For the second time in two years I have spoken at and participated in a national discussion about family -- who we define as family, the importance (and sometimes lack thereof) of biological ties, the experiences of donor-conceived and adopted people who are missing some of their history. The conference included governmental policy makers and regulators, doctors, social workers, offspring and parents.
And for the second time in two years, this national discussion took place in Canada.
The United States, which has a multibillion-dollar industry in reproductive technology -- with donor sperm, and donor egg, and surrogates sometimes stepping in to fulfill a conception role for an aspiring parent who cannot -- has not yet had this national discussion.
Canada's former "first lady" (previously wife to the Prime Minister) spoke at this event, as did the new president of its three-month old regulatory agency for reproductive health. There was a great to-do about how long it has taken (10 years) and how much has yet to be accomplished in this area, as Canada tries to catch up with the U.K. and Australia in discussing and monitoring the potential and real ethical and social concerns involving the rapidly evolving technologies.
Yet the U.S. hasn't even STARTED a process of developing oversight of this major industry. There is no regulatory body, other than the FDA's accreditation program that ensures that tissues are stored properly.
Now, I'm not big on governmental supervision of family matters, but we desperately need to find the listening ears in Congress who will at least engage our country in a national discussion about the incredibly complex and nuanced issues that impact families who use reproductive technology. To start: why don't fertility clinics require counseling of all clients who are using donated gametes to conceive? The infertile parent, the eventual offspring, the reactions of extended family, the stigma, the fear of the donor's place in their family, the conflicts about disclosing the truth to children about their origins -- all are worthy of major discussion.
And why do we not have a registry, like other countries do, so that families can learn more about a donor's medical history over time? What 20-year-old sperm donor knows his family history of cancer and heart disease and as-yet-to-be-detected genetic illnesses? How many medical forms do we fill out from childhood on that ask for family histories -- why on earth do we still not have something in place to allow donor-conceived children and adoptive children to learn more about their own background?
My part in this recent conversation was to lead a two-hour workshop and discussion about how we define family. We all define it differently, of course, based on our own experiences. But what we need to have a national discussion about is that tens of thousands of children in our country are not sure how to define family yet -- and it's about time we start helping them.
Mikki (who traveled by ferry, car, plane and train to get to this latest conference!)