Ethics Council discusses the consequences of egg donation

Couples frequently avail themselves of offers from foreign clinics to fulfil their desire for children with the aid of reproductive technologies that are prohibited in Germany. These technologies include egg donation. Because the egg donors are anonymous in many of the countries visited by couples wanting children, the children conceived in this way are denied their basic right to know their origins. Parents can of course explain to their child how he or she was conceived, but they cannot change the fact of anonymity – something which can prove highly problematic from a psychosocial perspective.

In his opening remarks, Peter Dabrock, Chair of the German Ethics Council, stressed the need to "bear in mind issues related to the structure and thus also legal structure of our society, thinking in terms of freedom and demonstrating awareness of particularly vulnerable persons and groups". In this context, he said, we ought also to ask the question: "Is it actually fair and plausible that we allow – or regard as legally possible – sperm and embryo donation, but ban egg donation? Is this distinction sustainable? What justifies it?"

Human geneticist Wolfram Henn, also a member of the German Ethics Council, used two case studies to illustrate that the discussion about egg donation is not abstract or theoretical, but raises concrete questions for all concerned, which must first of all be structured.

Council member Petra Thorn, a couple and family therapist whose work also includes counselling women and couples on issues related to egg donation, explained why egg donation is a very controversial procedure: "The donors put their own health at risk because of the medical intervention required. There is an income gap between the receiving couples and the donors, and many women probably donate eggs not only out of altruism, but also for financial reasons."

Ethnologist Michi Knecht from the University of Bremen reported on the state of empirical and ethnographic research on the issue of cross-border reproductive technologies, both from the perspective of couples wanting children who travel abroad, and from the perspective of women who offer such services abroad. There is, she said, considerable movement on the world maps of international reproductive medicine, and large commercial markets have developed, based on economic and legal asymmetries. We should ask ourselves, said Knecht, whether the reproductive mobility of "rich" women and couples means that health risks are being transferred onto women in countries with lower incomes, and whether a restrictive national legislation such as in Germany means that risks of exploitation are – albeit unintentionally – being shifted to other countries.

Birgit Mayer-Lewis, family researcher from the Otto Friedrich University in Bamberg, presented the individual aspects and social context of families after egg donation. As she saw it, the few available studies from abroad gave no indication that the "split maternity" accompanying egg donation had negative effects on the development of the child or family. Problems did, however, arise in coping with everyday family life, especially when it came to dealing with multiple parenthood, informing the child about his or her origins and integrating the conception history into the child's biography.

The following debate, moderated by Council member Andreas Lob-Hüdepohl, on the ethically appropriate approach to existing problems was between Susanne Lettow, philosopher at the Free University of Berlin, and Claudia Wiesemann, medical ethicist and Vice-Chair of the German Ethics Council. Susanne Lettow made the claim that the discussion of ethical questions connected to "reproductive travel" should not only focus on the participants in Germany; it should also – in light of the principle of equality and the criticism of dominance relations – take into consideration the situation of the egg donors abroad.

As Claudia Wiesemann sees it, transnational reproductive travel poses a massive problem of justice – with regards to the donors' healthcare which is not monitored in any way, with regards to the unavailability of the procedure to couples in Germany who are financially less well-off, and with regards to the unequal treatment of sperm and egg donation in Germany. She pointed out society's responsibility towards the rights of the child and health of the donors, and called for enabling good counselling without the risk of criminalization. It would however, said Wiesemann, be more consistent to lift the ban on egg donation in the embryo protection law.

The concluding panel discussion between the four speakers which was open to the audience culminated in the repeatedly voiced view that counselling services in Germany on issues related to egg donation should be decriminalized and, equally, together with psychosocial support to couples wanting children be improved.

The individual contributions are available here (in German).