From the Globe and Mail, By CAROLYN ABRAHAM, Saturday, December 14,
2002 - Print Edition, Page F1:Mommy's little secret
As we gather to mark the festive season, here's one juicy morsel
mom won't be dishing up: that guy you call your dad may not be. DNA
testing has revolutionized medical science, CAROLYN ABRAHAM
reports, but it also has uncovered the myth of female monogamy. Now
doctors are wondering how to break the news to men
They came to the hospital together, a husband, a wife and the
little daughter they feared had been cursed by inheritance. Since
birth, she had struggled to breathe, and all the signs pointed to
cystic fibrosis.
If the girl truly had the incurable disease that clogs the lungs,
she had to have received two copies of a CF gene, one from each
parent. Tests at the Hospital for Sick Children in Toronto
confirmed the family's worst fears -- and then some.
The girl was indeed afflicted. Her mom carried one of the culprit
genes. But her dad, the doctors discovered, was quite a different
story. His DNA showed no sign of a CF gene, which means he is not a
carrier and he is not her dad.
Hospital staff have felt bound to keep the secret from him. But
when they told the mom, it came as no surprise; it rarely does. "It
is probably true in a lot of families, that daddy is not who you
think it is," says Steve Scherer, a senior scientist in department
of genetics at the Hospital for Sick Children.
As families gather this festive season, here is a spicy fact that
mothers might be loath to dish out at the holiday table: It's now
widely accepted among those who work in genetics that roughly 10
per cent of us are not fathered by the man we believe to be dad.
Geneticists have stumbled upon this phenomenon in the course of
conducting large population studies and hunting for genes that
cause diseases such as cystic fibrosis. They find full siblings to
be half-siblings, fathers who are genetic strangers to more than
one of their children and uncles who are much closer to their
nieces and nephews than anyone might guess. Lumped under the
heading of "pedigree errors," these so-called mis-paternities,
false paternities and non-paternities are all science jargon for
the unwitting number of us who are chips off someone else's block.
The proverbial postman seems to be ringing twice in everyone's
neighbourhood. Non-paternity is believed to cut across all
socio-economic classes and many cultures. Factor it into
genealogical attempts to trace ancestry and it can snap entire
branches from a family tree. Considered in light of long-held views
about sexual behaviour, it exposes the myth of female monogamy and
utterly shakes the assumption that women are biologically driven to
single-mate bliss.
The widespread use of DNA analysis has presented science and
society with all sorts of new ethical problems, and now it's
pulling this naked truth out of the closet and into the courtroom.
Men who call themselves "Duped Dads" are looking for legal redress
to protect themselves against paternity fraud, raising questions
about the definition of fatherhood. Several U.S. states are
considering legislation that could exempt non-biological fathers
from having to pay child support.
Even the most learned among us are grappling with the implications.
Last month, the 10-per-cent non-paternity rate was cited during a
science seminar for judges in Halifax.
"The judges were just shocked; they really couldn't get over how
many people this would affect," Dr. Scherer said. "They kept saying
things about all those poor people who might be misled -- never
realizing that one of them might actually be among them!"
The notion of a woman carrying the child of someone other than her
partner is older than the Christmas story itself. No geneticist
believes non-paternity to be purely the product of modern
immorality; they have been tripping over the infidelities of
earlier generations for decades. Cheryl Shuman, director of genetic
counseling at the Hospital for Sick Children, said that 15 years
ago, when genetic tests were less powerful, researchers had to draw
blood from a child, his or her parents and both sets of
grandparents. "Sometimes we'd get a call from the grandmother, and
she'd say, 'Listen, my son, or my daughter, doesn't know that their
father is not their real father. . . .'" In the interests of
maintaining family peace, Ms. Shuman said, the tests would be
dismissed as "uninformative."
Over the years, the hospital has relied on the advice of lawyers
and ethicists to develop policies for handling the situation. For
example, its consent form now warns what a genetic test can reveal.
Parents "will sometimes giggle in the waiting room when they read
the paragraph about non-paternity," Ms. Shuman said. "But then we
get the phone call later, forewarning us as to what we might find."
When a test disqualifies a father, "most women do express some
surprise, but then there is a resignation, or an acceptance that
they were kind of half anticipating this was going to happen. But
then all this is followed very quickly by panic and questions as to
whether or not we will betray their confidentiality."
