already knew: It was 99.9902 percent positive that he was her father.
Most sperm banks across the country now give donors the option of allowing their identities to be revealed to offspring once they turn 18.
William Jaeger, director of Fairfax Cyrobank, said that only 29 of the bank's 265 donors have agreed to have their identities revealed, which shows the chilling effect a mandatory-identity requirement would have on the industry.
"Legislation of this type would really create a hardship for families who need donor sperm to conceive a child," Mr. Jaeger said.
He also said sperm supplies have decreased so much in Britain since it passed such a law in April that some clinics have closed and others must import sperm.
The American Society for Reproductive Medicine also opposes the legislation, saying it would increase the cost for families to get help conceiving.
"It is [now] relatively inexpensive to conceive through insemination of donor sperm," said Dr. Robert Brzyski, chairman of the ethics committee for the group, in Birmingham, Ala. "If donors become scarce because the anonymity is removed, then the cost of that will increase."
In April, 2009, a New York Federal judge ruled that sperm banks can be sued under product liability laws for failing to detect a sperm donor's genetic defect. The case clears the way for a 13 year-old retarded girl from PA. to sue New York-based IDANT[1] for using sperm with a mutation known as “Fragile X”[2] which caused her to be born mentally retarded.
So, if human sperm is officially a product, what does that make the child born via donor insemination? In the future, will parents be able to return their children to the cryo bank if the child fails to meet their specifications, like, if the child’s not blonde enough or not proficient enough with the violin? When is that going to start happening?
In the absence of any significant federal or state regulation of the Cryo banking industry the threat of product liability lawsuit is a very good thing. But, consider this: this isn’t exactly like a consumer being sold a faulty product, who is injured and then seeks a claim; this is the faulty product itself suing the company that made it (in this case, a her). I don’t think this has happened before. Ever. Imagine a single Toyota Prius suing Toyota for assembling its breaks incorrectly!
[1] Owned by the DAXOR CORPORATION. You’ve really got to see their website: http://www.idant.com/ All it needs is some ‘80s David Cronenberg-esque analogue synthesizer and they're all set. No but seriously. Who would buy human semen from a company called IDANT who proudly proclaims: owned by the DAXOR CORPORATION? Also, DAXOR agents are now hunting me.
[2] No, I’m not making this up.
In 2005, the FDA began regulating the sale of semen within the United States (though regulating might be too strong a word - they basically institutionalized practices that had already become the norm within the cryo banking community). Cryo banks that don't comply with FDA regulations don't risk being shut down but are not allowed to say they're FDA approved, which in the highly competitive sperm-banking business, might mean losing a leg-up to a competitor.
This is relevant to all things donor insemination, of course, because as mild as the FDA's regulations might be, it's one of the few regulatory gestures made by the Federal government towards the medically assisted reproductive industry. For the most part, Federal and state governments have wanted to steer clear of any kind of regulation, intentionally leaving the details of the baby-making business in the (no doubt, benevolent) hands of the free market.
Here's the FDA's statement:
Human cells or tissue intended for implantation, transplantation, infusion, or transfer into a human recipient is regulated as a human cell, tissue, and cellular and tissue-based product or HCT/P. The Center for Biologics Evaluation and Research (CBER) regulates HCT/Ps under 21 CFR Parts 1270 and 1271. Examples of such tissues are bone, skin, corneas, ligaments, tendons, dura mater, heart valves, hematopoietic stem/progenitor cells derived from peripheral and cord blood, oocytes and semen. CBER does not regulate the transplantation of vascularized human organ transplants such as kidney, liver, heart, lung or pancreas. The Health Resources Services Administration (HRSA) oversees the transplantation of vascularized human organs.
