Surrogacy. The debate on "surrogates" birth in complexity

mere porteuse inde Gestation pour autrui. Le débat sur les « mères porteuses » accouche dans la complexité

Photo Monde2 June 19, 2009 (St. Clair)

The law on bioethics , ethics vi e which we can better understand news by reading this, will take a position on the issue of surrogacy, better known under the item of debate surrogates .

This is a complex issue that lawmakers will have to decide. Today, this possibility is forbidden in France. "The fact to intercede" to resort to this practice is liable to one year imprisonment and a 15,000 euro fine. The fine is doubled if the act is done for profit reasons. The French ban was passed in 1994 and again in 2004. However there have been cases of surrogacy in France, as authorized by law are not at variance, not only because the variance law did not exist. It was between 1987 and 1991 the number of children born to mothers during this period is estimated at 70. To my knowledge, there are no epidemiological studies on the monitoring of these children since that could allow lawmakers to decide in full knowledge and avoiding the fantasies of both sides. (Shift 24/06/2009: The Express returns in its edition of Thursday, June 25 on the issue via an article taking the journey of three families with the testimony of children born to mother).

Many today are people and organizations to take a stand on this issue.

Among the proponents of a controlled surrogacy authorization are: the Association Maia , the Committee Clara , Elisabeth Badinter , the Minister for Family, Nadine Morano , Genevieve Delaisi Perceval, a working group of the Senate.

Among the opponents, the ranks provided more we find, the "father" of the first French test-tube baby, the doctor René Frydman , the philosopher Sylviane Agacinski, the Housing Minister Christine Boutin, the 'OPECST (parliamentary office dedicated to ethics that includes several representatives and senators sensitive to these issues and publish reports), the National Consultative Ethics Committee , Catholic and Protestant as well as representatives of Islam and to a lesser extent the churches c onsistoire of Paris . About opponents, René Frydman said he was "outraged by the lobbying of certain associations that advocate the legalization of this practice to defend the interests of a few wealthy." It is bitter, strong, perhaps too much.

Each side has their own influence to advance his ideas. Interviews are given, open blogs, participation in conferences or seminars companies, mail and files sent to parliamentarians, reflections committed to advance his ideas, defend his point of view (as the synthesis of the Board State shows) increase its visibility and participate in the construction of the decision on this complex subject.

Arguments.

  1. Accept an act of generosity . "Giving" his body time to pregnancy for a couple to host her own child is a selfless act of high level. This was the main motivation of French surrogates in the late 80s This act is sometimes proposed by relatives of the woman who can not bear his child's mother, sister, friend ... http: // www. dailymotion.com/video/x6hb3u
  2. Avoid reproductive tourism. Many countries in the world accept surrogacy. These include the United States, Canada, Belgium, Great Britain, the Netherlands, Ukraine, Denmark and Greece, five countries of the European Union. Other countries, such as India, accepts this practice and conduct an industrialization of the process as it will be objected by opponents of legalization. Accept surrogacy would thus avoid double standard measures between those who have the financial and cultural means of establishing contacts abroad in this sense, and those who, for various reasons, can not do . According to this argument is that the principle of equality prevails.
  3. Avoid civil status issues . As suggested by the case Mennesson , resort to surrogate mothers abroad is not without its problems upon return to France of biological parents with their child. Who is that child? The child's mother under French law? Who is his mother according to the law? One who delivers the child. QED. However, the interest of the child here that have a legal identity, a civil status, without which no act of everyday life can be achieved (a passport, vote, pass an exam ...) is essential, in our culture, on all the other principles can be put forward.
  4. Do not refuse the advances in medical technologies. While the donation of gametes, male and female sperm and eggs is permitted, that embryo donation is accepted, why is it that the loan of his body be forbidden a consenting person? Under q ual ethics or moral? Would it not deny the interest of the progress of science in the medical field to reject this progress is reaching?
  5. Help fight the suffering of women who can not have children. Beyond the issue of convenience that could motivate women not to give birth (fear of childbirth, fear of the decay of the body thereafter anxiety about suffering ...), there are a number of purely medical reasons that prevent women to bear children. This is the case of women whose uterus has been altered by radiotherapy for example, women with the syndrome of Mayer-Rokitansky-Kuster-Hauser . In total, it is estimated, according to the Red Cross, 300 the number of women affected by the syndrome Mayer and postpartum hemorrhage. Or in society of ours there is a strong social pressure (not to mention biological and psychological pressures) that women of childbearing age would. This partly explains the fertility levels in our country, and it reinforces the suffering of those who can not afford the social role that is given to them.
  6. A movement is emerging in public opinion. Not that the French, according to polls, have become largely to this development, but 1/3 of them are not opposites. Now we know the laws that lead to profound changes can not be made without the consent of a significant part of the population. For at least two reasons, first, because it allows proponents of this evolution to have support and relay in the public, secondly, because it suddenly cut the ground from under the feet of opponents, more supports in the opinion, it is less of opponents in the street, on internet forums, in newspaper columns. Today, however, the point of view of public opinion, the game is not won for advocates of legalization. However, they have managed their first bet: that to the public square the question. It is no longer taboo. This is a first essential step in the recognition of surrogacy.
  7. This is already done, it is done. The argument seeks to show that these practices are ancient and still current, despite the ban, are somewhat specious point of view of the morality of public debate, but it is a fact. In France, as I mentioned in the introduction, it was a reality tolerated for four years. And even today, without that we know how many people are involved, this practical course. Except in centers in the country at least by citizens traveling abroad.
  8. And the father in all this? It is often considered that the issue of surrogate mothers affects mostly women. It is true that there is no father-bearer and for good reason. However, "women can not have children on their own." At one point at least, a little time before fertilization, the man is required. By his presence, and his ejaculation, or in absentia, having frozen his own sperm or giving his sperm in a CECOS. Or in the case of a couple of potential parents, a man and a woman so the meaning of the law, if we have seen the power of desire, need or desire, feminine, instead of the father, his wish his desire or need, is neglected. It has also the right to have children, if it exists. And in a free society, he can decide who he wants to be. If this woman he wants for mother of his children can not accommodate the gestation of their child, not where it undergoes a double penalty. That of seeing his wife suffer and that not being able to be a father.