If the case involves an expectant mother, Ms. Shuman explained, the
hospital's legal obligation is clear: The developing baby is
considered part of the mother and the results of the tests
therefore belong to her.
After birth, the course of action is less clear, she said, but
lawyers advise that the child is to be considered the patient,
whose needs trump those of the parents. Since telling the father
could trigger a breakup and leave the child without proper support,
the hospital keeps the secret. Sometimes it can be a whopper.
In one family with four daughters, the DNA analysis was so
surprising that counselors asked the mother to explain. "It turned
out that the daughters had three different fathers," said Peter
Ray, a scientist at the hospital. "We cannot make any conclusions
based on the family structures as they are presented to us."
In the research world, when scientists come across a father in a
mismatched family, they toss the sample. If pedigree errors are not
caught, Dr. Scherer said, they can wreak statistical havoc with a
study: "People have made careers designing software to catch these
kinds of things."
Sample mix-ups can skew results, as can an extremely rare condition
discovered in 1989 in which a child inherits two copies of the same
chromosome from one parent, obscuring the contribution of the
other. But as the number of gene hunts and diagnostic tests has
grown and grown, the leading cause of these anomalies has proved to
be mistaken fatherhood. Some peg the range at 5 to 10 per cent;
others, such as Jeanette Papp of the University of California at
Los Angeles, feel that 15 per cent is reasonable for the Western
world, even if there is no hard evidence. "It's hard to do studies
on these things for ethical reasons," says Dr. Papp, director of
genotyping and sequencing in UCLA's department of human genetics.
"I mean, how do you tell people what you're really looking for?"
A British survey conducted between 1988 and 1996 by Robin Baker, a
former professor at the University of Manchester, confirmed the
10-per-cent figure. That seems high to skeptics such as Dalhousie
University geneticist Paul Neumann, although even he admitted that
"my colleague, who's a woman, tells me women have no trouble
believing it. . It's the men who can't."
Bernard Dickens, a specialist in health law and policy at the
University of Toronto, said that in another British example, the
non-paternity rate was three times that.
In the early 1970s, a school teacher in southern England assigned a
class science project in which his students were to find out the
blood types of their parents. The students were then to use this
information to deduce their own blood types (because a gene from
each parent determines your blood type, in most instances only a
certain number of combinations are possible). Instead, 30 per cent
of the students discovered their dads were not their biological
fathers.
"The classroom was, of course, not the ideal place to find out this
information," said Prof. Dickens, who is often consulted on ethical
issues by geneticists at the Hospital for Sick Children.
He feels, as do many researchers, that culture can determine
whether false paternity is very high or very low. For example, in
Muslim Egypt, the integrity of lineage is so important that neither
sperm or egg donation nor adoption is permitted, let alone sexual
indiscretion. But false paternity causes obvious problems for
anyone who values a clear pedigree and makes it a statistical
impossibility to trace the true identity of our ancestors back more
than a few generations.
Robert Moyzis, a molecular geneticist at the University of
California at Irvine, recently had to break this news to a friend
who had spent considerable energy and resources compiling a family
history that stretched back 1,000 years. "I had to plug the numbers
into a computer model and prove it to him. The chances that he was
related to the ancestor he thought were zero."
Logistically, it may seem that only men are naturally programmed
for multiple partners. After all, they can produce sperm by the
thousands 24 hours a day, seven days a week, and do it well into
their retirement years. Women, on the other hand, are limited to
the eggs they were born with, maturing one a month and not much
past their fourth decade of life. The precious few shots that women
have at reproduction may drive them to seek the best mate for
prospective offspring -- though the decision might be wholly
unconscious.
This notion is bolstered by the "sperm wars" theory, in which
Britain's Dr. Baker has noted that sperm of two different men can
effectively battle over the spoils of fertilizing the egg in a
woman's reproductive tract.
In 1999, a questionnaire in Britain found that most women tended to
be unfaithful to their long-term partners around the time they were
most fertile. That same year, researchers at St. Andrew's
University in Scotland concluded that women seem to desire
different types of men at different times of the month. When they
are most likely to conceive, they are attracted to men who have
very masculine features, preferring more feminine men when they are
not ovulating.
