12 July 1999
To: Persons Responsible at HFEA Licensed Clinics and HFEA Inspectors
Date: 12th July 1999
STANDARD PATIENT INFORMATION
Part 4 of the HFEA's Code of Practice requires centres to cover certain issues in their patient literature. While much of this information is centre specific, there are subjects that are generally applicable.
A number of clinics have suggested that it would be useful for the HFEA to produce standard texts explaining these subjects that they could, if they so wish, reproduce in their literature. In response to this the HFEA has developed the following material that your clinic may wish to use all or in part. Copies of these texts are attached. They can also be found on the HFEA website, www.hfea.gov.uk.
- Welfare of the child
- Consent to storage and use of gametes
- Parental responsibility
- The HFEA register
I would like to stress that the use of these texts is not compulsory. They have simply been produced for your convenience. I hope that you will find them helpful.
Welfare of the Child
The Human Fertilisation and Embryology Act (1990) requires that the welfare of the child must be taken into account before any treatment can commence at a licensed centre. This includes the welfare of any child born as a result of the treatment (including the need of that child for a father), and of any other existing child who may be affected by the birth.
Many factors need to be taken into consideration in this assessment including who would be legally responsible for any child born as a result of treatment, and who it is intended will be bringing up the child.
People seeking treatment are entitled to a fair and unprejudiced assessment of their situation and needs. This is conducted with skill and sensitivity appropriate to the delicacy of the case and the wishes and feelings of those involved. The HFE Act does not exclude any category of woman from being considered for treatment. However, in situations where the child will have no legal father the clinic will pay particular attention to the prospective mother's ability to meet the child's needs throughout childhood. Where appropriate, the clinic will consider whether there is anyone else within the prospective mother's family and social circle willing and able to share the responsibility for meeting those needs, and for bringing up, maintaining and caring for the child.
The assessment will involve the centre taking a detailed medical and social history covering:
- Your commitment to having and bringing up a child/children
- Your ability to provide a stable and supportive environment for any child produced as a result of treatment
- Your medical histories and the medical histories of the families
- Your health and consequent future ability to look after or provide for a child's needs
- Your ages and likely future ability to look after or provide for a child's needs
- Your ability to meet the needs of any child or children who may be born as a result of treatment, including the implications of any possible multiple births
- Any risk of harm to the child or children who may be born, including the risk of inherited disorders or transmissible diseases, problems during pregnancy and of neglect or abuse
- The effect of a new baby or babies upon any existing child of the family
In addition, where treatment involves the use of donated gametes, the following will be taken into account:
- A child's potential need to know about their origins and whether or not the prospective parents are prepared for
- the questions which may arise while the child is growing up
- The possible attitudes of other members of the family towards the child, and towards their status in the family
- The implications for the welfare of the child if the donor is personally known within the child's family and social circle
- Any possibility known to the centre of a dispute about the legal fatherhood of the child
The centre is also required to satisfy itself that the GP of each prospective parent knows of no reason why either might not be suitable for the treatment to be offered. GPs will be asked to provide factual information, medical or otherwise that might have implications for the health or welfare of any resulting child. Written consent will be sought before any contact with a GP is made. This should be given after discussion about these issues and prior reading of the letter/questionnaire that will be sent to the GPs. However, failure to give consent will be a factor that may be taken into account in considering whether or not to offer treatment.
If any of these inquiries give cause for concern, the centre will make further inquiries of any relevant individual, authority or agency as it can. Again, consent will be sought before any contact with these bodies is made. However, failure to give consent will be a factor that may be taken into account in considering whether or not to offer treatment.
The clinician responsible for administering the fertility treatment is responsible for making the final decision about whether or not treatment will be offered. Treatment may be refused on clinical grounds or, if the centre believes that it would not be in the interests of any resulting child, or any child already existing, to provide treatment, or is unable to obtain sufficient information or advice to reach a proper conclusion.
If treatment is refused for any reason, the centre should explain the reasons for this and the factors, if any, which may persuade the centre to reverse its decision. It should also explain the options that remain open and where counselling can be obtained.
The HFEA keeps a confidential register of information about donors, patients and treatments. This register was set up on 1st August 1991 and therefore contains information concerning children conceived from licensed treatments from that date onwards.
As from the year 2008, people aged 16+ (if contemplating marriage) or 18, who ask the HFEA, will be told whether or not they were born as a result of licensed assisted conception treatment, and if so, whether they are related to the person they want to marry.
As the law now stands no information about patients, their children and donors will be given out by the Authority, under any circumstances other than those outlined above. The names of the children are not collected. The current law does not allow people who apply for information from the register to know the identity of current or past donors*, or of patients and their children. It is a criminal offence to disclose that information.
The kind of information the Authority now collects relates to a donor's appearance, interests and occupation. In the future, Parliament might decide that adults who contact the Authority and learn that they were born as a result of treatment using a donor might be given some non-identifying details about that donor. However, the law as it presently stands and the HFE Act (1990) forbids the names of current and past donors from being disclosed.
* An exception would be if the child was born with a disability as a result of a donor's failure to disclose inherited disease. If they were to sue a clinic for damages, a court might require the HFEA to disclose the donor's identity under the Congenital Disabilities (Civil Liabilities) Act 1976.
Consent to the Storage and Use of Gametes
In all cases, people giving consent to the storage and/or use of their gametes or embryos produced from them may vary or withdraw their consent at any time up until the time that the genetic material has been introduced into the patient i.e:
- The semen has been used for insemination
- In GIFT with donor eggs, the eggs have been placed in the fallopian tubes
- The embryos have been replaced
Where an unmarried couple is being treated, the male partner will not have 'parental responsibility'. Parental responsibility is defined by the Children Act 1989 as 6all the rights, duties, powers, responsibilities and authority which by law a parent of the child has in relation to the child and his property'. Section two of the Act states:
1. Where a child's father and mother were married to each other at the time of his birth, they shall each have parental responsibility for the child.
2. Where a child's father and mother were not married to each other at the time of his birth -
a. The mother shall have parental responsibility for the child.
b. The father shall not have parental responsibility for the child, unless he acquires it in accordance with the provisions of the Act.
Unmarried couples are therefore recommended to seek their own legal advice about the male partner's rights and responsibilities in relation to the potential child who may be born as a result of the treatment.
(The Government intend to amend the Children Act 1989 so that an unmarried father who registers his child's birth jointly with the mother will acquire parental responsibility without further formality.)
Page last updated: 17 August 2012