Ethics for Donors and Surrogates
Safeguarding from exploitation
Deciding to donate your eggs or sperm (gametes) to help strangers become parents or agreeing to carry a child for someone else, dedicating nearly an entire year of your life to the process, is undoubtedly a brave and kind thing to do. Often, it's called altruistic, or 'an unselfish concern for the welfare of others'. In some definitions of altruism, this includes situations that may even disadvantage or harm the person carrying out an act for the benefit of others. In the context of gamete donation and surrogacy, this is a particularly important distinction.
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Though sperm donation comes with no physical risks, it is a different matter entirely for egg donation and surrogacy. Both require intensive reproductive labour, health risks, and a greater investment of emotion and energy. There are concerns within feminist and medical ethics communities that women in particular are being incentivised to put their own health and needs last in service to others, something women have historically been encouraged or even forced to do. And though the majority of donors and surrogates enter into these services willingly and with positive motivations, it is imperative that we recognise the undue burden put on women and female-sexed people for reproductive success, both for themselves and others.
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As the demand for assisted fertility treatments, donors, and surrogates increases, it is crucial that everyone involved in the process - from hopeful parents and donors to the medical staff treating them - understands and acknowledges the ethical challenges that may arise. Doing so is the only way to ensure the safety and dignity of the people providing their reproductive labour, and to prevent economic or emotional exploitation.
Tips for ethical practice
Protect yourself and others
01
Assess Motivation
Think carefully about your motivations for donating or becoming a surrogate. It can be a deeply rewarding experience for many, but it’s important to think carefully about the potential risks, as well as the emotional impact of your decision on both yourself, your family, and the children you help create.
02
Research the professionals
Thoroughly research all professionals involved in the assisted conception process: donor/surrogate matching agencies, egg and sperm banks, fertility clinics and doctors, and legal services you may require. Don’t just take the professionals’ word for it – look at if and how they are regulated, what previous clients say about them, and how they operate.
03
Red flags
Red flags include: lack of transparency about the process or their qualifications; lack of or inadequate counselling and aftercare; frequently changing clinic ownership or company names; high turnover of staff; and language that commodifies or dehumanises donors, surrogates or donor conceived people.
04
Feelings about contact
Think deeply about how you will feel if your donor offspring make contact in the future, or if they wish to pursue a sibling relationship with other children born from your donations or your own children whom you’ve raised. Conversely, how will you feel if they never make contact and you never know anything about them?
For surrogates:
If you’re considering becoming a surrogate, you will almost always be known to the Intended Parents for whom you are carrying a child. To what extent you stay in touch after the baby is born is up to the individuals involved to decide, though any agreement drawn up on this matter will not usually be legally binding. Therefore, it is important to discuss and agree beforehand what level of contact you will have with the family in the future, if any, and ensure you feel comfortable that this will be adhered to.
05
Consumer DNA testing
With the rise in usage of consumer DNA tests to help donor conceived people (DCP) find their genetic relatives, you may want to consider testing and registering yourself with consumer genealogy sites like Ancestry, 23&Me, etc.. This will make it easier for your donor offspring to contact you in the future if they wish to do so. Even if you don't register your DNA, the likelihood that one of your own relatives matches with them is relatively high, given the popularity of such sites.
06
Enabling contact
If you donated prior to 1 April 2005 in the UK, when anonymous donation was still permitted, you may opt to remove your anonymity to help DCP find you. Regardless of when you donated or if you will in the future, it is important to regularly update your contact details with the donor registration database run by the body that oversees donor conception in your country. In the UK this is the Human Fertilisation and Embryology Authority (HFEA).