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FROM THE EDITOR

Hi there,

The word bioethics seldom crops up in Google News searches, but this week it was in flashing lights. The US Presidential Commission for the Study of Bioethical Issues had released a preliminary report into abuses by American public health doctors in Guatemala in the late 1940s. The shocking story was came to light last year: doctors deliberately infected hundreds of soldiers and psychiatric patients and others with venereal diseases without their consent. Some died.

How could this have happened? It took place only a few years after Nazi doctors were tried for similar offences, so there was no excuse for ignorance of the notion of “informed consent”. “The attitude toward the Guatemalan people was pretty much what you’d expect if they were doing research on rabbits,” says John Arras, of the University of Virginia, a bioethicist on the Commission.

Could such abuses happen again? That’s the big question. In one sense, the field of bioethics exists to ensure that it won’t. There are allegations that clinical trials are outsourced to the developing world to escape strict protocols for informed consent. A film has even been made about this – The Constant Gardener. These need to be investigated.

But one area that gets very little attention is the ethics of assisted reproduction. Below you will find news about egg freezing, which the British Fertility Society regards as ethical. But have its effects on children been tested? Surely these have to be considered, not just its effects upon women. Intracytoplasmic sperm injection is a technique which has become a mainstay of IVF. Yet it was never clinically trialled. Now it appears that there is a higher incidence of birth defects in ICSI babies. A generation hence, will people be talking about experiments on rabbits? What do you think?

NEWS By Michael Cook

NEWS  By Michael Cook
Editor
BioEdge

 

1.I must admit that I have never been a fan of using human embryonic stem cells. I have serious ethical reservations and from what I understand of the science, they are incredibly hard to handle. So I wasn’t surprised at our lead story this week, the news that Geron, one of the few companies in the world working with these cells, had thrown in the towel.

What did surprise me was how small a splash it made. Amazingly, an article in New Scientist, ever an enthusiastic booster of embryo research, blandly declared, never mind, there has been amazing progress with adult stem cells.

Treatments based on adult stem cells are undoubtedly in the lead, with some very encouraging results this year… So at the moment, adult cells are leading the way clinically? Absolutely. For instance, there are almost 200 trials under way globally using mesenchymal stem cells extracted from bone marrow. In terms of sheer numbers and commercial potential, they are way in front.”

Perhaps the journalist was too young to remember the fierce debates across the world six or seven years ago. Some scientists and journalists were ridiculed and ostracised for saying much the same thing. I wonder if journals like Science, Nature and New Scientist are drafting mea culpas. Somehow I doubt it.

There’s more in this week’s newsletter: Canada’s euthanasia debate is getting warmer; a surprising celebrity surrogacy in the UK; the European Court of Human Rights upholds Austria’s ban on sperm donation — and more.

 

 

2. My apologies – some of the news is a bit dated, as BioEdge was on holiday last week.

There’s one item in this week’s newsletter which requires your input. In a recent issue of The Atlantic, bioethicist Jonathan Moreno nominated three institutions and three bioethicists for a “bioethics hall of fame”.

As the executive editor of the American Journal of Bioethics, Summer Johnson McGee, points out, any selection is bound to be controversial. However, Moreno’s selection is very US-centric (three American universities and three American academics, all at the same university) and skewed towards the pragmatic, politically savvy, utilitarian stance at which American excel.

Whom would you nominate as the world’s best think-tanks and the best practitioners? BioEdge has quite an international readership. I’ll be interested to see if other countries or other persuasions merit bioethics Oscars. Please post your comments below and they will appear in the “Pointed Remarks” blog.

Meta-analysis challenges abortion policies

by Michael Cook | Sep 08, 2011 |
tags: abortion

The media seems to have ignored a significant study on the effects of abortion which has appeared in latest issue of the British Journal of Psychiatry. After a meta-analysis of 22 published studies with data on 877,181 participants, 163,381 of whom had experienced an abortion, Priscilla K. Coleman, of Bowling Green State University, in Ohio, has concluded that abortion is associated with mental health problems.

“Overall, [she writes] the results revealed that women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be directly attributable to abortion. The strongest effects were observed when women who had had an abortion were compared with women who had carried to term and when the outcomes measured related to substance use and suicidal behaviour.”

