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The Management of Biological Origins in the New Reproductive Technologies

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The Management of Biological Origins in the New Reproductive Technologies Family Connections: the management of biological origins in the new reproductive technologies Erica Victoria Haimes Thesis submitted for the degree of Doctor of Philosophy, Department of Social Policy, University of Newcastle Upon Tyne 1990 Family Connections: the management of biological origins in the new reproductive technologies. Abstract This thesis investigates the management of information about the biological origins of individuals conceived through the use of a third party; that is, by donated gametes or surrogacy. From a review of policy reports and academic studies of families created in this way, I identify three possible management strategies: complete secrecy; openness about the means of conception coupled with third party anonymity; openness about the means of conception, coupled with releasing the identity of the third party to the individual conceived, when adult. The middle strategy is exemplified by the Report of the Committee of Inquiry into Human Fertilisation and Embryology (the 'Warnock Report', 1984). This I explore in two ways: first through a detailed analysis of the Report itself, then through a series of in-depth interviews with committee members. I conclude that although the Report can be read as a prescription for the creation of 'normal families', in which the above management strategy on origins is a device for protecting ideologically-correct but biologically-anomalous families, from the Interviews it appears that this represented a suspension of more profound difficulties experienced by members when discussing these issues. These difficulties arose from what members found to be an irresolvable dilemma over the contribution of biological factors to family life. In the final chapter I examine the nature of the contrast between the Report and the interviews; I then locate the above dilemma in broader theoretical debates and finally I suggest that the strategy of recommending anonymity between all parties exposes rather than resolves the tension between the 'biological' and the 'social' in everyday, lay, reasoning about family life. In the light of this conclusion I speculate on possible developments in the management of origins information and the likely impact of third parties being named in the future. Erica Haimes March 1990 CONTENTS Acknowledgements Preface ii A Question of Origins Introduction 1 Issues of origins in the new reproductive technologies 3 Lessons from earlier research 13 Literature review 24 The approach of this study 37 Notes 41 II Managing Origins: variations on a theme Introduction 43 Managing through policy 44 Managing in the family 67 Synthesis 82 Notes 87 III Secrecy, Anonymity and Openness: evaluating the strategies Introduction 92 Secrecy in third party conceptions 94 The Warnock Report: anonymity and openness 111 Third party conceptions and the family 126 Conclusion 141 Notes 144 IV The View from Warnock, I: talking about the new reproductive technologies Introduction 147 Participating in the committee's task 150 Talking about the new reproductive technologies 154 Synthesis 185 Notes 191 V The View from Warnock, II: the family, anonymity and the 'child' Introduction 193 The family 194 Anonymity 206 The 'child' 219 Conclusions 228 Notes 235 VI Conclusions Introduction 237 Family Connections? 238 Future policy developments 253 Future research 261 Summary 264 Notes 270 Postscript: Human Fertilisation and Embryology Bill 271 Appendix: Methodology 274 Bibliography 288 Acknowledgements Many people have helped me in many different ways to complete this thesis, so I should like to take this chance to thank them properly. In particular I should like to acknowledge the support and friendship of Noel Timms, Alf Davey, Yvette and Fritha Haimes, Jim Valentine and Frances Price. Colleagues at the Health Care Research Unit, University of Newcastle and in the Department of Sociology and Social Policy, University of Stirling have also given me much encouragement. In addition I should like to thank the members of the Warnock Committee, and Dame Mary Warnock in particular, for their co-operation in this research, without which the thesis could not have been written. My greatest debt however is to three individuals who must feel they have lived with this thesis for a very long time. First, Peter Selman who, as my supervisor, thought I would simply be using him as a sounding board for my ideas, because that's how I convinced him to take on the job in the first place. He has been much more than that and I am very grateful for all the help he has given over the past seven years, as supervisor, friend and advocate. Rachel Loudon has also given much more than I originally asked for: besides typing the thesis she has provided support, encouragement and friendship as well as practical advice and it is difficult to thank her enough. My greatest thanks though go to Robin Williams, who has literally had to live with the thesis and its consequences over the last seven years. In this, as in everything else, he has given me his love and support and it is impossible to record just how much I have gained from that. I should like to dedicate this thesis to him, with love, in small recognition of all he has given me. ii PREFACE Dockery and Son To have no son, no wife, No house or land still seemed quite natural. Only a numbness registered the shock Of finding out how much had gone of life How widely from the others. Dockery, now: Only nineteen, he must have taken stock Of what he wanted, and been capable Of ... No, that's not the difference: rather, how Convinced he was he should be added to Why did he think adding meant increase? To me it was dilution. Where do these Innate assumptions come from? Not from what We think truest, or most want to do: Those warp tight-shut, like doors. They're more a style Our lives bring with them: habit for a while, Suddenly they harden into all we've got And how we got it; looked back on, they rear Like sand-clouds, thick and close, embodying For Dockery a son, for me nothing, Nothing with all a son's harsh patronage. Life is first boredom, then fear. Whether or not we use it, it goes, And leaves what something hidden from us chose, And age, and then the only end of age. Philip Larkin (1963) Many of the sentiments expressed in Larkin's poem provide the backdrop to this study: what it means to have children or not to have children; whether children are an addition to the self in providing a future or a 'dilution' of the self, by blurring any sense of uniqueness and individuality. Reactions to such questions might differ if assumptions about the biological tie between parents and children could be relied upon no longer. iii The decision to have, or to enable others to have, children with whom there is an incomplete genetic relationship, is a significant social development. Through the use of donated sperm, eggs and embryos, and through surrogacy, individuals and couples are 'added to' in the sense of having children, but are not 'increased' genetically, since the child will instead bear the genes of at least a third person and, in some cases, a fourth person too. There are many consequences of that decision but one in particular provides the focus of this study: the uncertainty of how to handle information about that child's genetic origins. One strategy might be to disguise the lack of a genetic link, another might be to deny its importance, others might be to confront or celebrate the creation of a non-genetic relationship. The choices are not simple as each has implications for how we think about individuals, parents, children and families. A recent newspaper article gives a flavour of what is involved. Under a headline 'Losers in the egg and sperm race' Christine Walby and Barbara Symons condemned the secrecy surrounding artificial insemination by donor (AID) and argued for the right of people conceived with the help of hitherto anonymous third parties to gain as much information as possible about those third parties. They saw this information as vital to a development of a proper sense of identity and therefore regarded non-identifying genetic information as insufficient. Walby said the secrecy surrounding AID was a wish 'to make everything seem as normal as possible' (The Guardian, 13/7/89). The article also cited a recent television programme which had featured Suzanne Ariel, a person conceived through AID, arguing for similar rights of access to information. The studio audience was invited to vote on this: 75% said a person should be told s/he was the result of AID, but almost as many also iv said s/he should not be given identifying information about the donor. Dr Ruth Curson of King's College Hospital responded to the article by asking, If we enforce honesty about egg and sperm donation, are we going to be logical about the whole thing and tissue-type every child in the country together with his or her parents and make sure the child knows that it is the product of an extramarital affair or will we continue to have different standards for different groups? (The Guardian, 20/7/89). Similarly a gynaecologist on a radio programme the previous year (Woman's Hour, Radio 4, 22/1/88) asked whether it helped a child to be told about his/her conception and the identity of the donor. He questioned the Importance of an exact genetic identity when compared to the quality of the upbringing, as contributions to producing a happy child and adult. It is this type of debate which I wish to explore in this thesis. My purpose from a specifically sociological perspective, is to contribute to our understanding of the social world in several ways.
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