Parts 1270 and 1271 require tissue establishments to screen and test donors, to prepare and follow written procedures for the prevention of the spread of communicable disease, and to maintain records. FDA has published three final rules to broaden the scope of products subject to regulation and to include more comprehensive requirements to prevent the introduction, transmission and spread of communicable disease. One final rule requires firms to register and list their HCT/Ps with FDA. The second rule requires tissue establishments to evaluate donors, through screening and testing, to reduce the transmission of infectious diseases through tissue transplantation. The third final rule establishes current good tissue practices for HCT/Ps. FDA's revised regulations are contained in Part 1271 and apply to tissues recovered after May 25, 2005. The new requirements are intended to improve protection of the public health while minimizing regulatory burden.
Not all trade barriers concern steel, corn and coffee. Major human semen exporters like the United States say they are having a hard time penetrating Mexico's sperm market. Human semen trade is an estimated US$100 million industry worldwide, but Mexico is abstaining from entering the market and using its own internal resources. Mexico has not banned the imports outright; however, strict federal standards and restrictions keep foreign semen out of the country. The Fertility Institutes, a semen supplier with offices in both the United States and Mexico, has been unable to swap semen across the border among its clinics. "Not because of a lack of need or desire, but because of the inability to meet all requirements of both countries, as well as FedEx and other international shippers," says Fertility Institutes' Jeffrey Steinberg. Meanwhile, strong demand in Canada for human semen on recent years--which sells for about the same price as cattle semen in the open market--eased border restrictions for sperm imports from the United States. Leading U.S. semen trader Xytex has shipped its U.S. genes to Canada and several countries in Europe since 1983, but the company says getting across its southern border poses a much bigger challenge. "It's virtually impossible," says Holly Fowler, spokesperson for Xytex. Foreign exporters trying to ship their specimen into Mexico apparently must overcome the country's main barrier to entry into the sperm market: national pride.
1) Consumer/Mom Literature: Written mostly for and by women concerning the options available for DI as well as first-hand accounts from women who have experienced it. This is, by far, the largest sub-genre and the easiest material to come by, readily available at your local Barnes and Noble. As you might imagine these books are almost 100% in favor of all RTs and their area of concern is not so much whether or not these practices are ethical but rather focus on what the best methods, techniques and approaches for getting pregnant, and how best to manage the future child in the absence of a father and how to break the news to the future child that they are donor offspring. Much to this sub-genre's credit, the authors seem to be almost unanimously against keeping the DI procedure secret from the child. While many of these books do give ample historical context to DI (some even go so far as to discuss the eugenic implications of the procedure) these books are, for the most part, like any other consumer literature – they are buyer's guides that treat the mother-to-be like a consumer and the child-to-be like a product to be appropriately priced and researched before purchased. Frankly, I found many of these books to be quite alienating. But there are a few that I thought were fairly comprehensive in their perspective:
On Our Own, Melissa Ludtke
Single Mothers By Choice, Jane Mattes
Having Your Baby By Donor Insemination, Elizabeth Noble
2) Medical/Bioethical Literature: Mostly written by and for doctors and/or academics concerning the ethical decisions and ramifications of DI within the larger context of RTs. Besides the fact that these books are harder to come by, more expensive and more difficult to understand than the aforementioned Consumer-Mom literature[1] these books are concerned with the way DI and other RTs contrast with what we as a culture have long considered to be normal and how best to deal with the schism between the new normal and old normal.[2]
For instance, Brent Waters, in his book Reproductive Technologies asks the million dollar question: If medicine is now displacing marriage as the principle institution ordering procreation – how do we begin to understand the ethical framework from which modern medicine arose? To answer this very difficult, very relevant question, Waters says:
…contemporary medicine is practiced against the backdrop of a Western philosophical crisis. With the collapse of Christendom and the Enlightenment’s failure to fill the void, Western societies lack consensus on a normative practice of medicine. Thus an ‘anonymous perspective of reason’ is needed in which no religious or moral orthodoxy is imposed or privileged. A secular framework of moral deliberation encompassing a pluralistic world is required, necessitating a neutral mode of public moral discourse. The role of the moral philosopher in general, and the bioethicist in particular, is not to judge the truth of conflicting claims but to develop credible options among a diverse population. They map the terrain of contending values, identifying procedures for resolving conflict…Although a secular bioethic must acknowledge a wide spectrum of moral convictions, freedom is the dominant value….