Abortion is probably the most contentious issue in medicine – and bioethics – so it is rather surprising that these challenging conclusions in a respected journal (impact factor 5.78) have been largely ignored, apart from a few pro-life sites.

The results of review put a cloud over previous reviews which argue that the mental health of women who have had an abortion is related to their existing problems, not to the abortion itself. In 2009 a task force of the American Psychological Association reported, for instance, that “There is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women.”

However, Dr Coleman says that recent meta-analyses are flawed for three reasons. Only a handful of studies have actually included unintended pregnancy carried to term as a control group. Many recent studies were not taken into account. And finally, the reviews “lacked sufficient methodologically based selection criteria”. She singles out the APA review for ignoring “dozens of methodologically sophisticated international studies”.

The policy implications of Dr Coleman’s study are obvious. Ninety percent of UK abortions are carried out “on the presumption that abortion actually reduces the risk to mental health associated with continuing the pregnancy”. If this is not true, then “clinicians should convey the current state of uncertainty related to benefits of abortion”.

Are desperate Somalis selling their organs?

by Michael Cook | Sep 08, 2011 |

tags: Kenya, organ trafficking, Somalia

Allegations of organ trafficking to crop up regularly wherever civilians are caught up in wars. Kosovo’s prime minister stands accused of involvement in trafficking organs of Serb prisoners during the war with Serbia. Israelis have been accused on stealing organs of Palestinians. There have been reports of Iraqis selling organs.

Now a Turkish investigative journalist, Osman Sagirli, from the newspaper Turkiye, has reported that starving and exhausted Somilis are selling their organs after arriving in the United Nations Dadaab refugee camp in Kenya.

Mr Sagirli says that he spent 33 days in the camps and took photos of refugees lining up to board private jets at an airport run by the UN. He says that the UN is keeping the sensational story secret. He says that his photos show cooler bags used to keep the organs fresh. (See above.)

Stories of organ trafficking are grist for the mills of lurid tabloids and often highly politicised, especially in the Middle East. This report may be an attempt to discredit the European Union and the United Nations. But there is little doubt that people in extreme poverty are at risk of becoming the victims of organ mafias. ~ Turkiye, Aug 19; Turkiye, Sept 3

The future of memory-altering drugs

by Michael Cook | Sep 08, 2011 |
tags: memory altering drugs, neuroethics

Give memory-altering drugs a chance, argues the editor of the well-regarded Neuroethics & Law blog. Adam Kolber, of Brooklyn Law School, writes in Nature that drugs could be of immense benefit for people who have experienced traumatic stress, such as rescue workers or victims of assault. The use of memory altering drugs is looking “increasingly promising”.

“…excessive hand-wringing now over the ethics of tampering with memory could stall research into preventing post-traumatic stress in millions of people. Delay could also hinder people who are already debilitated by harrowing memories from being offered the best hope yet of reclaiming their lives.”

Opposing Professor Kolber is the widespread view that it is more ethical to cope with bad memories through personal struggle with one’s emotions. One of the most prominent voices has been George Bush’s US President’s Council on Bioethics. In a 2003 publication, Beyond Therapy: Biotechnology and the Pursuit of Human Happiness, its authors argued that “Memory- and mood-altering drugs pose a fundamental danger to our pursuit of happiness”. Kolber claims that this attitude is crippling the development and application of useful drugs.

“Fear that the potential fruits of research may be prohibited or heavily regulated could deter researchers from pursuing studies on memory manipulation or funders from supporting them. Instead, researchers should be encouraged to explore pharmaceutical and non-pharmaceutical methods of helping people cope with trauma.”

Egg freezing now viable option, says British expert

by Michael Cook | Sep 08, 2011 |
tags: egg freezing, IVF, social infertility

Egg freezing has become a viable option for younger women who want to delay having children, says IVF specialist Gillian Lockwood in the journal Reproductive Biomedicine (subscription required). Because of “Social, educational, emotional and financial pressures” many women are not ready for child-bearing until their late 30s, when their fertility has already declined significantly. But “freezing a woman’s eggs at age 30 literally ‘freezes in time’ her fertility potential and gives her the chance of a healthy pregnancy at a time of her choosing.”

Dr Lockwood, the spokesperson on ethics for the British Fertility Society, argues that three technological developments have made this possible: intracytoplasmic sperm injection, dehydro-cryoprotectants and vitrification. She claims that “now young women who have cryopreserved eggs can be offered the same chance of a live birth per embryo transfer as women undergoing conventional IVF treatment.”