The researchers suggested that women may subconsciously feel that
beefy men may make a better biological contribution to a baby, but
softer features may signal a better father.
And strangers may have a biological advantage. "There is actually
data from Britain," said sexual-behaviour expert Judith Lipton,
"that suggests a woman may be more likely to conceive with a fresh
partner because a woman can essentially develop antibodies against
her regular partner's sperm, so that she may be more likely to be
impregnated by fresh sperm."
Between 30 and 50 per cent of women cheat on their partners,
compared with 50 to 80 per cent of men, said Dr. Lipton, a
psychiatrist with the Swedish Medical Center in Washington who last
year co-wrote The Myth of Monogamy with her husband, David Barash.
"This jibes with the idea that as many as 10 per cent of these
relations may result in pregnancy," she said, explaining that women
may cheat as an escape from a bad marriage, for revenge on a
cheating partner, to find a better provider, or just for fun. All
this messing around might have been predicted by animal behaviour,
but it has been only recently that researchers learned just how
hard faithful females are to find in any species.
Dr. Barash, a zoologist and professor of psychology at the
University of Washington, explained that while it was generally
known that most mammals are rarely monogamous, certain species were
held up as paragons of virtue. Scientists believed, for example,
fidelity was definitely for the birds. "But not even the swans are
monogamous, and they were the poster children for monogamy. Despite
their waterfront property, they still sneak around with the
neighbours."
With the 1980s advent of DNA fingerprinting, a quick molecular test
that, among other things, tells scientists whether two creatures
are genetically related, researchers have realized social monogamy
has little bearing on sexual monogamy in the animal kingdom. "A lot
of hanky-panky goes on even if two creatures set up house
together," Dr. Barash said.
Despite thousands of hours of observation, birds managed to fool
not only their mates into thinking they were faithful, but their
observers. Yet DNA tests show that 10 to 50 per cent of birds are
fathered by a male other than the one sharing the nest.
"We always knew the possibility was there for males to be available
and receptive to EPC -- extra-pair copulation -- but what was not
known was that the mated females would do the same thing," Dr.
Barash said.
In part, researchers figured females would be deterred from
cheating since they had more to lose than a male by fooling around
-- their mate might stop foraging to feed the hungry offspring,
cutting off the animal equivalent of child support, or worse, turn
violent. Yet this, he said, seems only to have inspired females to
perfect the art of secrecy and deception: They persistently sneak
off in search of stronger genes, better feeding grounds, good
providers and protectors.
These trysts may have been overlooked, said Frances Burton, an
anthropologist at the University of Toronto, because the
researchers were often male. "There is a weird double feedback
thing that goes on when it comes to observing animals, particularly
non-human primates. We impose upon the observations human
prejudices . . . it can obfuscate whatever truth there is."
Even the fact that female animals actually derive enjoyment from
copulation wasn't fully accepted until 1971, when Prof. Burton
showed that female monkeys stimulated with an electric toothbrush
did in fact reach orgasm. "Though they rarely did with male
monkeys," she added, "because the males did not engage them for
long enough periods."
Now the hope that fidelity is compatible with wildlife has all but
vanished. DNA testing is crossing one species after another off the
list. Of 4,000 mammalian species, only 3 per cent are still
considered candidates. Birds, bees, snails, snakes, fish, frogs . .
. not even mites are monogamous. You have slide well down the food
chain before Dr. Barash will put his monëy on a contender:
Diplozoon paradoxum,a parasitic flatworm found in the gills of
freshwater fish. The first time two worms mate, their bodies are
fused together for life.
None of this should imply that humans are incapable of monogamy, he
added. "Saying something is natural is often used to justify
unacceptable behaviour. It's natural to poop on the floor, but we
spend a lot of time becoming house broken."
His wife, however, said the moral transgression of infidelity
cannot compare with the deception of lying about paternity. She
thinks paternity fraud should be considered a crime of the highest
order.
"Reproductive deception is morally similar to rape," Dr. Lipton
said. "If you trick someone into raising a baby not his own, and he
puts 20 years of his life into an endeavor based on a falsehood,
that is appalling. "If I were the queen of the world, birth
control, of any form, would be available to any woman who wants it
and DNA testing would be available for all the men so that they
would know who their babies are."
There are certainly those -- the "Duped Dads" among them -- who
would agree with her.
