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Abstract

Increasingly, an individual or a couple raising a newborn child may not be biologically related to the child. The child may be conceived with donated gametes -- a donated egg or sperm or both. A surrogate may gestate the child. The couple may be same-sex. Although we are aware of these developments, we are failing to collect information about them that is vital for medical, public health, and social science research as well as for protecting human rights. Information drawn from birth records is crucial for research, but it is becoming less accurate and less useful as parents who are not biologically related to their children succeed in having their names listed as the child’s birth parents. Whether or not the intended parents’ names appear on birth certificates, the certificates fail to provide the children with a full account of their biological origins and their legal and social status. And the predecessor “certificates of live births” filled out by birth attendants fail to fulfill their traditional function of advancing medicine, public health, and social science. These failures represent serious losses for both the children and the society. The article examines the failures and makes an “immodest proposal” to separately document biological parentage, genetic and gestational, on one hand, and social and legal parentage on the other. This would promote a society that supports all families, while recognizing individuals as complex products of “nature and nurture.” Under the proposal, the confidential “certificate of live birth” prepared by birth attendants would be revised to include relevant information about all of an individual’s parents, biological and social. And the states would issue, in place of today’s birth certificate, a “certificate of parentage” that simply and truthfully documents the individual’s legal identity. The states would retain and make available to adult individuals upon request the more complete information recorded at birth, thereby respecting the needs and desires and advancing the rights of individuals conceived with donated gametes.

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