Sperm donor has 150 sons and daughters

by Jared Yee | Sep 08, 2011 |
tags: sperm donation, US

Cynthia Daily and her partner used donated sperm to conceive a baby seven years ago, and they hoped that one day their son would meet some of his half siblings – a sort of extended family. Ms Daily searched a web-based registry for other children with the same father and created an online group to track them. There are now 150 children, all conceived with sperm from one donor and more are on their way.

As more women useartificial insemination, oversized groups of donor siblings are starting to appear. Ms Daily’s group is among the largest, but many others with 50 or more half siblings are appearing on websites and in chat groups, where sperm donors are tagged with unique identifying numbers.

This may not be news to readers of BioEdge, but it has finally reached the pages of the New York Times in a recent feature which highlights growing concern among donors, medical experts and parents. There are a number of hazards to having so many children fathered by the same donors, including the possibility that genes for rare diseases could spread more widely, and increased odds of accidental incest between half sisters and half brothers, who often live close to one another.

“My daughter knows her donor’s number for this very reason,” the mother of a teenager conceived using sperm donation in California – who asked not to be identified to protect her daughter’s privacy – told the New York Times. “She’s been in school with numerous kids who were born through donors. She’s had crushes on boys who are donor children.”. Critics say fertility clinics and sperm banks earn huge profits by allowing too many children to be conceived with sperm from popular donors, and that families should be given more information on the health of donors and the children conceived with their sperm. They are also calling for legal limits on the number of children conceived using the same donor’s sperm and a re-evaluation of the anonymity that cloaks many donors.

“We have more rules that go into place when you buy a used car than when you buy sperm,” said Debora L. Spar, of Barnard College and author of “The Baby Business: How Money, Science and Politics Drive the Commerce of Conception.”

Wendy Kramer, founder of the Donor Sibling Registry, had her son via a sperm donor and founded the registry in 2000 to bring together so-called “donor families”. She said that some sperm banks in the US have treated donor families unethically and that new legislation is in order. “Just as it’s happened in many other countries around the world,” she said, “we need to publicly ask the questions ‘What is in the best interests of the child to be born?’ and ‘Is it fair to bring a child into the world who will have no access to knowing about one half of their genetics, medical history and ancestry?’ These sperm banks are keeping donors anonymous, making women babies and making a lot of money. But nowhere in that formula is doing what’s right for the donor families.” ~ New York Times, Sep 5

Should sperm donors be anonymous?

by Jared Yee | Sep 08, 2011 |

tags: Australia, sperm donation, sperm donors

The rights ofsperm donors to anonymity are being reviewed in Australia. Laws that protected donors’ identities up until 1988 may be overturned. This Ten News video highlights some of the pitfalls of anonymous sperm donation – a woman suffering stage 4 bowel cancer cannot inform her donor siblings of the inherited disease. ~ Ten News, Jul 27

Pioneering UK stem cell trial passes safety test

A pioneering clinical trial to inject foetal stem cells into the brains of patients disabled by stroke has been approved to progress to the next stage after the treatment brought up no safety concerns in the first 3 candidates. ReNeuron, the British biotech behind the trial, said the independent Data Safety Monitoring Board had analysed the safety data from its ReN001 stem cell therapy and recommended that the trial progress to a higher dose.

The procedure involves injecting ReNeuron’s neural stem cells into patients’ brains with the aim of repairing areas damaged by stroke, thereby improving physical and mental function. It uses stem cells derived from human fetuses rather than embryos. ReNeuron’s chief executive Michael Hunt said the approval was an important landmark, and the preliminary data also supported the group’s other therapeutic programs using the neural stem cell line upon which the ReN001 stroke treatment was founded. ~ Reuters, Sep 1

Detecting hidden consciousness in vegetative state patients

by Jared Yee | Sep 09, 2011 |
tags: Canada, PVS, US, vegetative state

 

Some patients previously thought to be unconscious are in fact aware of themselves and their surroundings, according to Dr Adrian Owen of the University of Western Ontario. Dr Owen’s research shows that brain scanning technology can be used to aid diagnosis by detecting hidden indicators of consciousness invegetative patients, but also, in some cases, to help them communicate.

