Donor Conception Disclosure: Directive or Non-Directive Counselling?
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It is widely agreed among health professionals that couples using donor insemination should be offered counselling on the topic of donor conception disclosure. However, it is clear from the literature that there has long been a lack of agreement about which counselling approach should be used in this case: a directive or a non-directive approach. In this paper we investigate which approach is ethically justifiable by balancing the two underlying principles of autonomy (non-directive approach) and beneficence (directive approach). To overrule one principle in favour of another, six conditions should be fulfilled. We analyse the arguments in favour of the beneficence principle, and consequently, a directive approach. This analysis shows that two conditions are not met; the principle of autonomy should not be overridden. Therefore, at this moment, a directive counselling approach on donor conception disclosure cannot be ethically justified.
KeywordsCounselling Ethics Donor conception Secrecy Disclosure
- Association of Biomedical Andrologists, Association of Clinical Embryologists, British Andrology Society, British Fertility Society, and Royal College of Obstetricians and Gynaecologists. 2008. UK guidelines for the medical and laboratory screening of sperm, egg and embryo donors. Human Fertility 11(4): 201–210.CrossRefGoogle Scholar
- Australian and New Zealand Infertility Counsellors Association. 2012. Donor conception: Ethical aspects of information disclosure. Submission to Nuffield Council on Bioethics. http://www.nuffieldbioethics.org/sites/default/files/files/ANZICA.pdf. Accessed September 1, 2013.
- Baran, A., and R. Pannor. 1993a. Lethal secrets: the psychology of donor insemination. Problems and solutions, 2nd ed. New York: Amistad Press.Google Scholar
- Baran, A., and R. Pannor. 1993b. Perspectives on open adoption. Adoption 3(1): 119–124.Google Scholar
- Beauchamp, T., and J. Childress. 2013. Principles of biomedical ethics, 7th ed. New York: Oxford University Press.Google Scholar
- British Association of Counselling and Psychotherapy. 2013. Ethical framework for good practice in counselling & psychotherapy. Leicestershire: BACP.Google Scholar
- British Infertility Counselling Association. 2013. Guidelines for good practice in infertility counselling: Third edition 2012. Human Fertility 16(1): 73–88.Google Scholar
- Boivin, J. 2003. A review of psychosocial interventions in infertility. Social Sciences & Medicine 57(12): 2325–2341.Google Scholar
- Bonte, P., G. Pennings, and S. Sterckx. 2014. Is there a moral obligation to conceive children under the best possible conditions? A preliminary framework for identifying the preconception responsibilities of potential parents. BMC Medical Ethics 15(5): 1–10.Google Scholar
- British Medical Association. 2008. Parental responsibility: Guidance from the British Medical Association. http://bma.org.uk/practical-support-at-work/ethics/children. Accessed October 1, 2014.
- Canadian Fertility and Andrology Society Counselling Special Interest Group. 2009. Assisted human reproduction counselling practice guidelines. http://www.cfas.ca/index.php?option=com_content&view=article&id=936%3Aassisted-human-reproduction-counselling-practice-guidelines&catid=999%3Aguidelines-counsellors-sig-&Itemid=521. Accessed September 1, 2014.
