Is it time for federal and state governments to consider legal rules and boundaries for the fertility industry?

Is it time for federal and state governments to consider legal rules and boundaries for the fertility industry? A new research-based report by the Evan B. Donaldson Adoption Institute, Old Lessons for a New World, suggests that the answer may be “yes.”

The Donaldson Institute – a national not-for-profit organization devoted to improving adoption policy and practice – suggests that the legal and regulatory framework for adoption provides a model that assisted reproductive technology [ART] could utilize.

Five principal findings of the research:

• The problematic effects of secrecy and of withholding information – on adopted persons, birthparents, and adoptive families – offer insights for ART policy and practice related to the circumstances of a donor offspring’s conception, disclosure of medical and other background information, and the identities of those involved.
• The child-centered focus of adoption provides a vital perspective for placing greater attention on the children conceived through ART.
• Adoption has knowledge to share concerning the creation of “nontraditional” families, particularly as more single, gay, and lesbian adults use ART.
• ART and adoption can mutually benefit from examination of the impact of market forces (including the costs of services and the potential commodification of the individuals involved) on the ethics and quality of services provided.
• The legal and regulatory framework for adoption provides a model that ART can utilize to inform its standards and procedures.

Based on those findings, the Adoption Institute makes these recommendations:

• Children born of ART should be able to learn the circumstances of their births, as well as their biological and medical backgrounds. To ensure that this happens, the U.S. should join Great Britain and other countries in mandating that donor-conceived offspring be given access to this information at age 18, and practice models should be implemented for ART practitioners to provide for such disclosure. The U.S. also should establish a national database to collect, maintain, and facilitate access to information enabling gamete providers to routinely update the medical, historical, and other information they supplied at the time of donation.
• To develop best practices for ART, further research should identify more clearly the similarities to and differences from adoption in serving the interests of everyone involved, most importantly the children. Counseling should be provided to all participants in ART akin to that in best-practice adoptions, including improved informed-consent procedures for gamete providers and recipients and post-birth counseling to support families in giving relevant information to their donor-conceived children.
• Research drawing from relevant adoption lessons should be conducted to expand professional and participant understanding of the experiences of all members of assisted-reproduction families – including those headed by gay, lesbian and single parents – and to gauge the extent to which services are available to adults wishing to utilize ART.
• In order to create more constructive, ethical practices, the market forces affecting adoption and assisted reproductive technologies – supply, demand, costs and income – should be analyzed to develop a better understanding of how they influence decision-making by gamete providers, birthparents, recipient families, and prospective adoptive families.
• States should enact legal and regulatory frameworks for ART, based on model legislation and research, as well as on the experiences of other states and nations, to promote ethical practices and provide protections for gamete providers, intended parents, and offspring.

In closing, The Donaldson Institute believes that taking these steps could help ART progress from its current state – of achieving the medically possible – to providing research-informed practices that focus more attention on the long-term medical, psychological and social needs of those it serves.