In a 2006 study, he and his colleagues used functional magnetic resonance imaging (fMRI) to find if a 23-year-old woman in a persistent vegetative state (PVS) would respond to a set of pre-recorded spoken statements. Subsequently, Owen’s group performed fMRI on 54 minimally conscious and vegetative patients, and told them to imagine playing tennis if they wanted to answer “yes” and to imagine walking the streets of a familiar city if “no”. Five of the patients were able to answer the questions correctly in this way.

All 5 had been diagnosed as being in a PVS, and only 2 responded to behavioural tests of awareness. However, absence of evidence cannot necessarily be interpreted as evidence of absence. Responses may be too low to be detected by the scanner, or because patients were asleep during the scanning.

Owen said:

“We now know from that paper and from our follow-up papers that close to 20% of patients who are thought to be vegetative are actually conscious, but are nevertheless incapable of demonstrating their consciousness through standard clinical assessments.” ~ Guardian, Sep 2

Disabled patients could “mind-meld” with robots


by Jared Yee | Sep 09, 2011 |

tags: locked-in syndrome

A new, noninvasive method for recording patterns of brain activity could give “locked-in” patients -the ability to interact with others and even give the impression of being physically present with friends and family. With brain-machine interface systems people can control robots, prosthetics or cursors with conscious thought. But this often requires fatiguing concentration, according to Jos? del R. Mill?n, of Switzerland’s ?cole Polytechnique F?d?rale de Lausanne (EPFL).

Mill?n’s goal is to make robot control as easy as driving a car on a highway. A partially autonomous robot would allow a user to stop concentrating on tasks he or she would normally do subconsciously, such as following someone or avoiding running into walls. If the robot encounters an unexpected event and has to make a split-second decision, however, the user’s thoughts can override the robot’s artificial intelligence. Mill?n and colleagues built a telepresent robot to test their technology.

They modified a commercially available robot called Robotino, which looks like a platform on 3 wheels, and can avoid obstacles on its own using infrared sensors. On top of the robot, the researchers placed a laptop running Skype, over a wireless internet connection. This allowed the human controller to see where the robot was going, and because the laptop showed a video of the user, it allowed others to interact with the user as though the user were actually there. The user wore a cap of tiny electroencephalogram (EEG) electrodes, to translate brain waves into navigation commands and transmit them to the robot.

Mill?n’s group has shown that with a bit of practice, a healthy person can control the robot without much effort. He found that paraplegics performed just as well as the healthy subjects, Mill?n and his colleagues reported this week in Boston.

Mill?n says that the bed-bound patients were excited to take part in the study. “This opens a new possibility for families,” he says, who could interact with bed-bound loved ones over a video connection without needing to sit at a computer. ~ Science Now, Sep 6

Other news

Tangled tale of surrogacy in Nepal

by Jared Yee | Mar 18, 2011 |

From Nepal comes a family dispute which highlights the complexity of surrogacy. Mrs Sambhavi Rana has appealed to Nepal’s Supreme Court to stop her husband, Ujjwal Rana, from bequeathing the couple’s property to his three-year-old daughter Bina. This case is the first of its kind in Nepal which has no laws governing surrogacy, although Nepalese women are said to act as surrogates for Indian citizens.

Bina was conceived by a commercial surrogate mother, Ayushma Nagarkoti, with whom Ujjwal Rana had signed a formal contract. Rana also undertook to pay maintenance and medical costs for her for two years and the woman agreed to hand over the child when she was two. Ujjwal Rana had notified the chief district officer about the arrangement. He also declared that his wife – who was incapable of giving birth – agreed to the contract. Now his wife has challenged this version of events and says that she knew nothing about it. She has also challenged his claim that she was unable to conceive, has accused him of mental and physical abuse.

Nagarkoti is married and her husband is working abroad. She told the court that he had consented to the surrogacy.

Judge Tek Narayan Kunwar resolved the dispute last week. He ruled that a surrogate child should have the same rights as a biological one, and should be entitled to inheritance rights. However the decision is likely to trigger a debate. Lawyers say that it ignored the role of the mother and the need to get her consent for obtaining a child through a surrogate mother. ~ Times of India, Mar 8

UK surrogate refuses to hand baby over

by Jared Yee | 4 Feb 2011 |

Surrogate mother refuses to give up baby

A surrogate mother who changed her mind about giving her baby to a couple was allowed to keep her, a UK High Court judge ruled two weeks ago. After getting married in 2005, the couple were unable to have a baby following a series of miscarriages. Mr and Mrs W contacted the surrogate over the internet in 2009 and made an informal agreement that a baby conceived with Mr W’s sperm, would be handed over following birth.

