Response to Walker and Broderick from the Australian and New Zealand Infertility

Counsellors’ Association JENNY BLOOD

Australian and New Zealand Infertility Counsellors Association

nfertility counsellors explore with couples and donors the many implications of medical intervention that they may I choose to access. One of the implications explored is the

issue of disclosure or non-disclosure of a donor conception. Infertility counsellors acknowledge the need for sound research in this area, but until reliable studies are conducted counsellors will continue to work professionally in the context of all information that is currently available to them, from parents, donors and donor offspring.

The Australian and New Zealand Infertility Counsellors Association Incorporated (ANZICA) is an organisation whose membership of psychologists and social workers have a broad and extensive clinical experience in the area of infertility. As an association, we were very concerned to read the article by Walker and Broderick (1999).

We believe this article does not represent the current state of infertility counselling in Australia and New Zealand, and that the authors’ case is simplistic and based on unsubstantiated assumptions. The references they used to support their hypothesis represent the views of particular researchers; they are not current references and it should not be assumed that their views translate into current practice. It would have been far more useful to have sought accurate data directly from the counsellors concerned rather than make assumptions based on outdated information.

The purpose of this response is therefore to describe current practice in Australia and New Zealand. To suggest that couples and donors are “compelled” to have counselling misrepresents the situation. Couples wishing to access treatment within Australia and New Zealand are required under the guidelines of the Reproductive Technology Accreditation Committee to see a counsellor; this, however, is not an assessment (as Walker and Broderick imply) nor is it therapeutic counselling (unless requested by the couple), but an opportunity to explore with the couple and the donors the psychological, emotional, social, and legal implications of the medical intervention that they are considering undertaking.

Counsellors in this area do not claim that the couples they see have psychological problems, as suggested by

Walker and Broderick (1999); rather, they are couples who are faced with the significant life crisis of loss of reproduc- tive choice and control. As couples, they can make their own decisions about infertility treatment, the use of donor gametes, and the issue of disclosure. Infertile couples do not need advice on what they should do; rather, they have the right to make their own autonomous decisions, based on good, reliable information and free from the influence of others. The counsellors’ role is to facilitate, through consid- eration of all aspects of family values, the individuals’ rights to self-determination for themselves and their families.

The issues of disclosure or nondisclosure are not dealt with in isolation; they are a part of the exploration of the impact of the infertility and the decision-making associated with it. The impact of disclosure on the offspring and the family as a whole is, as Walker and Broderick suggest, unclear. Little research has been conducted in this particular area; however, to claim from one study with a “reasonable” response rate that the views of all donors and recipients have been represented is dangerous. This study was conducted at a particular point in time and in a particular community, and may not represent the views of other donors and recipients. It certainly does not represent the offspring, whose voices - it must be acknowledged - we may currently have difficulty hearing, but this should not mean that they are totally ignored as irrelevant to the debate.

Although the data are not generally published, counsel- lors do have inquiries from parents, offspring, and donors seeking information; the clinical experience is that some individuals do want to know about the other people involved in the creation of a particular family. Thus, although initially it is the infertile couple who are the client, in time their offspring may also present for counselling, requiring good information and an opportunity to explore the implications of their parents’ decision to use donor material. At all times, the counsellor must balance the needs and rights of all parties involved in the conception, and to place all individuals in the context of the family relationships that necessarily arise from the decision to use donor gametes.

Counsellors see the human face of the offspring who present for information about their genetic heritage, and the human face of couples proceeding with treatment in States where registers exist; and they are aware of the social activi-

Address for correspondence: Jenny Blood, President, ANZICA, c/- Reproductive Biology Unit, Royal Women’s Hospital, 132 Grattan Street, Carlton VIC 5053, Australia.

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RESPONSE TO WALKER AND BRODERICK FROM THE AUSTRALIAN AND NEW ZEALAND INFERTILITY COUNSELLORS’ ASSOCIATION

the case, and we find it repugnant that such a statement can be made with no knowledge of the current practice in Australia and New Zealand nor any attempt to ascertain the particular practices of psychologists and other counsellors working in this area. As an organisation, we welcome reliable and sound research in this area, but until such time as this occurs, we work with the couples, the donors, and the offspring to ensure that their requests are met in the context of good professional practice and standards.

1 References Baran, A,, & Pannor, R. (1993). Lethal secrets: The psychology of

donor insemination, New York Amistad. Walker, I., & Broderick, P. (1999). The psychology of assisted

reproduction - or psychology assisting its reproduction? Australian Psychologist, 34. 3 8 4 .

ties and advocacy of the Donor Conception Support Group. All this suggests that we do not only see individuals with problems, as the authors suggest, but families who are living with the experience of raising their children. Counsellors in this area recognise the danger of anecdotal evidence such as that described in Lethal Secrets (Baran & Pannor, 1993; again a dated publication) and place little weight on it. But equally, until good research is possible, it would be irrespon- sible and arrogant not to listen to and learn from the couples we meet and their children, whose story is yet to be told.

As an organisation representing psychologists working in the area of infertility counselling, we refute the accusa- tion that psychologists “have also sought for their profes- sion a position of moral judge of others’ fitness to be parents” (Walker and Broderick, 1999, p. 42). This is not

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