Essential Elements of Informed Consent in Egg Donation and Surrogacy

Chapter

Abstract

Assisted reproductive technology encompasses a myriad of medical, ethical, moral, emotional, psychological, and religious issues. This is especially true when considering the variety of complex concerns that arise when a patient wishes to be a surrogate or donate her eggs. Informed consent represents a particularly important consideration in the field of assisted reproductive technology. The purpose of this chapter is to identify the most significant ethical and legal issues confronting egg donors and gestational surrogates and offer guidance to medical professionals in a position to communicate relevant information to their patients in order to obtain their informed consent.

Infertility currently affects 7.3 million people in the USA. Of those struggling with infertility, 40 % of cases are attributed to male infertility, 35 % to female tubal factors, and 25 % attribute infertility to problems with female ovulation. At least 25 % of infertile couples have more than one factor causing infertility. Approximately 5–10 % of infertile couples will have no readily apparent cause for their infertility. With the help of assisted reproductive technology, millions of people have been able to have children and create families that they otherwise would not have conceived. With new scientific breakthroughs, however, medical professionals are now forced to reassess practice areas that have been set in stone for decades. This is why informed consent is so important to protect physicians from liability.

Keywords

Insurance Coverage Infertility Stake 

Notes

Acknowledgment

Danielle M. Austin is a law student at Fordham University School of Law. She is a summer clerk at the firm, Melissa B. Brisman, Esq., LLC, where she assists Ms. Brisman in the legal aspects involved in helping her clients start or expand their families.

