背景:近年来,一些司法管辖区提倡公开捐赠者的概念,尤其是那些实行身份释放捐赠的人。然而,在过去的10年中,关于披露决定的研究没有得到系统的整合,以审查父母是否在告诉他们,以及哪些因素可能会影响他们的决定。
目的:父母向他们的受孕孩子透露,在过去的10年中,哪些因素影响了他们在不同背景和家庭形式中的披露决定?
方法:英语参考书目搜索,在2012年至2022年间发表的来自7个数据库的同行评审期刊文章进行了研究.手动检查所包含文章中引用的参考文献以识别其他参考文献,并且还手动搜索引用所包含文章的参考文献。纳入标准是针对父母的文章(包括异性恋,单身母亲的选择,同性伴侣,和变性人)在两个司法管辖区都有或没有身份释放规定的捐赠者构思人。研究只关注代孕,捐助者,捐赠者构思的人,或医疗/生育人员被排除在外,以及无法分别提取供者-受者父母数据的研究也被排除在外.包括定量和定性研究。遵循系统评论和荟萃分析指南的首选报告项目,并使用JoannaBriggs研究所的系统评论关键评估工具来评估文章质量和偏见。
结果:37篇文章符合纳入标准,代表34项研究和4248名父母(包括异性恋,单身,同性,和变性父母,尽管大多数是异性恋)来自匿名捐赠的国家和具有身份释放规定的国家或随后颁布了这些规定的国家(澳大利亚,比利时,芬兰,法国,香港,中东,西班牙,瑞典,英国,和美国)在这些父母群体中注意到了披露的总体趋势,其中在10岁之前向其捐赠者受孕的孩子披露最多。Further,大多数还没有告诉的人,报告计划披露,尽管延迟决策也与整体披露较低有关。同性和单亲父母比异性恋父母更有可能披露信息。人们认识到披露是一个涉及正在进行的对话的过程,并且决策受到多个相互作用的内部人的影响,人际关系,以及外部背景和社会因素。方法的局限性,例如不同的人口群体和参与者的背景(包括那些选择不披露的父母可能不太可能参与研究),在整合调查结果时得到了认可。
结论:本综述加强了对解释父母的披露决定和研究探索立法规定的作用的理论模型的必要性,文化,和决策中的捐赠者/家庭类型。围绕披露信息获得更多持续的心理支持对于促进父母和家庭福祉可能很重要。
BACKGROUND: Disclosure of donor conception has been advocated in several jurisdictions in recent years, especially in those that practice identity-release donation. However, research on
disclosure decisions has not been consolidated systematically in the last 10 years to
review if parents are telling and what factors may be impacting their decisions.
OBJECTIVE: Are parents disclosing to their donor-conceived children, and what factors have influenced their disclosure decisions across different contexts and family forms in the last 10 years?
METHODS: A bibliographic search of English-language, peer-reviewed journal articles published between 2012 and 2022 from seven databases was undertaken. References cited in included articles were manually scrutinized to identify additional references and references that cited the included articles were also manually searched. Inclusion criteria were articles focused on parents (including heterosexual, single mothers by choice, same-sex couples, and transsexual) of donor-conceived persons in both jurisdictions with or without identity-release provisions. Studies focused solely on surrogacy, donors, donor-conceived persons, or medical/fertility staff were excluded as were studies where it was not possible to extract donor-recipient parents\' data separately. Both quantitative and qualitative studies were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed and Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews were used to assess article quality and bias.
RESULTS: Thirty-seven articles met the inclusion criteria representing 34 studies and 4248 parents (including heterosexual, single, same-sex, and transsexual parents although the majority were heterosexual) from countries with anonymous donation and those with identity-release provisions or who had subsequently enacted these provisions (Australia, Belgium, Finland, France, Hong Kong, Middle East, Spain, Sweden, the UK, and the USA) A general trend towards disclosure was noted across these groups of parents with most disclosing to their donor-conceived children before the age of 10 years. Further, the majority of those who had not yet told, reported planning to disclose, although delayed decisions were also associated with lower disclosure overall. Same-sex and single parents were more likely to disclose than heterosexual parents. There was recognition of disclosure as a process involving ongoing conversations and that decisions were impacted by multiple interacting intrapersonal, interpersonal, and external contextual and social factors. Methodological limitations, such as the different population groups and contexts from which participants were drawn (including that those parents who choose not to disclose may be less likely to participate in research), are acknowledged in integrating findings.
CONCLUSIONS: This
review has reinforced the need for a theoretical model to explain parents\'
disclosure decisions and research exploring the role of legislative provisions, culture, and donor/family type in decision-making. Greater ongoing access to psychological support around disclosure may be important to promote parent and family well-being.