During the pregnancy the surrogate mother changed her mind and refused to hand over the baby when it was born last July. Mr Justice Baker said the now six-month-old baby, known only as T, had formed a bond with her mother. “In my judgment, there is a clear attachment between mother and daughter,” he said. “To remove her from her mother’s care would cause a measure of harm. It is the mother who, I find, is better able to meet T’s needs, in particular her emotional needs.”

During the pregnancy, relations between the donors and surrogate deteriorated and legal proceedings began just a week after birth. The judge said that there had been irresponsible behaviour on both sides, accusing Mr and Mrs W of not telling the whole truth and the mother of adopting a false identity to elicit information from the couple, falsifying a document and lying to the court.

The judge said the risks of entering into surrogacy agreements were “very considerable”. “In particular, the natural process of carrying and giving birth to a baby creates an attachment which may be so strong that the surrogate mother finds herself unable to give up the child,” he said. ~ Guardian, Jan 21

IVF more deadly than abortion for women, says BMJ

by Jared Yee | Feb 03, 2011 |

only two women died as a result of having an abortion in Britain in 2007, seven died as a direct result of IVF between 2003 and 2005, obstetricians have noted in a recent BMJ editorial. This happened even though there are only a quarter the number of IVF cycles as abortions, according to Dr Susan Bewley, a consultant obstetrician at Guy’s and St Thomas NHS Foundation Trust in London.

Four of the IVF deaths between 2003 and 2005 were from ovarian hyperstimulation syndrome, brought on by fertility-boosting drugs, while three were due to multiple pregnancies. Dr Bewley and her colleagues wrote that systematic reporting should occur for serious adverse health outcomes related to IVF, so that lessons can be learnt and the appropriate action taken.

A recent study from the Netherlands showed that overall IVF pregnancy mortality rates were higher than overall mortality rates in the general population of the Netherlands. There were 42 deaths per 100,000 IVF pregnancies as opposed to 6 deaths per 100,000 pregnancies overall. UK results have confirmed this.

Dr Bewley and her colleagues point out that in the developing world, women die as a result of complications from excess fertility and unsafe abortion, but that in post-industrial societies, infertility treatment now poses a higher risk of maternal death. While IVF is very safe in the UK, the authors of the editorial argue that better information about the risks of fertility treatment is needed, better identification of women at high risk, and more single embryo transfer as the norm to prevent disability and death. ~ BMJ 2011; 2011; 342:d436; London Telegraph, Jan 28

Japanese politician has IVF baby at 50

by Michael Cook | 21 Jan 2011 |

A 50-year-old Japanese woman once touted as a possible prime minister has given birth after IVF. In conservative Japan, which bans surrogate mothers and donor eggs, the decision of Seiko Noda, who has been divorced since 2007, has stirred up a debate over reproductive technologies.

Ms Noda, a veteran campaigner for reproductive rights, told Vogue Japan recently that it was not her first choice. “I thought about adopting a child, but I hit a wall. I was told that considering the future of the child, it wasn’t possible to do that for a woman who is almost 50, like me. An egg donor was the last resort.”

Ms Noda has not been shy about her desire to conceive a child. In 2004, she told her story in a book titled “Watashi Wa Umitai” or “I Want To Give Birth.” She is also a campaigner for innovative measures for raising the birthrate in Japan.

IVF is not popular in Japan, the Wall Street Journal reports. So brokers organise it in the US or India where women can buy donor eggs and hire surrogate mothers.

