Anonymous donation assumed children would never know. Long before Parliament sanctioned anonymous donation, doctors recruiting sperm donors offered them anonymity. They saw this as a simple contract between the donor and the potential parents where the doctor acted as broker. All parties would want secrecy because of the perceived stigma of infertility and the presumed desire of the donor for lack of legal/financial or other involvement. No one thought about the effect on or the rights of the people so conceived because it was assumed they would never know the truth about their origins. Now that people conceived through donor insemination will in growing numbers know about their origins, either because their parents tell them or because they take advantage of their right to consult the HFEA register, the assumption underlying the offer to donors and parents of anonymity is no longer valid. We have a changed world.

The Donor Conception Network contains members with a spectrum of views on the issue of the lifting of donor anonymity, and what follows is our own personal view. Donation is a responsible act - with lifelong consequences Gamete donation is a responsible act. It carries great responsibilities. It has long term consequences. The fact that a donor is or may be acting altruistically to help others does not diminish the responsibility. If a donor has been wilfully careless about his or her medical history and a child is born with an inherited disability, that person can sue the donor, regardless of the donor's motives. Not just an event that can be forgotten A donor will have a special and indisputable link to any person born as a result of his or her donation. A donor is not merely helping a childless couple to conceive a longed for baby, but assisting in the creation of a person who will become first a young child, then a teenager, then a young adult, and eventually a parent and grandparent. Gamete donation is not just an event that happens and is then over and can be forgotten about. It is a process that has a lifelong effect on the families involved - on the present or future family of the donor, on the recipient family, and that of the person born. This lifelong responsibility does not of course include parenting the child or financial responsibility.

Comparison with adoption The person born and his or her family will have the same needs as other individuals and their families. That range of needs may include the need to know about their genetic history. It was once believed that adopted people would not want or need information about their birth parents. We now know that it is normal and healthy for adopted people to want access to information about their genetic origins, and the law has given them that right, whether they decide to make use of it or not. Most do not, but depriving them of the right was seen as unjust. Similarly it can be expected that a minority of those people conceived with the assistance of donor gametes will want to access to origins information.

What justifies relieving donors of accountability for their actions? The general rule is that people are morally and legally accountable for the consequences of actions for which they bear responsibility. Although anonymous donation of sperm has grown to be the norm, there are few if any other examples of responsible acts that carry long term consequences involving other people where the responsible party is guaranteed anonymity for life and almost total absolution from that responsibility.

So the right question to be asked is why donors need or seek anonymity and how it can be justified. In the ethical debate the onus is on those who seek to maintain anonymity as to how they can justify it.

Would donors refuse to donate?
It is often said that without anonymity donors would never donate. If this were indisputably true, it would at least be the beginning of a justification. But there is some suspicion that, just as it was said that payment to donors was essential to recruitment, the truer statement is that it is more difficult, more time consuming and more resource intensive to recruit donors who are willing to be identified and do not want to be paid. But it is difficult to distinguish cause and effect. Donors attracted by the escape from responsibility offered by anonymity may be encouraged to think less responsibly.

Should donors who cannot cope with consequences be donating? If potential donors do not want to accept the long term consequences of their donation, is this because they are currently encouraged to think this way - that their act is a simple, uncomplicated and unconnected one with no consequences? Are they told that many of the people born from their gametes both will know that they have been conceived in this way, and also that they may one day feel a strong need find out about them? Or are they constantly assured that their act, while helping others, carries no long term consequences. Little is reported in the research about the attitudes and feelings of donors. Most are still students and people in low paid employment doing it for the money. Many keep the fact of their donation a secret from those close to them - their parents and friends, a sure indicator that they see this as having nothing to do with others. How will these donors feel when they have children of their own? Potential donors who cannot cope with the possibility of long term consequences, should not be donating. Donors should instead be recruited from among those who have already had at least one child, and can understand what a parent/child relationship is like, and are prepared for their identities to be known to the people conceived as a result of their gamete donations.

Changing the culture of donor recruitment will take some time and we will not arrive there overnight. We must avoid turning donor insemination from what is currently a safe procedure carried out under regulated conditions into a back-street underground trade. But respect for the autonomy of those born as a result of conception with donated gametes will lead us to a changed world in which lying, deceit and secrets have no part.