References

  1. 1.
    Abma JC, Chandra A, Jones J, Mosher WD, Martinez GM. Fertility, family planning, and reproductive health of U.S. woman: data from the 2002 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat. 2005. http://www.cdc.gov/nchs/data/series/sr_23/sr23_019.pdf. Accessed 29 June 2010.
  2. 2.
    American Society for Reproductive Medicine. Infertility: an overview, a guide for patients. 2003. https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/infertility_overview.pdf. Accessed 15 July 2010.
  3. 3.
    Erickson TM, Erickson MT. What happens to embryos when a marriage dissolves? Embryo disposition and divorce. Wm Mitchell L Rev. 2009;35:469.Google Scholar
  4. 4.
    Reproductive Fertility Law Center. Informed consent documents at the IVF Clinic. 2010. http://blog.reproductivelawcenter.com/2010/02/17/informed-consent-documents-at-the-ivf-clinic/. Accessed 29 June 2011.
  5. 5.
    Papadimos TJ, Papadimos AT. The students and the ovum: the lack of autonomy and informed consent in trading genes for tuition. Reprod Biol Endocrinol. 2004;2:56. Citing: Beauchamp TL, Childress JF. In principles of biomedical ethics: respect for autonomy. 5th ed. New York: Oxford University Press;2011. p. 57–112.Google Scholar
  6. 6.
    Macklin R. Ethics, informed consent and assisted reproduction. J Assist Reprod Genet. 1995;12:404–90.CrossRefGoogle Scholar
  7. 7.
    Stoffard JC, Fox J. Egg donation consent forms. In: Seibel MM, Crockin SL, editors. Family building through egg and sperm donation. Sudbury: Jones and Bartlett Publishers, Inc; 1996. p. 159.Google Scholar
  8. 8.
    Stanford Psychiatry and Law Seminar. Competency to make medical decision. http://www.stanford.edu/group/psylawseminar/Competency.htm. Accessed 30 June 2011.
  9. 9.
    Atwell BL. Surrogacy and adoption: a case of ­incompatibility. Columbia Hum Rights Law Rev. 1988;20:1.Google Scholar
  10. 10.
    McDonald G. The physician-patient relationship, duty to obtain informed consent. In: California medical malpractice: law and practice. 2010;§2:11.Google Scholar
  11. 11.
    The New York State Task Force on Life and the Law. The Advisory Group on Assisted Reproductive Technologies and the State of New York Department of Health. Thinking of becoming an egg donor? 2002. http://www.health.ny.gov/publications/1127. Accessed 1 July 2011.
  12. 12.
    Johnson MA. Prototype egg donation contract with commentary. The American Surrogacy Center, Inc. 2000. http://surrogacy.com/legals/proeggdo.html. Accessed 29 June 2011.
  13. 13.
    Lawrence CC. Procreative liberty and the pre-embryo problem: developing a medical and legal framework to settle the disposition of frozen preembryos. Case W Res L Rev. 2002;52:721.Google Scholar
  14. 14.
    Society for Assisted Reproductive Medicine. Society for assisted reproductive technology releases latest clinical outcomes data; 56,778 children born from 2009 ART procedures. 2011. http://www/asrm/org/news/article.aspx?id=5701. Accessed 29 June 2011.
  15. 15.
    Neal EM. Protecting women: preserving autonomy in the commodification of motherhood. Wm Mary J Women Law. 2011;17:611–7.Google Scholar
  16. 16.
    American Society for Reproductive Medicine. Third party reproduction: sperm, egg, and embryo donation and surrogacy, a guide for patients. 2006. https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/thirdparty.pdf. Accessed 7 July 2011.
  17. 17.
    The New York State Task Force on Life and the Law. The Advisory Group on Assisted Reproductive Technologies and the State of New York Department of Health. Thinking of becoming an egg donor? 2002. http://www.health.ny.gov/publications/1127. Accessed 26 July 2011.
  18. 18.
    Association of American Medical Colleges. Explaining that somatic cell transfer describes a laboratory technique that involves removing the nucleus of an unfertilized egg cell, replacing it with the material from the nucleus of a “somatic cell” (skin, heart, or nerve cell for example), and stimulating this cell to begin dividing. http://www.aamc.org/advocacy/library/research/res0003.html. Accessed 29 June 2011.
  19. 19.
    The Practice Committee of the American Society for Reproductive Medicine. Repetitive oocyte donation. Fertil Steril. 2008;90:S194–5. https://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Committee_Opinions/Repetitive_oocyte.pdf. Accessed 21 July 2011.
  20. 20.
    Neal EM. Protecting women: preserving autonomy in the commodification of motherhood. Wm Mary J Women Law Spring. 2011;17:611–7.Google Scholar
  21. 21.
    Ethics Committee of the American Society for Reproductive Medicine. Interests, obligations, and rights of the donor in gamete donation. Fertil Steril. 2009;91:22–7. http://asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Ethics_Committee_Reports_and_Statements/interests_obligations_rights_of_donor.pdf. Accessed 10 July 2011.Google Scholar
  22. 22.
    Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology. 2008 guidelines for gamete and embryo donation: a practice committee report. Fertil Steril. 2008;90:S30–44. https://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Guidelines_and_Minimum_Standards/2008_Guidelines_for_gamete.pdf. Accessed 21 July 2011.
  23. 23.
    See Sample Donor Consent forms @ www.asrm.org.
  24. 24.
    Perdue AL. For love or money: an analysis of the contractual regulation of reproductive surrogacy. J Contemp Health Law Policy. 2011;27:279–300.PubMedGoogle Scholar
  25. 25.
    Lord RA. Surrogacy agreements. Williston on contracts West Publishing. (St. Paul, MN). 4th ed. 2011;7:§16:22.Google Scholar
  26. 26.
    American Society for Reproductive Medicine. Third party reproduction: sperm, egg, and embryo donation and surrogacy, a guide for patients. 2006;3. https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/thirdparty.pdf. Accessed 7 July 2011.
  27. 27.
    Watson JL. Growing a baby for sale or merely renting a womb: should surrogate mothers be compensated for their services? Whittier J Child Fam Advoc. 2007;6:529–31.Google Scholar
  28. 28.
    Nestle ME. Informed consent to nonmedicinal psychiatric treatment. Am J Proof Facts 2d. 2010;31–487.Google Scholar
  29. 29.
    Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology. Guidelines on number of embryos transferred. Fertil Steril. 2009;92:1518–9. https://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Guidelines_and_Minimum_Standards/Guidelines_on_number_of_embryos.pdf. Accessed 15 July 2011.Google Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.San MartinUSA
  2. 2.Reproductive PossibilitiesMontvaleUSA

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