Since 1991, sperm donors in the UK have had the legal right to withdraw consent for the use of their sperm in fertility treatment. This has the potential to adversely affect patients. It may mean that previous recipients of a donor’s sperm cannot have further children who are full biological siblings to an existing child, and that embryos created from the donor’s sperm and a patient’s eggs must be destroyed. We have informally investigated withdrawal of consent by sperm donors donating after 1 April 2005, when lifelong anonymity for gamete donors ended.
Cash incentives and the payment of funeral expenses are two ideas being put forward to encourage people to donate human organs and tissue. The Nuffield Council on Bioethics is asking the public if it is ethical to use financial incentives to increase donations of organs, eggs and sperm. Paying for most types of organs and tissue is illegal in the UK. The public consultation will last 12 weeks and the council's findings will be published in autumn 2011.
We provide our bodies or parts of our bodies for medical research or for the treatment of others in a number of ways and for a variety of reasons. However, there is a shortage of bodily material for many of these purposes in the UK. What should be done about it? The Council has set up a Working Party, chaired by Professor Dame Marilyn Strathern, to explore the ethical issues raised by the provision of bodily material for medical treatment and research. Questions to be considered include: * what motivates people to provide bodily material and what inducements or incentives are appropriate? * what constitutes valid consent? * what future ownership or control people should have over donated materials? * are there ethical limits on how we try to meet demand?
Farrell and Brazier set out the arguments for obtaining specific informed consent for allogeneic blood transfusion.1 They do not deal with allogeneic blood products, but I think their article can be assumed to cover this too. This subject is controversial, and the question of how to seek and record consent has been the subject of a recent consultation by the Department of Health’s Advisory Committee on the Safety of Blood, Tissues and Organs. A question Farrell and Brazier avoid is who should be responsible for gaining informed consent? Should it be those who provide the blood (the transfusion service, probably most informed about the risks) or those who prescribe it (probably least informed)? This is of crucial importance in the debate and has considerable resource implications.
Within transfusion medicine, the question of whether separate informed consent should be obtained from patients for blood transfusion has provoked considerable debate. There has long been support for such an approach in the United States.1 A BMJ editorial in 1997 made it clear that reform was on the professional agenda in the United Kingdom, despite the established position that obtaining general consent for medical treatment included consent for blood transfusion.2 At the time, however, professional consensus proved elusive because of concerns over a range of practical problems, including who should be responsible for obtaining such consent and in what circumstances it should be obtained.3 The issue has now been brought to the fore again, highlighted by the recent stakeholder consultation launched by the UK government’s independent Advisory Committee on the Safety of Blood, Tissue and Organs.
This paper analyses elements of the legal process of consent to the donation of ‘spare’ embryos to research, including stem-cell research, and makes a recommendation intended to enhance the quality of that process, including on occasion by guarding against the invalidity of such consent. This is important in its own right and also so as to maximise the reproductive treatment options of couples engaged in in vitro fertilisation (IVF) treatment and to avoid possible harms to them. In Part 1, with reference to qualitative data from three UK IVF clinics, we explore the often delicate and contingent nature of what comes to be, for legal purposes, a ‘spare’ embryo. The way in which an embryo becomes ‘spare’, with its implications for the process of consent to donation to research, is not addressed in the relevant reports relating to or codes of practice governing the donation of embryos to research, which assume an unproblematic notion of the ‘spare’ embryo. Significantly, our analysis demon
A woman whose husband became a sperm donor without her knowledge is seeking to change the law (reported in BioNews 671). Her claim is that a husband's sperm constitutes a 'marital asset', over which a wife should have some legally enforcable rights. Currently, there is no legal requirement for a spouse to consent to her partner's sperm donation. But perhaps there should be? After all, marriage is usually understood to entail a degree of shared decision-making. And since begetting children - with one's spouse - is traditionally a primary reason for tying the knot, can it really be compatible with marital mores for husbands to conceive children with other people?