The enlightened and well-informed decision the Supreme Court of British Columbia rendered last week in Olivia Pratten's favour should make all Canadians proud. By putting children's well-being first and acknowledging the right of donor-conceived individuals to know their genetic identities, just like adopted children, B.C. joins a growing list of jurisdictions that have banned donor anonymity in recent years. The decision may also encourage other provinces to follow suit.
Donors who did not consent at time of donation to the disclosure of their identity are probably still protected, since any new legislation is likely to grant past donors a veto. Sadly, then, this decision might not help Ms. Pratten - or others conceived in the past - in their search for their donors or siblings. However, for a future generation of donor-conceived individuals, this is a great victory that will promote their chances of being treated fairly.
Promote, not ensure, because even those conceived after the new legislation goes into effect will not be guaranteed information about their donor. Unless their parents tell them the truth about the circumstances of their conception, they will not be aware that they are being denied information that could be crucial for their health and psychological well-being.
While the trend toward banning anonymity is gaining momentum worldwide, none of the jurisdictions that have made this policy change have also adopted a mechanism for ensuring that children are told the truth about the circumstances of their conception. Suggestions to impose disclosure on parents indirectly by marking birth certificates of donor-conceived individuals have been rejected. Such state intrusion into intricate family dynamics is perceived by most as unacceptable. The decision is left in the hands of the parents.
Yet, research shows that the great majority of parents choose not to tell the truth, even in countries that guarantee offspring access to identifying information. Even in Sweden, the first country to ban donor anonymity, the vast majority of parents who conceived in the 1980s and 1990s still did not inform their children that they were born of donated sperm. Research suggests that parents are reluctant because the topic is awkward, to protect the relationship between the child and the genetically unrelated parent, or to hide the fact of infertility.
These research findings show that policy is only a part of the solution. Indeed, a legal requirement that records be created, preserved and disclosed to offspring is a crucial first step. Yet, for legislation to be effective in protecting the interests of donor-conceived individuals, we need a campaign encouraging parents to be honest with their children and the provision of appropriate counselling and tools.
We need to enhance our educational efforts - of parents and of the public at large - and endorse a culture of openness and acceptance. We need to fight the stigma of infertility and promote a more nuanced understanding of family relationships, and of genetic relatedness and non-relatedness. We need to acknowledge the fundamental human interest in knowing one's genetic origins, while respecting the integrity and privacy of the family. Children's right to know should come first, and the best way to protect this right is to support parents in making informed decisions.
Last week's court decision highlights the social and ethical challenges raised by gamete donation. Donor-conceived children deserve to be treated fairly and this can only be achieved if they are told the truth. The challenge we face is in endorsing a cultural change that would encourage parents to be open and honest with them.
Vardit Ravitsky is assistant professor in the bioethics programs at the University of Montreal.