Freedom. Never has the word flapped so lonely in the wind. Freedom of choice. Freedom to be oneself. Freedom from the other. But if everyone is free in their own realm of biotechnological decision-making what happens to community, neighborhood, belonging, togetherness? Now that men and women no longer need each other for reproduction what does a man see when he looks at a woman? What does a woman see when she looks at a man? What do we think about when we think about ourselves?
I got really into this subgenre. I couldn’t stop. These books are academic, slow going and, really, kind of far out. I found that reading several of these books in a row is like huffing glue: brief high-highs interspersed with fat black patches of nothing. Let me just say: these books are interesting (theoretically) but I wouldn’t want to live in a world ruled by scientists or bioethicists. Remember the technocratic dystopia described in Aldous Huxley’s Brave New World? Well, you know where I’m going with this.
Good stuff:
Ethics of New Reproductive Technologies, Jonathan Glover
The Future of Human Reproduction, ed. John Harris and Soren Holm
The Artificial Family, donors R. Snowden and G.D. Mitchell[3]
A Question of Life: The Warnock Report, Mary Warnock
Reproductive Technology: Towards a theology of Procreative Stewardship, Ethics of New Reproductive Technologies, Brent Waters
3) Philosophical Literature: Most of the philosophical literature here does not refer to DI by name but rather to the nature of human reproduction in the age of science and, in particular, how this effects being, conciousness, one's existential perspective and whether or not such an existential perspective even still exists. This is yet an even smaller sub-genre than the previous two, depending on what philosophical texts you want to drag into the conversation. One book from thus sub-genre stood out from all the rest: Jurgen Habermas's The Future of Human Nature, published in 2003, in which he examines the difference between the “grown” and the “made.” He asks, “…whether the instrumentalization of human nature [the made][4] changes the ethical self-understanding of the species in such a way that we may no longer see ourselves as ethically free and morally equal beings guided by norms and reasons.”
In other words, by “making” new human beings via technology we are essentially giving birth to a new existential or extra-existential or even non-existential perspective, a people for whom we "naturally" conceived humans can't possibly apply our "normative" ethical framework. It would be like critiquing a film based on television standards.
By the way, whenever the subject comes up in conversation, I tell people I am a “product” of donor insemination. Several of my friends have commented that this is a rather cold or unfeeling self-description but I do believe it’s apt.
Useful references:
The Human Condition, Hannah Artendt
Secrets, Sissela Bok
The Future of Human Nature, Jurgen Habermas
The Question Concerning Technology, Martin Heidegger
The Republic, Plato
4) The Literature of Eugenics: It turns out that Francis Galton and the history of Eugenics is the story within the story, as it were, concerning DI.[5] I believe this story gives adequate context to the questions and practical applications facing DI today. Needless to say, I was surprised by what I found and I’m guessing you will be too.
Did you know, in the early 20th Century, the United States had a comprehensive sterilization program in 26 states in which the “ lower tenth” - those determined to be stupid, poor, ugly - were legally forced into sterilization in an effort to improve the race? Did you know, in the early 20th Century, the U.S. and U.K. eugenics programs were far more advanced than their Nazi counterparts and were in fact the models upon which Nazi Germany based their eugenics program? Did you know that American, British and Nazi German scientists worked hand-in-hand in cooperative eugenics programs, both here and in Germany, and were forced to separate only after the United States entered the war in 1941? Did you know that it was only at the end of World War II, when word of the Nazi concentration camps (a direct result of their eugenics program) spread around the world, that all the western nations closed the doors on their own eugenics programs, afraid of being associated with the Holocaust? And did you know that, at the end of World War II, the West's eugenics programs were not, in fact, "closed" but were merely transformed into what we now call genetics?[6]
Yeah, I didn’t either. It might be the great untold story of the 20th century.
