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Truth and the Child 10 years on: Information Exchange in Donor Assisted Conception
  1. Christine Harrison
  1. Department of Pediatrics and Joint Centre for Bioethics, University of Toronto, and Bioethics Department, The Hospital for Sick Children, Toronto

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    Edited by Eric Blyth, Marilyn Crawshaw and Jennifer Speirs, Birmingham, British Association of Social Workers,1998, 83 pages, £5.95.

    The original Truth and the Child was published in 1988 after publication of the Warnock Report, which identified issues arising from the increasing use of human reproductive technologies. The authors of the original collection felt that the rights of children to information about their origins had not been addressed satisfactorily by the committee chaired by Warnock, which indeed supported a policy of donor anonymity. This policy of anonymity was incorporated into the Human Fertilisation and Embryology Act (1990). Ten years on, this new collection revisits the issue, offering powerful arguments, anecdotes, and some research supporting the authors' position that with regards to information about origin the interests of the children created by donor insemination should take precedence over those of their infertile parents or the gamete donors who enabled their creation.

    We have learned from the practice of adoption that for some people knowledge about their biological origins is crucially important if they are to have a strong sense of their own identity. Every day it becomes clearer that knowledge of family medical history, including genetic information, may be necessary during one's life in order to make choices about one's own health, medical care, and decisions to procreate. Current practice—and legislation from most countries, as reviewed in the appendix of this book—supports parents in secrecy, not just about the identity of the donor, but about the very fact that the child was created with donated gametes.

    The interdisciplinarity of the authors of the various essays in Truth and the Child contributes to the success of this book, which is published by the British Association of Social Workers. Contributors include an anthropologist, a paediatrician, a sociologist, a psychiatrist, a clinical geneticist, social workers, and academic lawyers. Very interesting and valuable are contributions from a family with two adopted children; from two “donor offspring”; from an egg donor; from a mother of children conceived by donor insemination, and from a mother of twins born following a surrogacy arrangement. These are voices often left out of the medical and ethical discussions of these issues.

    The arguments presented by the contributors all lead to the same con-clusion: children should have complete information about their biological origins. Some of the arguments in favour of this stance are:

    The children will find out anyway, either inadvertently from a family member or friend, or in the course of their lives through the health care system, especially with the increased use of genetic testing; those writing as “donor offspring” report sensing that something was different in their families (for example family resemblances and circumstances of one's birth are never mentioned).

    The children have a right to know—several authors refer to the section in the United Nations Convention on the Rights of the Child which claims for children the right to a name, nationality, knowledge of parents, and right to preserve one's identity.

    It is damaging to family relationships to begin and exist on a foundation of dishonesty. Stigmas attached to these practices are thus reinforced and perpetuated. Practices in other countries, and data from Sweden, suggest that there should be little difficulty recruiting gamete donors who are willing to be identified. This addresses the main argument against total openness, which is that no one would be willing to donate.

    This is just a sampling of the arguments presented in this work; others are grounded in the contributor's discipline or personal circumstances. That this book manages to present this wide variety of perspectives in less than 100 pages is to its credit and the editors should be congratulated for the consistent quality of all contributions.

    How powerful are the arguments presented in Truth and the Child? Very powerful indeed, if we may judge from the fact that the British government has recently announced plans to change the law guaranteeing donor anonymity and thus conferring on children conceived with donated gametes the right (once they become adults) to trace the donor.

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