Bloodline is so important for Japanese that IVF children have to be adopted. In 2003, a TV actress, Aki Mukai, had twins through an American surrogate mother after cervical cancer left her infertile. But because she was not the birth mother, she could not registered as the children’s mother. She fought the case all the way to the supreme court – and lost. The children were deemed to be foreigners until they were adopted in 2008. ~ Wall Street Journal, Jan 6; ABC News, Jan

British couple flouts surrogacy law, and keeps baby too

by Jared Yee | 10 Dec 2010 |

A senior family court judge permitted a British couple to keep their newborn child despite their technically breaking the law by paying more than “reasonable expenses” to the American biological mother. Mr Justice Hedley said the current rules on payments were not clear, and that the welfare of the baby must be the central consideration. He said that only in the “clearest case” of surrogacy for profit would a couple be denied the court order necessary to keep the baby. His comments are the first made by a senior legal figure in recent years, and might be taken by many infertile couples as a sign that they can now pay women to bear children for them without the fear of legal penalty. On the other hand, the decision is also likely to lead to calls for the law to be tightened up to discourage “rent a womb” commercial surrogacy.

Mr Justice Hedley said in the High Court on Wednesday, “It is clear to me that payments in excess of reasonable expenses were made in this case.” The money paid to the surrogate mother was also described as “compensation” rather than expenses. The judge described the concept of reasonable expenses as “somewhat opaque” and continued: “Welfare is no longer merely the court’s first consideration, but becomes its paramount consideration. The effect of that must be to weight the balance between public policy considerations and welfare decisively in favour of welfare. It must follow that it will only be in the clearest case of the abuse of public policy that the court will be able to withhold a (parental) order if otherwise welfare considerations support its making.”

He also warned that the courts would continue to consider the amount of money paid in each individual case, to ensure that a market does not emerge. “Notwithstanding the paramountcy of welfare, the court should continue carefully to scrutinise applications for authorisation (of payments)… with a view to policing the public policy matters…and that it should be known that that will be so,” he told the London Telegraph. Surrogacy has been regulated in Britain since 1985. ~ London Telegraph, Dec 8

At least it’s better than prostitution

by Michael Cook | 10 Dec 2010 |

The Confederation of Indian Industry has predicted that surrogacy will be a gigantic US$2.3 billion industry by 2012. This is becoming an increasingly familiar statistic. But what is life like for a surrogate mother? An article in the University of Chicago feminist journal Signs is an in-depth investigation of the recruitment and life of surrogates. Author Amrita Pande did fieldwork in the town of Anand, in Gujarat, between 2006 and 2008. She interviewed 42 surrogates, their husbands and in-laws, 8 intending parents, 2 doctors, and 2 surrogacy brokers.

One quote from a broker named Nirmala sticks with you:

“To convince the women I often explain to them that it’s like renting a house for a year. We want to rent your womb for a year, and Doctor Madam will get you money in return. I tell them surrogacy is not immoral. It is much better than a woman going from one man’s bed to the next to make money. Prostitution will not pay her much and can also lead to diseases.”

Read the full story in Signs. ~ Biopolitical Times, Dec 6

New laws will outlaw overseas surrogacy in NSW

by Jared Yee | 8 Dec 2010 |

New laws in New South Wales are poised to stop people paying surrogates overseas to have their babies. Community Services Minister Linda Burney has introduced legislation to extend the ban on commercial surrogacy to overseas arrangements. While the aim is to stop surrogates from third world countries being exploited, many prospective parents in Australia are unhappy about the new laws. Ms Burney said she was also concerned about the welfare of the child, especially when surrogates are donating eggs.

“If we are banning commercial surrogacy in Australia, why would we allow it to take place somewhere else?” she said. “I believe very much that a child has an absolute right to know who they are and where they come from and that’s not possible if they’re a surrogate child from overseas.” Professor Jenni Millbank, family law specialist at the University of Technology, Sydney, says there is already an indication from prospective parents that they will go ahead with surrogacy overseas in secret to avoid a hefty fine or jail term.

However, that could prevent the children from knowing their full history. “We should be making surrogacy in Australia more available in situations where we know it can be better regulated, it can be fairer,” she said. “The informed and continuing consent of birth mothers can be properly assessed, so my solution would be a liberalisation of the Australian approach.”

Ms Burney says the goal is not punishing the child, so people who flout the ban on overseas commercial surrogacy will still be able to apply for correct documentation. “They will still be able to go through an adoption process. They’ll still be able to do those sorts of things for that child, but they will be taking the risk in New South Wales that the authorities will be notified,” she said. ~ ABC News, Dec 4

UK woman may act as surrogate for gay brother

by Michael Cook | 20 Nov 2010 |

Reproductive technologies are leading to more and more complicated family relationships. Now an unnamed woman is set to make history in the UK by acting as a surrogate for her brother and his gay partner – making her both the mother and aunt of the same baby.