Arguments against.

  1. There is no GPA without trade. It is a punchline. In many cases, surrogacy is manipulated to become a business. In India, women confined in a shelter, are recruited to become surrogate mothers on behalf of foreign or domestic wealthy who "buy" this opportunity for a little less than 10,000 euros. In Ukraine, it takes 15,000 euros. In North America, approximately 40,000 Euros. Depending on the nature of contracts, legal liability, insurance, the price varies. The earth is flat, wrote the American journalist Thomas Friedman. Nothing is more true regarding surrogacy. It is possible to choose its production area and the guarantees that come with it. The argument is without question but it remains theoretical. Nobody can say with accuracy that France would happen in the same way as the practice is prohibited. Everything leads us to believe that this issue is a major obstacle to acceptance by the public: a child can not have a price, though here we are not talking children but purchase loan or lease bellies then evicting the tenant.
  2. This is not "a public health priority." In an interview on this issue with the weekly L'Express, the gynecologist René Frydman, already indicates that requests for assisted reproduction, which is favorable in fertilization vitro, artificial insemination ... are difficult to meet. For reasons of ways in the few medical centers offering these services or because of a strong lack of gamete donors. Thus, the Biomedicine Agency says in its annual report that 400 couples a year are waiting for egg donation but only 220 women volunteers each year to keep the gift inherent in medical treatment and in the end to give more of their eggs.
  3. The medical profession does not accept this technique. The vast majority of doctors are reluctant to accept changes in the legislation on surrogacy. Jean-François Mattei, MD, former health minister, author of a remarkable book on bioethics, asserts against for the reasons here. Or, even if at the time of the debate the authorization of the Voluntary Interruption of Pregnancy in France in the early 70's, there were more than 10,000 sign against the anti-abortion appeal, it is difficult to change laws Bioethics without their consultation or their consent. The pressure group it is, even if the front is not always united, represents a strong power of influence especially as the number of parliamentarians from their ranks and therefore less sensitive to their arguments by atavism .
  4. The status of the surrogate mother is blurred a legal point of view. Who is the woman who gives birth to a child who is not biologically his? Who is this child to this woman giving birth? We do not measure well the psychological effects for the woman who gave birth to her child leave his biological mother. The working group of the Senate who has studied the issue suggests that the surrogate mother can change your mind within three days after delivery. That is to say, it may decide to keep the child who is not quite far from it, his. Typically, in the classical case, during the three days following the birth of a child, the whole family, aunts, uncles, brothers, sisters, fathers, mothers, friends came to the maternity hospital, or the kitchen, or in the pool, see the child, praise the mother, the father of the child, talk about his resemblance to so and so, giving gifts, take her in his arms. At birth the child was already nine months. We give him, we gave him a name, an identity. He was welcomed into the family with open arms. It is the future. There is hope. How then accept that for three days, three long days, a couple is in the feverish anticipation of a change of mind of the woman in labor? What anguish! What suffering of waiting! Finally, what about the right of access may request that perfected the surrogate? She still carried the child, fed, talked, perhaps even whispered words of love. And if that is not the case, then studies have proven the importance of the peace of the mother during the pregnancy and the presence of the father, why this child would he deny, from the Initially, beyond the vicissitudes of the lives of couples, these attentions.
  5. This implies that a contract is not eligible. Use a surrogate requires a contract between the two parties, the carrier and recipients, with commitments of both sides, rights and duties. From a philosophical point of view, this assujétion, the alienation of man by man is not admissible. This is already happening in work contracts, but not with these implications, this constancy during the time of pregnancy. This contract also entails legal responsibilities. What will happen if the surrogate mother prefers fair break, alcohol to strawberries, rolled cigarette Russian cigarette? The selection of surrogate mothers should be able to guarantee upstream part of the serious candidates but can not ensure full loyalty of the surrogate mother vis-à-vis its commitments.
  6. And if the biological parents refuse the child? This question is rarely asked. Presumably a couple who engages in this process knows why he undertakes, his thinking has matured, tried everything outside of this process. But what if during the time of pregnancy parents separate? Does the common law on parental authority applies? How to decide?

