GESTIÓN EN SALUD PÚBLICA: Defending donor anonymity. Incinerating babies. Commercial surrogacy.

Michael Cook
Editor
BioEdge

Hi there,

This week we've tried to give the gist of one of the most surprising arguments I've come across in a long time. Bioethicist Inmaculada De Melo-Martín contends in most recent issue of The Hastings Center Report that a ban on sperm and egg donor anonymity is misguided, unnecessary, socially harmful and "morally problematic": in short, unethical. (Read all about it here.)

It's quite a thought-provoking paper. IVF clinics defend donor anonymity on pragmatic grounds: unless donors are guaranteed anonymity, they are unlikely to donate. But I've never read a robust ethical defence.

Melo-Martín's central idea is that we construct our own lives; we are not condemned to act out a genetic script. So what can possibly be the problem if you are "a genetic orphan"? We have plenty of other resources - family, friends, society -- with which to build an identity. There is a germ of truth in this in this repudiation of genetic determinism. I may have a gene which predisposes me to like chocolate, but this does not condemn me to eke out a pitiable existence as a chocoholic.

But there's something more to this than meets the eye. The debate over donor anonymity hinges on the most fundamental issue in contemporary bioethics: what is the body for, anyway? Are we simply spirits "fastened to a dying animal", as W.B. Yeats wrote in "Sailing to Byzantium"? In that case, our burdensome bodies are of no great ethical significance. I think that Melo-Martín belongs to this school of thought. It's a kind of revival of Platonic dualism.

The more common sense Aristotelian view is that persons are somehow body and spirit, neither one nor the other, but both simultaneously. It's difficult to explain, but it corresponds to our experience. We do write our own script in life, but our genes are just as fundamental to our life experience. Without knowing our mother and father, we feel incomplete or at least we feel that something is lacking. In other words, our bodies are not something that we possess, but are an integral part of who we are. This week's story on surrogacy exemplifies this approach.

The dialogue between Platonism and Aristotelianism has been going on for about 24 centuries, so it's unlikely to be solved soon. But it's not merely an academic bunfight. As the controversy over donor anonymity shows, it continues to affect vital contemporary issues.

Cheers,