War Against the Weak, Edwin Black
Better For All the World, Harry Bruinius
The Unfit: A History of a Bad Idea, Elof Axel Carlson
Essays in Eugenics, Francis Galton
5) DI Offspring Literature: Besides a handful of articles and blog posts[7], would you believe there’s almost nothing whatsoever written from the perspective of a man or woman created by DI? Nothing. I'm sure the secrecy and shame that has long surrounded the practice has something to do with it. I heard about a young woman, a product of DI, who, several years ago, supposedly wrote a memoir in the ‘90s condemning the practice. She was taken on Larry King Live and hailed by Pat Robertson and other Religious Righters as evidence that donor insemination and all other RTs are unholy, unnatural, etc. But, after much research, I was unable to find this young woman’s name, her book, or her supposed appearance on Larry King.
[1] Think of the difference between Variety and People magazine: one caters to the industry insider and one caters to the consumer.
[2] When they say normal they typically mean Christian; many of these books inevitably (and understandably) talk about Man’s relationship to God and whether or not Man is supplanting God’s infinite wisdom and procreative decisions with Science.
[3] Incidentally, the only book I came across written by a donor.
[4] The brackets are mine.
[5] For my dollar anyway.
[6] All of this and much much more can be found at Edwin Black’s mind-boggling War Against the Weak.
[7] The most comprehensive blog is PCVAI (People Conceived Via Artificial Insemination) at yahoo, but you have to be a donor offspring to gain access.
In 1884, a merchant and his Quaker wife, unable to become pregnant, visited the Jefferson Medical College in Philadelphia where they met with Dr. William Pancoast. After a series of tests, Dr. Pancoast discovered the husband to be azoospermic, or sterile, while the wife was found to be perfectly fertile. Uncertain of how to treat the couple, the doctor consulted with his class of six medical students, one of whom suggested that they use the semen from the “best looking” man among them to inseminate the woman. Dr. Pancoast agreed and called the wife in once more for a final examination. He anesthetized the woman with chloroform and, with a rubber syringe, injected his student’s semen into her while his six students observed.
It was only after the birth of her son nine months later - the first ever reported human DI pregnancy in the United States - that Dr. Pancoast confessed to the merchant what he and his students had done. The husband, by most accounts, responded positively but asked that the doctor and his students keep the secret from his wife. They agreed, and she was never told.
Without realizing it Dr. Pancoast and his six anonymous medical students set a precedent that day in 1884 for the practice of DI that has continued until this day.[1] But what right do semen donors have to anonymity? In this case, does the donor’s right to anonymity outweigh the mother’s right to know with whose semen she has been inseminated? Does the donor’s right to anonymity also outweigh the unborn child’s right to know who his true father is?
I suspect the identity of the “true” biological father was kept secret for three reasons: 1) It was initially kept secret from both the husband and wife to protect Dr. Pancoast and his students from recriminations in case the merchant and/or his wife found their decision to inseminate her to be dishonorable or criminal; 2) The husband wanted to protect his wife from the potential shame of knowing she’d been inseminated, unknowingly, while passed out, by an anonymous man and; 3) Not wishing to lose face in his wife’s eyes the husband did not want his wife to know that he was incapable of impregnating her. In any case, the chief motivating factor in maintaining donor anonymity in this first ever use of human DI in the U.S. was - unambiguously – fear; each actor in the scenario was afraid that what they had done might be perceived as wrong and sought to protect themselves from wrongdoing by cloaking themselves in secrecy.
It is an important story and one of the most frequently told in the literature of DI. It’s almost become a kind of origination myth. Each author tells the story in a slightly different way, from a slightly different perspective, like the many apostles each representing Christ[2] in their own subjective voice. In the absence of any federal or state legislation since 1884, the decisions made by Dr. Pancoast and his six anonymous students have, remarkably, set the standards for a medical practice that has become increasingly common and even, in the past few decades, highly commodified.