The issue of opening of surrogacy to gay couples does not arise here. Because it is assumed that it is the biological child from the gametes of a couple, thus differentiated between men and women, to be carried by the surrogate mother.

Seen from reading these arguments together that this issue is complicated by its possible consequences. It also confronts us with our a priori. As Sylviane Agacinski said, "In this field, France is not late, she is ahead." Each will be his opinion , Sylviane Agacinski is clearly against, but in any event, our country is undoubtedly ahead of the issue of public debate around this topic.

Mikaël Cabon

"Should we legalize surrogacy?" - Kewego
Sylviane Agacinski and François Olivennes discuss this thorny issue.

The woman who is on the photo illustration of the home page of this article is not a surrogate. This photo is taken from the database of the US Department of Agriculture.
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  1. [...] To surrogate mothers in France, I just published an article on this question on the blog Lobbycratie. . A major issue for our society like that of research on stem cells, [...]

  2. Eric75 says:

    Surrogacy (where the woman who carries the child has no genetic link to the embryo worn) often amalgamated with surrogacy (where the woman has a child of her own genes) began in 1984 California. Following the fear of conflict around custody and parentage of children born by this action, but also to respond to a risk of commodification of the female body, commissions have studied laws to regulate practices which premiered was passed in 1985 in England.
    Followed Australia, Israel, New Zealand and the US states (mostly by case law). Following the implementation of these legal provisions, conflicts over phenomena that could be described as "moral panic" disappeared. And since the practice of surrogacy is growing continuously in conditions that are not challenged, no authority is also back on legalization.
    It is unfortunate that the effectiveness of these legal provisions has not been evaluated by the French institutions that are expressed on the GPA or fluttering like against-examples or "less-called ethics" of the few countries like Belgium and India, where there is no legal framework.

    The interest of the child and the notion of kinship:
    The interest of a child who is not yet born is a very abstract concept that refers to the same perception of the relationship, and that ultimately is used as a "right" of the child not to be born, so passive eugenics to couples who can not bear a child. The same history should prevent us to limit the relationship to one of the biological, gestation, at the expense of transmission of a genetic heritage and most importantly, the social fact: mother or father is the one who behaves as such under the definition in society.
    This is not to deny the importance of trade in utero between the pregnant woman and the fetus, but considering the huge variety of experiences of pregnancy and the lack of determinism uterine. The assertion that the GPA would mean abandonment falls into this reductive approach to parenting. If we followed this definition of abandonment, it would return to France in the legalization of embryo donation to be consistent. But it is not so, because a child is desired and expected continuously by a couple can not be considered abandoned. The attachment is not a biological function but psychological construction.
    Claim biological gestational primacy is often an expression of defiance, a refusal by the intrusion of medicine thought as a form of mechanized reproduction. Unlike the stereotypical view of a delivery under the sole protection of Mother Nature, we must remember that half a century, advances in reproductive medicine, including fantasized representations are the specimen and the incubator, helped to end the scourge in our rich infant mortality countries and that of women died in childbirth.
    Infertile couples never claim "right to the child," but the "right of children", including the right not to be deprived of the history of his birth, when everyone agrees, starting with the adoptive parents need to remove secrets related to the birth.

