"I think in the United States we need more regulation of assisted reproductive technologies to protect the rights of children, donors and parents," said Naomi Cahn, a law professor at George Washington University and co-author of the book Finding Our Families: A First-of-Its-Kind Book for Donor-Conceived People and Their Families.
Cahn believes donor-conceived children should at least have access to full medical information about biological parents, if not information about ethnicity and country of origin. Parents, she said, should have the right to know how many times a donor’s sperm or eggs were used to conceive a child. And donors should have a right to know what happens to their sperm or eggs.
The Three Graces from Primavera by Sandro Botticelli (1445-1510), Uffizi Gallery, Florence
The American Society for Reproductive Medicine (ASRM) takes umbrage at the suggestion that ART is lightly regulated.
“I used to call it the ‘myth of un-regulation,’ but it’s actually a malicious and often deliberate falsehood most often conveyed by folks with ideological opposition to reproductive medicine,” Sean Tipton, the ASRM’s chief lobbyist, wrote in an email message. “Reproductive medicine is one of the most heavily regulated fields of medicine in the US.”
As evidence, Tipton points out that the federal government regulates all drugs and medical devices, as well as the reproductive tissues used in ART. States, he said, license practitioners (as they do all medical professionals). But the heart of his argument is that “the professional self-regulation is extensive.”
ASRM does issue lengthy guidelines to its membership, which consists of fertility clinics and sperm banks. However, critics point out, it does not sanction those who are in violation of guidelines.
Critics argue that ASRM’s main function is to advance the business interests of its members, unfettered by government regulation.
"It's a field characterized by strong anti-regulatory sentiment because it evolved as a business, not a research enterprise," said Arthur Caplan, director of the division of Medical Ethics at New York University’s School of Medicine.
Debra Mathews of the Berman Institute of Bioethics agrees that the industry is lightly regulated because "assisted reproduction has grown up as a medical services business not under the auspices of medical research." The federal government ensured that situation would continue when, in 1996, Congress passed an amendment banning the use of federal funds in research related to the creation of embryos.
There are also political reasons politicians have little interest in taking up ART legislation.
"It is unregulated because it touches on two, 'third-rail' issues," said NYU’s Caplan. "It touches on abortion and also the creation of embryos, which politicians run away from because too many people still disagree about the right to use reproductive technologies, particularly who should pay for them and how much."
The lack of regulation does have some benefits, critics say. Without regulation, for instance, gay couples and single people don't face any built-in barriers to using ART to produce children.
But others see disadvantages, none more loaded than a lack of restrictions on the number of children that can be produced by any single donor. The concern is that offspring of a frequent donor could inadvertently meet and fall in love, raising the possibility of "accidental incest."
Donor-conceived children also argue that donors should be subjected to better medical screenings. Generally, donors are only tested for sexually transmitted diseases. There are no laws requiring medical testing for genetic diseases or requiring that donors – usually in their 20s at the time of donation — update medical information as they age and inherited diseases may surface.
Many donor-conceived offspring believe that they, like their counterparts in Britain, should have a right to more than medical information and that the identity of biological parents should be revealed to them.
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