ABSTRACT
To investigate why men offer sperm donation via the internet, a questionnaire was disseminated via 39 Dutch-language websites thought to be visited by potential sperm donors. Nine internet donors completed the survey, men who typically knew the women they were donating to. Their responses were compared with those of a control group of 35 general sperm bank donors who were recruited using flyers in Dutch sperm banks, and who were typically unaware of the identity of the eventual recipients. The findings shed light on the motives and attitudes of internet donors. Both groups of donors indicated that their primary motivation for donating was altruism (>80% of all respondents). However, internet donors had a more pronounced desire to procreate than sperm bank donors (6 out of 9, i.e. 66 vs. 22%, respectively) and more often felt that they had good genes they wished to pass on (5 out of 9, i.e. 55 vs. 31%, respectively). The main reason internet donors gave for donating via the internet was that they wanted to know the prospective parents and be kept up to date on the progress of the offspring conceived from their donations. This distinguishes them significantly from sperm bank donors. A further finding was that they were not prompted to avoid the formal donation circuit for which, by law in the Netherlands, pregnancies resulting from donations have to be registered in a central database. This study is subject to several, in some cases inevitable, limitations, but it provides an interesting starting point that future studies can seek to confirm and extend.
ABSTRACT
OBJECTIVE: To assess how the laws pertaining to the mentally incompetent and their guardians relate to each other and how these topics are handled in daily practice. DESIGN: Structured interviews. METHOD: We administered a questionnaire to healthcare providers and patient guardians in four sectors: care for mentally disabled, nursing home care, psychiatry and intensive care. The topics discussed during the interviews were mental incompetence, advance directives, representation, resistance, and complaint and conflict resolution. For further exploration of the results, we presented these to focus groups in three sectors. We received written comments from several experts of the intensive care sector. RESULTS: Most healthcare providers' initial assumption was that the assessment of mental competence should be more thorough when the treatment is more drastic. The healthcare providers were unenlightened on matters concerning the tasks and authority of patient guardians. This sometimes created tension when their opinions deviated from those of the guardians. It was notable that guardians of mentally incompetent patients in intensive care perceived themselves to be most informed. There is indeed frequent consultation with relatives or guardians in the intensive care unit; however, they are hardly ever asked to participate in decision making. CONCLUSION: There is much ambiguousness on issues relating to mental incompetence and representation among healthcare providers. According to the legislation, reconstructing the will of the patient or client is paramount. Guardians should be involved in establishing mental incompetence and in decisions about treatment, care and research. Advance directives also play an important role. This study has resulted in recommendations on legislation, self-regulation and daily practice.
