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Monday, May 21, 2012

The Ethics of Adoption and Reproductive Technology

The need for ethics reform in both adoption and reproductive technology can be traced in large part to our desire as human beings for instant gratification -- we want what we want now, and often without thinking through the long-term consequences of our actions.  Many people desperately want children, and I would never minimize the pain of being unable to conceive.  I saw my daughter's dear friend struggle with infertility -- and witnessed with sadness and empathy her frustration and profound depression.

But being desperate for a child should not be an excuse for willfully ignoring the long-term consequences of our decisions.  When people are desperate, it is far too easy for adoption agencies and fertility clinics to exploit that desperation.  It is far too easy to treat infants like commodities or "treatments," because infants, obviously, cannot speak for themselves.

As a result, we have all kinds of child trafficking abuses that thrive in a culture where anonymity and sealed records are accepted.  We have an entire generation of donor-conceived adults starting to express their frustration at being cut off from half of their biological roots because the practice of anonymous sperm and egg donation has been accepted and encouraged.  On the internet, we see ads promoting low-cost surrogacy in India for "40 to 70 percent less" than the cost of US surrogacy.  What are these future children going to think about their half-Indian, low-cost identity?  Of course if the prospective parents pay $12,000 to $15,000 more, they can contract to have the egg from a Caucasian woman implanted into the Indian woman's womb, therefore guaranteeing a 100 percent white baby.

The situation is so appalling on so many levels that it renders me almost speechless.  Just because we can do something technologically does not mean that we should do it.   As Alessandra Rafferty pointed out in a 2011 Newsweek article, "You need a license (in the US) to sell a condo or cut hair in a salon, but not to broker human life."  While the UK, Sweden, Norway, Germany, Italy, New Zealand and Australia have all legislated for more transparency in the fertility business, America's $3 to $4 billion fertility industry continues to move right along, for the most part privatized and largely unregulated.

For years, adult adoptees have been expressing their frustration at being severed from all their DNA connections for all time.  The power brokers have not responded with constructive legal changes, and now we have a whole chorus of donor-conceived adults joining the choir.  About 75 percent of all surveyed donor offspring would recommend to today's prospective parents that they use a known or willing-to-be-known sperm donor, according to the online Donors Sibling Registry.

Says Toronto journalist Olivia Pratten, age 28, "I'm not a treatment, I'm a person, and (my) records belong to me."  Kathleen LaBounty, who grew up just outside Houston, is now the mother of two and would like to know her own medical history, for her own and for her children's sake.  Lindsay Greenawalt, a donor-conceived adult who blogs about her experiences at "Confessions of a Cryokid," says many donor-conceived people are reluctant to criticize the circumstances of their conception and their desire for information for fear of hurting their parents, whom they love.  Sound familiar?  We adoptees have been saying similar things for years.

Today Grennawalt counsels prospective parents to "put yourself in your future child's shoes.  Understand that it's not all about you."  While some are listening and advocating for change, many others charge right ahead, undeterred and willing to believe that just a few misguided souls are complaining.  When we allow ourselves to think about the subject logically, says Grennawalt, there is an ironic hypocrisy in the fact that a couple will do just about anything to have their own biological children, and yet then deny that their children -- either adopted or conceived through the fertility industry --  should have a need to know anything about their own biological connections.

When it comes to securing a baby, it would seem that almost anything goes.  In a free market, the business migrates to the least expensive and least regulated country.  Thus the popularity of foreign adoptions and surrogacy in India, where the cost runs about $25,000, as opposed to anywhere from $60,000 to $100,000 for surrogacy services here in the US.  Women are paid about $8,000 to carry a child for another couple, and of course, India does not yet have legislation governing surrogacy.  When we consider that the average income per year in India is $1,017, what choice do these women receiving such a proposition really have?  As they struggle to survive and to feed their children, I can only imagine the conflicting pressures they must feel.

What do the adoption and the fertility industries have in common?  Both are responding to a tremendous market demand, and both insist that anonymity remain a part of their practices.  Sealed records invite abuse and violate the civil rights of the adopted person.  Anonymity in the fertility business likewise invites abuse -- one sperm donor has spawned over 150 children -- and violates the right of the donor-conceived child to know his or her basic identity.

The sad truth is that money is driving the production of children, in both the adoption and the fertility fields.  Ethics are sadly lacking, and the lack of transparency in both industries is a major contributing factor.  When will US lawmakers wake up to the realities and do something constructive to further "the best interest of the child" rather than  "the best interest of the adoption and fertility industries?"



Sources:

Donor-conceived and Out of the Closet
Donor-conceived children seek missing identities
Who are You? The Ethics and Impact of Donor Conception
Debate Swirls Around Overseas Surrogacy
Donors Sibling Registry

6 comments:

  1. Great post. I agree with you, and yet honestly, I'm sometimes reluctant to say anything because I know the heartbreak that infertile friends have experienced and don't want to upset them. I'm just being honest. But I do think this is an area where technology has gotten way ahead of ethics.

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    1. How ironic, Dana. Just as you were writing this comment, I was adding your blog to my blog list! May the voices calling out for reform continue to get louder and louder. As Margie says over at Third Mom, "I think adoption is broken but worth fixing!" Glad we're linked.

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  2. Totally agree with you here. Because so many people have now been conceived using technology, it has become politically incorrect to announce its problem areas. But that shouldn't keep people from challenging the baby train industry.
    My nephew was conceived via IVF--the doctor placed two embryos in my SIL (and her problem had nothing to do with getting pregnant--she couldn't carry). At 28 weeks, the baby girl was lost. Their son, was born at 1.5 pounds and is almost two now. He doesn't walk, doesn't talk, and has a surgical feeding tube.
    The risks of IVF are just not talked about. We have now learned that even a single IVF baby is at greater risk for pre-term labor, and premature birth can have severe lifelong consequences.
    We are truly living in some wacky times. You might be interested in reading the memoir called "Inconceivable," which documents the experience one couple had after learning that the wrong embryo was implanted in the wife. I believe the other couple, whose genetic child it was, also have a memoir.
    Lots to think about!
    Best,
    Jennifer :)

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  3. Those who don't speak out are complicit, right? isn't it for all people who see this industry as unethical and inhumane to speak out? How do those who have to deal with infertility get a chance to think it through, be supported and come to terms with their lot? There are other ways to deal with infertility that are ethical and give a good chance of conception if it is meant to be, acunpuncture for one.There is no excuse for the unethical when it comes to human life.Greed and money are certainly not good reasons for supporting or allowing bad practice.

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  4. I was out for dinner with a friend and her nephew and his partner joined us. They are two ivy league educated men who sat in the restaurant discussing how they want a lot of children and have argued about who will be the first "father."I almost dropped off the chair!

    Later I told my friend (who is an attorney and a child psychologist) that if her nephew and his partner pursued creating children they needed to be aware that there is a community of donor conceived individuals who are vocal and that the child will have a mother. She knows my connection to adoption and agreed that I was right.

    I am not easily taken aback but the casual attitude about hiring a surrogate stunned me. Thanks for this posting, I will share it with her.

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  5. To me, that's what is so disturbing -- that there seems to be such a casual attitude about creating a new life using anonymous genes. My daughter, who went to an Ivy League school, says there was aggressive on-campus marketing for women's eggs even when she attended school 15 years ago. Like adult adoptees who share their criticisms about sealed records, those donor-conceived individuals who are speaking out in public forums are lambasted for their "selfishness." There seems to be a lot more sympathy for infertile couples than there is for children who have been cut off unnecessarily from their genetic links. Other countries are recognizing the need for reform. Hopefully at some point, the US will too.

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