What was the husband’s special relationship with the doctor that he was let in on the secret and his wife was not? And what about the six anonymous medical students? Who are they in this modern techno-myth? They are like the Council of Anonymous Masturbators standing in the background, bearing witness to this unique form of medicalized rape. They know whose semen it is. It is the “best looking” man’s semen and they are hiding his identity to prevent him from having to take any responsibility for the creation of new life, thus setting the stage for the practice of contemporary DI. The commemorative coin would show the bust of a featureless man and would read:
Celebrating 125 years of Donor Insemination!
Creating Life and Avoiding Responsibility!
Had the Quaker woman been told, on her way to the doctor’s office, that she was going to be drugged and impregnated with an unknown man’s semen with a rubber tube would she have consented? What right did Dr. Pancoast have to experiment on his patient?
As if to assuage its own guilt over grossly misusing that Quaker woman, the American Medical establishment convinced itself (and nearly everyone else) that donor insemination is a boon for women’s freedom. Thanks to Dr. William Pancoast and his six brilliant (and handsome) medical students (who shall remain dignified in their anonymity) women now enjoy a liberation and freedom of choice never before known in the history of the world. They are so free that they don’t even need men any more.
Dr. Pancoast, his six students and the Quaker woman’s husband kept their secret to themselves for the next 25 years. But, in 1909, the cat was, as they say, let out of the bag. Addison Davis Hard, one of Dr. Pancoast’s medical students (often speculated to be the “best looking”[3]) visited the donor offspring, then a twenty-five year old businessman living in Philadelphia, and revealed to that young man the story of his true conception.[4] Soon after, Hard published a letter in the American journal Medical World, in which he unveiled their collective secret to the world. An excerpt from Hard’s letter:[5]
From a nature point of view, the idea of artificial impregnation offers valuable advantages. The mating of human beings must, from the nature of things, be a matter of sentiment alone. Persons of the worst possible promise of good and healthy offspring are being lawfully united in marriage every day. Marriage is a proposition which is not submitted to good judgment or even common sense, as a rule…Artificial impregnation by carefully selected seed, alone will solve the problem. It may at first shock the sensibilities of the sentimental who consider that the source of the seed indicates the true father, but when the scientific fact becomes known that the origin of the spermatozoa which generates the ovum is of no more importance than the personality of the finger which pulls the trigger of a gun, then objections will lose their forcefulness and artificial impregnation become recognized as a race-uplifting procedure.
In the massive controversy that followed, the Jefferson Medical College, and all parties involved, took a considerable PR hit. Some claimed Addison Davis Hard was playing a joke. Some defended him, claiming that this procedure would in fact help limit unwanted pregnancy while others argued against AI as grotesque and absurd. But, most importantly, “The eugenicists were quickly on the scene and in the process divided the medical profession by their claims that the improvement of the genetic stock of America was now possible.”[6]
[1] The main difference today, of course, is that women know they’re being inseminated when they go to the doctor - but donor anonymity is still the norm.
[2] Of course, it’s worth mentioning that Jesus was the product of The Immaculate Conception. If a woman never has intercourse with a man but becomes pregnant via DI would she still be considered a virgin?
[3] Ladies and gentleman, America’s first semen donor!
[4] If Hard was, in fact, the donor father it’s interesting to note in this origination myth that it was the anonymous father who sought out the donor child – not the other way around. Clearly, no matter what anyone says, this is a two-way relationship. How many sperm donors are there who, having jerked off for money in college, found themselves, later in life, wondering - really wondering - where their children are, who their children are?
[5] Courtesy of Elizabeth Noble’s Having Your Baby By Donor Insemination.
[6] From R. Snowden and G.D. Mitchell’s The Artificial Family.