    Operating or female autonomy?
    The woman carrying the child of another would be used as a machine, "devoid of humanity"? Note that the use of degrading and reductive vocabulary such as "wombs for rent" is almost exclusively of those who claim to respect the dignity of women. This desire to caricature denies the autonomy of women and denigrates the very principle of giving.
    The dignity of the woman be not more respected if we understood that in surrogacy, she tries to act as fair and rational as possible, while respecting others? The fundamental challenge for society - but also for women - is to ensure that they are properly informed of the proposed approach, and that their expectations are not in sync with those of the intended parents. To achieve this logic of exchange and mutual respect, we must admit that for some women, pregnancy is a time of fulfilling life.

    Infertile couples want a real debate takes place on the question of a legislative framework that altruistic end the prohibition of surrogacy in France. Our country can no longer hide behind moralistic caricatures while GPA is already on the national territory in a clandestine manner, with all the risks that implies lack of supervision.

    We can not continue to France as if nothing had changed since the debates prior to 1994, as if they still had no recoil as if good practices did not exist. France, the country of human rights, neither can continue to deny the existence and rights of children born by surrogacy abroad.

  3. Claire said:

    It's great fun to read this article in light of the bill to legalize surrogacy filed January 27, 2010 by 70 senators. We realize that almost all of the arguments against surrogacy are false.

    Thus, as this bill is, you can make the GPA without commerce, without contractual arrangements, giving a clear status to the surrogate, establishing a lineage that protects the child of a (unlikely) withdrawal of parents ...

    There remains only the argument that the medical profession does not accept this technique. What is wrong! Just read the "Results of the questionnaire survey Medically Assisted Procreation (GEFF, BLEFCO and CNGOF, the SFG and FNCGM, October 2, 2008" to know the reality.

    This speaks for itself.

  4. Lahoyashra said:

    There is little on a forum, I read these words:

    "Personally, I am against the GPA.
    Want to have a child at all costs (at any price ... to trade in child conception yuck) while so many children are suffering and waiting to be adopted. I dare not approach the psyche that the child can develop to have been designed like that and trauma to the surrogate mother. It really is a mentality of rich and selfish. Somali women are trying to save children from starvation, then hire belly ... Would rather welcome these children and to pass momentarily to save the history. It is in this sense that I have written that the GPA is a rich selfish thing. "

    And hop, 4 lines on the idea received GPA but also the adoption.

    Otherwise, I am annoyed by the fact that two different words are mixed to me: "Surrogate Mother" and "surrogate".
    In most documents, the use of "surrogate mother" mask profound differences that there are between surrogacy (the woman who carries the child also provides the ovum) and surrogacy said GPA (Women bringing the child has no genetic link to the child). In fact, recent studies show many molecular exchanges between mother and child. These exchanges are regulated by the mitochondrial DNA said. In contrast to nuclear DNA, which is transmitted by a combination of nuclear DNA of parents, mitochondrial DNA is transmitted only by women. Thus, in the case of surrogacy, the woman who carries the child transmits its genetic heritage to the child, and intrauterine exchanges are governed by their own mitochondrial DNA. The contribution of the infertile woman in adoption as in this case purely social. But in case of surrogacy, the woman who carries the child does not transmit genetic heritage to the child, and intrauterine exchanges are regulated by the mitochondrial DNA of the infertile woman who provided her own eggs . Thus, the contribution of the infertile woman is present in this case not only in terms of physical examination with the child, but even involved in uterine life through its mitochondrial DNA. To simplify, there are two women involved in the pregnancy.

    These biological details seem very important. With this light, I think it's best:
    - Maintain the prohibition of surrogacy because of the similarity links and development between the woman and her unborn child.
    - Legalize surrogacy which allows a biological continuity between the child and the infertile couple, even during pregnancy. And further minimizes the risk of suffering of women in the child call his parents because the child will not look like him.