- Caughlin, J.P., and T.D. Afifi. 2004. When is topic avoidance unsatisfying? Examining moderators of the association between avoidance and dissatisfaction. Human Communication Research 30(4): 479–513.Google Scholar
- Dondorp, W., G. De Wert, G. Pennings, et al. 2014. ESHRE Task Force on Ethics and Law 21: Genetic screening of gamete donors: Ethical issues. Human Reproduction 29(7): 1353–1359.Google Scholar
- Edwards, J. 2009. The matter of kinship. In European kinship in the age of biotechnology, edited by J. Edwards and C. Salazar, 1–18. New York and Oxford: Berghahn Books.Google Scholar
- Hammarberg, K., M. Carmichael, L. Tinney, and A. Mulder. 2008. Gamete donors’ and recipients’ evaluation of donor counselling: A prospective longitudinal cohort study. The Australian and New Zealand Journal of Obstetrics and Gynaecology 48(6): 601–606.Google Scholar
- Hewitt, G. 2002. Missing links: Identity issues of donor conceived people. Journal of Fertility Counselling 9(3): 14–20.Google Scholar
- Human Fertilisation and Embryology Association. 2012. Code of practice, 8th ed. London: HFEA.Google Scholar
- Imber-Black, E.E., ed. 1993. In Secrets in families and family therapy. New York: Norton.Google Scholar
- Jadva, V., T. Freeman, W. Kramer, and S. Golombok. 2009. The experiences of adolescents and adults conceived by sperm donation: Comparisons by age of disclosure and family type. Human Reproduction 24(8): 1909–1919.Google Scholar
- Kirkman, M. 2004. Genetic connection and relationships in narratives of donor assisted conception. Australian Journal of Emerging Technologies and Society 2(1): 1–20.Google Scholar
- Klock, S. 2013. Disclosure decisions among known and anonymous egg donor recipients. In Principles of oocyte and embryo donation, edited by M.V. Sauer, 195–204. London: Springer-Verlag.Google Scholar
- Lalos, A., C. Gottlieb, and O. Lalos. 2007. Legislated right for donor-insemination children to know their genetic origin: A study of parental thinking. Human Reproduction 22(6): 1759–1768.Google Scholar
- McWhinnie, A.M. 1984. Annex: The case for greater openness concerning AID. In AID and after: Papers from BAAF, BASW and a Scottish Working Party. London: British Agencies for Adoption and Fostering.Google Scholar
- Nordqvist, P., and C. Smart. 2014. Relative strangers: Family life, genes and donor conception. Basingstoke, UK: Palgrave Macmillan.Google Scholar
- Nuffield Council on Bioethics. 2013. Donor conception: ethical aspects of information sharing. London: Nuffield Council on Bioethics.Google Scholar
- Rogers, C.R. 1942. Counseling and psychotherapy: Newer concepts in practice. Boston: Houghton Mifflin.Google Scholar
- Sachs, P., and L. Hammer Burns. 2006. Recipient counseling for oocyte donation. In Infertility counseling: A comprehensive handbook for clinicians, 2nd ed., edited by S.N. Covington and L. Hammer Burns, 319–338. New York: Cambridge University Press.Google Scholar
- Serre, J.-L., A.-L. Leutenegger, A. Bernheim, M. Fellous, A. Rouen, and J.-P. Siffroi. 2014. Does anonymous sperm donation increase the risk for unions between relatives and the incidence of autosomal recessive diseases due to consanguinity? Human Reproduction 29(3): 394–399.CrossRefPubMedGoogle Scholar
- Shenfield, F. 1999. Truth or dare? Anonymity: The case for. Progress in Reproduction 3: 8.Google Scholar
- Snowden, R., and E. Snowden. 1993. The gift of a child, 2nd revised ed. Exeter, UK: University of Exeter Press.Google Scholar
- Strauss, B., and J. Boivin. 2001. 2.1. Counselling within infertility. In Guidelines for counseling in infertility, edited by ESHRE Taskforce SIG Psychology and Counseling. Oxford: Oxford University Press.Google Scholar
- Thorn, P. 2006. Recipient counseling for donor insemination. In Infertility counseling: A comprehensive handbook for clinicians, 2nd ed., edited by S.N. Covington and L. Hammer Burns, 305–318. New York: Cambridge University Press.Google Scholar
- Vangelisti, A.L., and J.P. Caughlin. 1997. Revealing family secrets: The influence of topic, function, and relationships. Journal of Social and Personal Relationships 14(5): 679–705.Google Scholar
- Visser, M., P.A.L. Kop, M. VanWel, F. Van der Veen, G.J.E. Gerrits, and M.C.B. Van Zwieten. 2012. Counselling on disclosure of gamete donation to donor offspring: A search for facts. Facts, Views and Vision in Obstetrics and Gynaecology 4(3): 159–172.Google Scholar