Morgan Wise remembers how in 1999 the doctor rose from his chair,
walked around the desk and sat down in front of him. Mr. Wise's
youngest son had been diagnosed with cystic fibrosis years earlier,
but a medical test showed Mr. Wise did not carry a CF gene. "My
first thought was that they must have misdiagnosed my son," the
40-year-old railway engineer from Big Spring, Tex., said in an
interview this week. But then the doctor looked him squarely in the
eye and said: "Morgan, do you have any reason to think this boy
might not be yours?"
The possibility seemed outlandish. He had been married to the same
woman for 13 years and they had had three boys and a girl before
they broke up in 1996. But for peace of mind, he decided to go
ahead with paternity tests. In March, 1999, the results arrived by
mail -- a creased piece of paper telling him that not one of the
three boys was his.
"I felt anger toward [my first wife] and sadness, and I felt so
sorry for my kids," Mr. Wise recalled. "I told my boys, 'I love you
all, you'll always be my sons, the only difference is now I'm not
your birth father.' " Despite this revelation, a district court
judge ruled that Mr. Wise had to continue paying child support for
the three boys. Based on a 500-year-old common law, most states
operate on the presumption that a husband is the father of any
child born to his wife during a marriage.
Mr. Wise took his case to the media, hoping to generate political
support and contact other men in a similar situation. Instead, he
angered the judge, who revoked his visitation rights to the
children but left him responsible for $1,100 (U.S.) in monthly
support. "This," Mr. Wise warned, "could happen to anyone."
The Wise verdict has become a flash-point for men who discover that
their children are not their own. Many are actually eager to find
out, ordering paternity kits over the Internet. (The American
Association of Blood Banks reports that 30 per cent of men who
suspect they are not biological fathers are right.)
Men have set up support groups and begun to lobby to change what
they see as archaic laws. Three states have bills pending that
would take paternity fraud into account and at least three others
have already passed similar legislation.
The Wise case also has focused legal minds and ethicists on the
definition of fatherhood, and the prevailing view appears to be
that dad is the man who reads you bedtime stories, not necessarily
the man who shares your DNA.
In Canada, there has been no case in point. But Prof. Dickens at U
of T said a recent ruling suggests that Canadian courts would
discount DNA evidence over the best interests of the child. A few
years ago, he said, a man tried to win visitation rights for a
child he believed he had fathered with a woman who had since
married someone else.
The court ruled that the former boyfriend's biological contribution
did not outweigh the risks of compromising the bond the child had
forged with the mother's husband. "If you have acted in a
father-like way toward a child, then you are the father," Prof.
Dickens said. "Fatherhood is a social reality, not a genetic
reality."
He firmly believes that people who undergo genetic tests to find
out about paternity are entitled to such information. But those
being tested for a genetic ailment or some other inherited trait
cannot expect the same: "It's not for geneticists to spring this
information upon them. The point is, when you are testing for a
particular trait, it's either there or it's not there, and there is
no need to say why it is or why it isn't."
Some fathers, of course, feel differently. Stacy Robb, founder and
president of the support group DADS Canada, said that "it's unfair
because the doctors come across this information and they don't
tell the man listed as the father on the birth certificate. It's a
disregarding of men's rights. The point is mothers and fathers are
not treated equally."
And as the staff at Hospital for Sick Children are learning,
keeping secrets can backfire. In one case, a father who tested
negative for a gene that his sick child had inherited wrongly
believes himself to be both a carrier of a genetic disorder and the
child's natural father. Ms. Shuman said counselors have never told
him otherwise, even after his marriage broke up. But recently, he
contacted the hospital again to say he has a new partner and wants
to come in for further testing. He assumes that any child produced
in his new relationship also may be at risk.
Telling him there is no rïsk would reveal the truth about his first
child. Going ahead with the test denies him the truth about his own
DNA. Prof. Dickens suggests testing the new partner. If she turns
out to be a non-carrier, there is no need of further discussion.
But Ms. Shuman said that also may leave counselors with some
unwanted "moral residue."
"He hasn't come back in yet," she added, "but we may have to reveal
the results . . . It all gets messier than you might think. Welcome
to my ethically charged world."
Carolyn Abraham is The Globe and Mail's medical reporter.
- ATOM
