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Draft Ethical guidelines on the use of assisted reproductive technology in clinical practice and research submission

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Comment on specific Sections, clauses or sentences of the draft revised Draft Ethical guidelines
Specific Comments: 

Part B: Section 5.6.5

I think that parents should be mandated to tell their children that they are donor conceived (DC) for the following reasons:

  • While not enforceable, mandating telling would strongly reinforce the psycho-education and counselling done. Not making telling mandatory gives recipients a mixed message that telling is important but not that important that it is obligatory. Making telling mandatory gives parents a clear message about current societal expectations and adds significant gravitas to the recommendations made in the implications counselling process.
  • Recipients may be very clear and sincere in the counselling process that they intend to tell their offspring they are DC, but find the reality of telling their little children more difficult or uncomfortable than anticipated. Making telling mandatory helps parents not avoid this important step in helping their children have a clear sense of identity. This in turn would reduce the number of DC children who don’t get told until they are adults or who find out by accident; such discoveries often then lead the DC adults to question what else about their life and upbringing is a lie.
  • To rely on parents’ ongoing contact with clinics as the conduit to support them telling is unrealistic. Once children are conceived parents often have no further contact with their treating clinic.  
  • One way to further ‘encourage’ parents to tell is to denote on a DC child’s birth certificate that they are DC. While this may not be an optimal choice because it then create other privacy issues for DC children and adults, its merit is that it provide a clear way to communicate just how important it is for children to know their biological origins.

Part B: Section 5.3.3

It is unduly burdensome on clinics to ring other clinics about any previous donations made by would-be anonymous donors. How far afield would clinics be expected to go e.g. 500 km, inter-state to meet this obligation?

There are many loopholes that patients can use to obfuscate the fact that they have donated elsewhere, e.g. use internet networks, private arrangements, provide incorrect identity papers, that mean that even if clinics ring each other, it will not conclusively establish a lack of donations elsewhere. 

It would be more effective and efficient and leave the responsibility where it lies, if anonymous donors complete statuary declarations regarding their donation status.

Appendix 3a

Appendices: Section 3a

The guidelines do not present any compelling arguments to justify changing the current guidelines on sex selection. Choosing sex is about making assumptions about what it means to have a son or daughter.  If allowed, it may help to foster expectations of children that they are unable to meet. This may be particularly so  if they grow up to be same-sex attracted or transgender. 

It does not make ethical sense to change the rules on the basis that some adults may go to overseas clinics that lack the standard of care in Australia. Such parents have knowingly chosen to travel to such places, cognisant of the fact that the practice is not condoned in Australia, and therefore are responsible for any adverse outcomes from their actions.   

Page reviewed: 20 April, 2017