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Donor Insemination: International Perspectives
  1. Mary Ann Elston
  1. Royal Holloway, University of London

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    Edited by K Daniels and E Haimes, Cambridge, Cambridge University Press, 1998, x + 185 pages, 1998, £37.50 hc, £13.95 sc.

    Donor insemination (DI) is a neglected topic among social scientists. According to its editors, both established sociological experts in the study of assisted conception, this collection is the first of its kind. The reasons for this social scientific neglect must include DI's relatively “low-tech” character as a procedure (in comparison with so-called “new reproductive technologies” and the secrecy which has, historically, surrounded its use. As contributors to this book document, in the last decade the move to cryopreservation of semen in sperm banks, for example to permit screening for HIV/AIDS antibodies, has increased the technical complexity a little. And, following legislation or official guidelines, some information about semen providers and recipients and resulting offspring is now collected centrally in some countries, including the UK. But, at present, we still know very little about who has resorted to DI, for what reasons and in what circumstances, who has provided the sperm and why, or about the experience of those humans born as a result. This book fills some gaps and should be essential reading for anyone interested in the social and moral issues relating to assisted conception. For example, Daniels gives a valuable overview of research on semen providers and Blank an account of different approaches to regulation of DI in different countries. Haimes explores the changing representations of those conceived following DI during the twentieth century.

    However, the volume also confirms explicitly and implicitly, by the restricted empirical material some authors have to draw on, the many unknowns that remain. One implication of our ignorance is that we cannot assume that some of the potential problems often attributed to DI are actually widespread. There may be thousands of people conceived as a result of DI who live their lives in blissful ignorance of their genetic origins and in harmony with their social fathers and thousands who live perfectly happily with full disclosure. In their contribution, the Snowdens, whose long term research with a small group of parents from one UK service constitutes much of what we know about DI, note that generally DI parents do not wish to talk about their decisions or their family life. The Snowdens attribute this to unresolved tensions and ambivalence, and possibly fear of their discreditable secret being revealed. But it might be that these parents simply do not see that there is anything to talk about. However, as Novaes suggests in a perceptive discussion of the medical management of DI, particularly in relation to France, the increasing prominence of genetic models of disease and human behaviour may be making anonymity of sperm providers and secrecy about a child's DI origins more problematic. But it does not follow that reducing anonymity will necessarily bring unalloyed benefits. Moreover, any “geneticisation” of society might lead to more general questioning of the legitimacy and value of DI, and, just possibly, more rather than less secrecy about resorting to it.

    However, even if we should not assume that resort to DI or being conceived as a result of DI or secrecy about it routinely carries problems for individuals, the procedure clearly does raise ethical issues for society. Among those discussed in this book are the use of DI by those who are not (or not known to be) infertile but seek to conceive without engaging in heterosexual sex. Lasker, in her chapter on users of DI, notes that the proportion of this “unconventional” kind of DI recipient is likely to rise. New techniques to enhance sperm quality may make biological fatherhood more possible for subfertile men in stable couples. As Blank notes, it is not easy to frame legislation or guidelines to cover all the possible circumstances in which DI (as a medically managed procedure rather than self-insemination) might be requested. The medical profession may be called upon to exercise “professional responsibility” in situations where it is by no means clear what would count as responsible action or where the boundary between responsible action and, for example, eugenics might lie. Finally, anthropologist Jeanette Edwards provides a cautionary tale for those who hope that “public opinion” might serve as a stable and uniform criterion against which options might be assessed.