Lesbian couples' views about and experiences of not being able to choose their sperm donor.

In this qualitative study, we explore how lesbian recipients view and experience the selection of their anonymous sperm donor. The study was conducted in Belgium, where fertility centres follow a legal protocol that severely restricts personal choice in donor selection. While previous studies have shown that recipients want greater control and input in the selection of their sperm donor, this was not a main concern for most women in the present study. They generally acknowledged their lack of control on the selection outcome and accepted this as part and parcel of an anonymous donation policy that provides an opportunity to have a child. They actively and passively downplayed initial concerns about the donor selection procedure and felt they did not have or need a right to further control over the donor selection. In adopting this 'subordinate' position, they felt they should trust the hospital, which they hoped would fulfil rather high screening standards. Those who did want more choice were nuanced and careful about their motivations: they focused on selecting traits that would facilitate normal child development or increase family coherence. The findings shed light on how these patients perceive their position in this third-party reproduction setting.

Beyond sperm cells: a qualitative study on constructed meanings of the sperm donor in lesbian families.

STUDY QUESTION: What meanings do lesbian couples construct regarding their sperm donor? SUMMARY ANSWER: For some parents, the donor was increasingly presented as a person, whereas for other parents, the donor was seen as an instrument from the moment they received the sperm donation. WHAT IS KNOWN ALREADY: Few studies specifically focus on how lesbian couples deal with the issue of third-party anonymous gamete donation. It is often assumed that they have fewer difficulties than heterosexual couples with the involvement of a male procreator, since their status as a donor conception family is 'socially visible' and there is no social father who fears exclusion. STUDY DESIGN, SIZE, DURATION: Semi-structured interviews were conducted with 10 lesbian couples (20 participants), recruited via the Ghent University Hospital. All couples had at least one child, conceived through anonymous donor insemination, between 7 and 10 years old. PARTICIPANTS/MATERIALS, SETTING, METHODS: Within the data corpus, a particular data set was analyzed where couples referred to their donor and his position in their family. Step-by-step inductive thematic analysis was performed resulting in themes that are grounded in the data. All phases of the analysis were followed by team discussion. MAIN RESULTS AND THE ROLE OF CHANCE: This study reveals different donor constructs, indicating different ways of dealing with the third-party involvement in the family. Some parents diminish the role of the donor throughout family life and continue to present him as an instrument: something they needed in order to become parents. Others show an increasing interest in the donor as the children mature, which results in a more personalized account of the donor. LIMITATIONS, REASONS FOR CAUTION: In our qualitative cross-sectional study, we collected retrospectively constructed stories. Longitudinal qualitative and quantitative research is required to allow for an extrapolation of the conclusions made. WIDER IMPLICATIONS OF THE FINDINGS: This study shows how the concept of the donor is constructed within lesbian families and how it is challenged by the child's developing personality and features. When counseling prospective parents, it could therefore be useful to discuss the concept of the anonymous donor beyond the conception phase. STUDY FUNDING/COMPETING INTEREST(S): The project was funded by the Research Fund of Ghent University, Belgium. There are no competing interests.

Sleep better than medicine? Ethical issues related to "wake enhancement".

This paper deals with new pharmacological and technological developments in the manipulation and curtailment of our sleep needs. While humans have used various methods throughout history to lengthen diurnal wakefulness, recent advances have been achieved in manipulating the architecture of the brain states involved in sleep. The progress suggests that we will gradually become able to drastically manipulate our natural sleep-wake cycle. Our goal here is to promote discussion on the desirability and acceptability of enhancing our control over biological sleep, by illustrating various potential attendant ethical problems. We draw attention to the risks involved, possible conflicts of interests underlying the development of wake enhancement, and the potential impact on accountability for fatigue related errors.

Donor-conceived children looking for their sperm donor: what do they want to know?

OBJECTIVE: This paper aims to gain in-depth understanding of why some donor-conceived offspring want to know the identity of their sperm donor. METHODS: Step-by-step inductive thematic analysis was performed on first-hand quotes from donor-conceived offspring selected from a wide range of sources (including empirical studies and donor conception networks, registries and support groups). RESULTS: We found that at least 7 different objectives can underlie the wish to know one's donor: to avoid medical risks and consanguineous relationships; to connect with one's roots; to complete one's life (hi-)story; to understand where one's traits come from; to discover or assess one's defining characteristics and capabilities; to rectify a wrong-doing, and to map out one's ancestral history. CONCLUSION: The analysis shows that there is great variance among identity-seekers in the weight they attribute to wanting to know their donor. It is also clear that they have very different assumptions about the role and importance of genetics in terms of establishing 'who they are' or 'can become', including deterministic misconceptions. Rather than treat all donor-conceived offspring's needs as of equal concern, this analysis should help distinguish between and assess the relevance of the various motivations.

To the core of porcine matter: evaluating arguments against producing transgenic pigs.

BACKGROUND: The production of transgenic pigs for xenotransplantation is based on an urgent human need for transplantable organs. Although the particular genetic modifications are small and do not alter the organism phenotypically, several authors consider it to be morally problematic. In this paper we attempt to establish if there are genuine reasons to refrain from producing 'humanized' pigs. METHODS: We distinguish between two types of ethical arguments against transgenesis often confused in debating the matter: consequentialist and inherent arguments. Whereas the first type of argument pertains to the potentially negative effects of the procedure, the second type claims that genetic engineering of animals is 'inherently' wrong; that the action itself regardless of the effects - is to be considered immoral. If this is the case, then the discussion need not be taken further. If not, then these arguments do not stand in evaluating the procedure. RESULTS: We demonstrate that none of the claims asserting inherent wrongness of transgenesis is valid as such. CONCLUSION: Sound resistance to producing transgenic pigs is restricted to concerns regarding the concrete effects of the applications.

Proceeding with clinical trials of animal to human organ transplantation: a way out of the dilemma.

The transplantation of porcine organs to humans could in the future be a solution to the worldwide organ shortage, but is to date still highly experimental. Further research on the potential effects of crossing the species barrier is essential before clinical application is acceptable. However, many crucial questions on efficacy and safety will ultimately only be answered by well designed and controlled solid organ xenotransplantation trials on humans. This paper is concerned with the question under which conditions, given the risks involved and the ethical issues raised, such clinical trials should be resumed. An alternative means of overcoming the safety and ethical issues is suggested: willed body donation for scientific research in the case of permanent vegetative status. This paper argues that conducting trials on such bodies with prior consent is preferable to the use of human subjects without lack of brain function.