The same-sex couple has applied for fertility treatment at the London Women’s Clinic. Dr Kamal Ahuja, the LWC’s scientific director, said its ethics committee was considering the application, along with another by two men who want to have a child, with a female colleague acting as surrogate. These two applications are the first the LWC has received from gay men.

Since April, two men can be named parents on a birth certificate. Special ‘parenting orders’ can be granted to gay men so they are recognised as the legal parents of a child, not the surrogate who gave birth to the baby. The LWC was one of the UK’s first to welcome lesbians for donor insemination. Several hundred babies have been born to same-sex couples since then, and the proportion of gay patients has risen to almost a third from 7%. ~ Daily Mail, Nov 11

Posts Tagged surrogacy in canada

Surrogate Mothers need independence in decision making

Oct 10 2010


An unnamed Canadian couple who had taken up surrogacy created a new row of ethical moral debates over their surrogacy arrangement. The surrogate mother was pregnant with their child using embryos created out of their own gametes. When in the womb of the surrogate mother, the child was found to have medical risks to be born with Down’s Syndrome. The Intended Parents who had come to know of this wanted the surrogate mother to abort the child. The surrogate mother refused for the same. However, when the intended parents threatened to withdraw their support for the surrogacy arrangement, the surrogate mother decided to abort as she had two kids of her own. Neither the intended parents nor the surrogate mother approached the court of law. The above case was reportedly enumerated by Dr. Seethram at the Canadian Society of Fertility and Andrology conference during his presentation. These facts had brought to the world a new set of issues where the surrogate mother would be required to decide freely without any coercive environment. The intervention of governmental agencies occupied a prominent scope in the debates.

French Court holds IP to be legal parents, but not for nationality

Dominique and Sylvie Mennesson Photo: AFP

India does not seem to be the only country caught in midst of legal controversies over issues of surrogacy. France is also facing a similar question.

Since 1994, surrogacy arrangements are held to be illegal in France according to The French Law – Article 16-7 inserted by Act No. 94-653 of July 29, 1994 Art.1 I, II, art. 3 Official Journal of July 30, 1994 states -”Any agreement on procreation or gestation on behalf of others is void.”

A French couple, Dominique and Sylvie Mennesson paid a surrogate mother in California about $10,000 in 2000 to carry their child. The surrogate mother carried the child to term and have birth to twin daughters. On birth the twins Isa and L?a, were given US birth certificates recognising the Mennesson couple as the legal parents – but the French authorities refused to accept these.

The Paris Court of Appeals had held that Dominique and Sylvie Mennesson were the legal parents of the children, but refused to consider the children as French nationals. The Mennesson couple have reportedly stated that they will take their case to the Cour de Cassation which is France’s highest court. They hope to set a legal precedent for other parents of children born to surrogate mothers, after six years of legal action.

A draft law hoping to overturn the present law of holding any agreement for procreation of child was presented to the Senate in January, but has yet to be discussed.

Indiana court to decide in vitro baby’s legal mother

The Indiana Court decided a very interesting point on surrogacy which is quite on debate all over the world. The question is who should be considered to be the legal parents of the child born through surrogacy.

A 11 month old baby referred to as ‘Infant R’ in Court Documents was conceived by In-Vitro Fertilization using a legally wedded couple’s gametes. The child was carried by the wife’s sister. On birth of the child, the name of the mother was left vacant and only the name of the father was filled. The Couple applied to the Indiana Court for a declaration that the wife should be declared to be legal mother of the child and that her name should occupy the mother status in the birth certificate. The surrogate mother too filed an affidavit in support of their petition. But the judge refused, ruling that “Indiana law does not permit a non-birth mother to establish maternity. Indiana law holds the birth mother is the legal maternal mother.” Attorney Steven Litz applied the Court of Appeals to intervene, challenging the constitutionality of Indiana’s paternity law because it allows men — but not women — to establish legal parenthood. Such similar stand was taken in Arizona and Maryland Court where the similar paternity laws in surrogacy situations were inadequate to deal with reproductive technology. The Judges clearly did not want to delve into constitutionality aspects and were looking for a simpler solution for the whole problem. The matter is still pending.

