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Response
Old consent and new developments: health professionals should ask and not presume
  1. Rachel Horton,
  2. Angela Fenwick,
  3. Anneke M Lucassen
  1. Clinical Ethics and Law group (CELS), Faculty of Medicine, University of Southampton, Southampton, UK
  1. Correspondence to Professor Anneke M Lucassen, Clinical Ethics and Law group (CELS), Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; a.m.lucassen{at}soton.ac.uk

https://doi.org/10.1136/medethics-2019-105868

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    We thank Lucy Frith for her thought-provoking response1 to our paper, where we argued that it would be ethically acceptable to contact an anonymous egg donor to help facilitate diagnostic genetic testing for a donor-conceived child.2 While we read Frith’s commentary with interest, we still think that the egg donor should be contacted in the case that we describe. Frith raises concerns as to whether contact would constitute ‘overriding consent’, thus ’potentially set(ting) a dangerous precedent’ for existing gamete donors and donor-conceived children. In contrast, we consider that contacting the egg donor would not override her consent, as her views on contact in the instance that has now arisen were never sought. Our view is that given we do not currently know what she might want, contacting her is a more legitimate way of respecting her autonomy than trying to anticipate her likely answer. We strongly agree with Frith’s suggestion that future consent discussions around gamete donation should make explicit ‘the possibility of being contacted in the future if there is a relevant reason for doing so’.

    Limitations of consent

    Frith expresses a concern that contact would constitute ‘overriding [the egg donor’s] consent’, meaning that we have to ‘justify contacting the egg donor against her previously stated wishes not to be contacted’. However, our argument is that the egg donor was never asked whether or not she was happy to be contacted in the circumstances that have now arisen. Thus, there is no consent to be overridden, given that she never gave or withheld it in the first place. Frith rightly acknowledges that her arguments therefore ‘[do] not fully address [our] main worry that the donor’s wishes are essentially unknown, as she was not asked about this specific situation and …

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    Footnotes

    • Twitter @rach_horton, @Ajf3Angela, @annekeluc

    • Contributors RH drafted the initial response, which was developed and edited by AF and AML.

    • Funding AML’s work is supported by funding from a Wellcome Trust collaborative award 208053/Z/17/Z. AML was also supported by the NIHR Southampton Biomedical Research Centre. RH’s work is supported by funding from a Wellcome Trust Research Award for Health Professionals 218092/Z/19/Z.

    • Competing interests AML declares her relationships as Chair of British Society for Genetic Medicine, and Member of Ethics Advisory Committee for Genomics England.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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