The same question is arising in every country where surrogacy is permitted. Who is the legal mother of the child? The similar facts of the Jan Balaz Case was purpose of Nationality/Citizen. So is similar the British Nationals case which was handled by me. The solution for this legal problem can be arrived only with a comprehensive legislation dealing with the intricate issues of surrogacy. The much larger issue of international surrogacy calls for a international treaty concerning surrogacy.

Outsourcing Baby-Making in India

The disturbing realities of reproductive tourism as a global growth sector.

Ellen Painter Dollar

It’s a typical story in our global economy: Citizens of wealthy nations hire Indians to provide goods and services that cost less than the same goods or services domestically produced. But in the case of “reproductive tourism,” the Indian laborers are surrogate mothers who literally labor on behalf of foreign couples. They are paid to ‘host’ babies who are later carried home to the U.S., Britain, Israel, Australia, and other developed nations.

One expert recently referred to reproductive tourism as a “global growth sector,” with India leading the trend. (Reproductive tourism is not limited to India. British women regularly travel to U.S. fertility clinics to access a larger pool of donated eggs, and Indian-style surrogacy programs are springing up in Guatemala.) Fertility clinics in India market their services by offering foreign clients travel services so they can sightsee while in India for an IVF cycle or retrieving their baby. The clinics also recruit surrogates, usually poor Indian mothers; help clients obtain donor eggs and sperm; perform in vitro fertilization (IVF); house, feed, and provide medical care to surrogates during their pregnancies; and deliver babies.

Advocates for this business claim that everyone wins. Childless couples get the babies they long for, and surrogates receive income for better housing and education for their own children. But it’s not that simple. Indian surrogates must live in special housing while they are pregnant. They are well-fed and taken care of, but what does it say about whose families are more valuable when Indian mothers are away from their own children for months while they gestate babies for wealthier foreigners? According to a recent Slate article, many of the women cannot read their surrogacy contracts. Those from higher castes are paid more than those from lower castes, and surrogates are paid only if they deliver a living child.

Two scenes from the HBO documentary Google Baby illustrate the injustice and heartbreak in the fertility tourism boom. In one scene, an Indian woman who recently gave birth to a baby for a foreign couple sits by her husband as he talks about the difference their surrogate payment has made, allowing them to buy a house and other comforts. He says he expects his wife will serve as a surrogate again. He says that, although women’s brains are generally inferior to men’s, his wife made a good decision. The wife, who admitted in an earlier scene that handing the baby over right after birth was very painful, listens in silence.

In another scene, an Indian woman is on the operating table, giving birth via C-section. She says she can feel the doctor cutting, and it becomes clear that her anesthesia is not working. The anesthesiologist puts something into her IV line and soon, she is lying still, sedated. One doctor standing by her head pushes hard on her belly over and over, as if he is kneading a stubborn loaf of bread. Another doctor pulls the baby out. Immediately after delivering the baby, the doctor answers a phone call while a staff person wraps the baby and takes her away. The baby’s intended parents will not arrive in India to pick her up for several days, so in the meantime, the staffer will care for the infant.

The surrogate lies on a stretcher, her eyes dazed and vacant as her husband holds her hand and strokes her hair. A baby was just born, an event that usually brings people together. But all of the parties involved are essentially alone, disconnected from each other and from the central event of the baby’s birth: The doctor takes a phone call, the surrogate woozily recovers from sedation, the intended parents make travel plans, and the baby is whisked away.

In researching reproductive ethics, I come across those who scoff at the possibility of “designer babies” in which children are manufactured to meet cultural expectations. Many insist that such fears are overblown, because the public would never accept such violations of human dignity. Certainly most fertility patients set out to build a loving family, not exploit poor women or manufacture a child to their specifications.

But as reproductive technology grows in scope and capability, it raises significant moral questions that deserve our attention (as I wrote about IVF two weeks ago). Fertility tourism might be one area of reproductive ethics where conservative Christians, who traditionally focus on the sanctity of human life, and liberal Christians, who traditionally focus on human rights, particularly for women, can speak out together for justice and compassion. We don’t have to project some dystopian future to witness instances in which human dignity — the dignity of Indian mothers serving as surrogates and the babies they deliver — is violated by clinics, entrepreneurs, and aspiring parents who are turning procreation into a fee-for-service market.

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