Surrogacy. The debate on "surrogates" birth in complexity

Photo Le Monde2 du 19 juin 2009 (S. Clair)

Photo Monde2 of 19 June 2009 (St. Clair)

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

This is a complex issue that lawmakers will have to decide. Today this possibility is prohibited in France. "The fact to intercede" for use of this practice is punishable by one year imprisonment and 15,000 euros fine. This fine is doubled if the act is done for profit-making reasons. The French ban was passed in 1994 and again in 2004. However there have been cases of surrogate mothers in France, as authorized by law are not at variance, are not at variance because the law did not exist. It was between 1987 and 1991. 70 It is estimated the number of children born to mothers during this period. To my knowledge, there are no epidemiological studies on monitoring these children since then, which could allow legislators to decide in full knowledge of and avoid 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 testimonies of children born to carrier mothers).

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

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

Among the opponents, the most provided ranks, 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 which includes several deputies and senators sensitive to these issues and publish reports), the National Consultative Committee on Ethics , Catholic and Protestant churches as well as representatives of Islam and to a lesser extent the c of onsistoire Paris . About opponents René Frydman said he was "outraged by the lobbying of certain associations that advocate legalization of this practice to defend the interests of a few haves". It's bitter, strong, perhaps too much.

Each camp has their own influence to advance his ideas. Interviews are given, open blogs, participation in conferences or business seminars, mails and files shipped with parliamentarians, committed thoughts 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 for.

  1. Accepting 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. It was the essential motivation of French surrogates in the late 80s This act is sometimes suggested by relatives of the woman who can not bear her child, the mother, sister, friend ... http: // www.
  2. Avoid reproductive tourism. Several countries in the world accept surrogacy. These include the United States, Canada, Belgium, Britain, the Netherlands, Ukraine, Denmark and Greece, five countries of the European Union. Other countries, such as India accepts this practice and makes an industrialization of the process as it will be objected by opponents of legalization. Accept surrogacy therefore prevent double standard measures between those who have the financial and cultural means of establishing contacts with foreign countries in this regard, and those who, for various reasons, can not do . The argument is that the principle of equality prevails.
  3. Avoid problems of civil status . As suggested by the Mennesson case , recourse to surrogate mothers abroad is not without its problems upon return to France of biological parents with their child. Who is this child? The child of her mother according to French law? Who is his mother under the law? She who gives birth the child. QED. However, the child's interest, here that of having a legal identity, a civil status, without which no act of everyday life can be achieved (a passport, vote, take an exam ...) is essential, in our culture, over all other principles can be put forward.
  4. Do not refuse the advances in medical technology. 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 he would be prohibited a consenting person? Under q ual ethical principles or moral? Would it not deny the interest of scientific progress in the medical field that reject this progress is reaching?
  5. Help combat 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 decrepitude of the body thereafter, anxiety about suffering ...), there are a number of purely medical reasons that prevent women can bear children. This is the case of women whose uterus has been altered by radiation for example, women with Syndrome Mayer-Rokitansky-Kuster-Hauser . In total, it is estimated, according to Cross, 300 the number of women involved in the Mayer syndrome and postpartum hemorrhage. Or in society of ours, there is a strong social pressure (not to mention the biological and psychological pressures) that women of childbearing age would. This partly explains the fertility levels in our country, and this reinforces the suffering of those who can not afford the social role conferred on them.
  6. A movement is emerging in public opinion. Not that the French, according to opinion surveys, have become largely for this evolution, but 1/3 of them are not opposed. We know the laws which cause profound changes can be made without the consent of a substantial part of the population. For at least two reasons, first, because it enables supporters of this development to have support and drivers in public opinion, and second, because she suddenly cut the grass 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 supporters of legalization. They have passed their first bet, however, that of putting the issue on the public square. 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 which seeks to demonstrate that the practices are ancient and still present, despite the ban, are somewhat specious from the point of view of morality of public discussion, but is a fact. In France, as I recalled in the introduction, this has been a reality for four years tolerated. And even today, not that we know how many people are involved, this practice courses. If not 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 mainly affects women. It is true that there is no carrier-father and for good reason. However, "women can not do on their own children." At one point at least, a little before fertilization, man is necessary. 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 in the sense of the law, if we saw the power of the wish, desire or need, feminine, father's place, his desire, his desire or need, is neglected. He also has the right to have children, if it exists. And in a free society, it may decide with whom to have them. If this woman he wants for mother of his children can only accommodate the gestation of their child, would it not then undergoes a double punishment. That of seeing suffering and that of his wife can not be a father.

Arguments against.

  1. There is no GPA without trade. It is a punchline. In very many cases, surrogacy is manipulated to become a business. In India, women confined in a nursing home, are recruited to become mothers-carriers on behalf of foreign or domestic super-rich who "buy" this possibility for just under 10,000 euros. In Ukraine, it takes 15,000 euros. In North America, about 40,000 euros. Depending on the nature of contracts, legal responsibilities, insurance, the price varies. The land is flat, wrote the American journalist Thomas Friedman. Nothing is more true regarding surrogacy. You can choose its production area and guarantees that go with it. The argument is without question but it remains theoretical. No one can say exactly that in France this would happen in the same way as the practice is prohibited. Everything leads us to believe that this is a considerable barrier to acceptance by public opinion: a child can not have prices, although here we do not talk about children but purchase loan or lease bellies then the tenant eviction.
  2. This is not "a public health priority." In an interview given on this issue with the weekly L'Express, the gynecologist René Frydman, indicates that already assisted reproductive requests, which he supported, Fertilization in vitro, artificial insemination ... are difficult to meet. For reasons of means in the few medical centers offering these services or because of a strong lack of gamete donors. Thus, the Biomedicine Agency indicates in its annual report that 400 couples per year are awaiting egg donation but only 220 women volunteers every year to follow the medical treatment inherent in the gift and ultimately to several 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 Minister of Health, author of a remarkable book on bioethics, asserts against for the reasons explained here. However, 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 against the anti-abortion sign a call, it is difficult to change laws Bioethics without their consultation or assent. The pressure group that is, even if its forehead is not always united, represents a strong power of influence even more than many parliamentarians are from their ranks and therefore less sensitive to their arguments by atavism .
  4. The surrogate mother's status is unclear from a legal point of view. Who is the woman who gives birth to the child who is not biologically his? Who is this child to this woman in labor? It does not measure well the psychological effects for the woman who gives birth to her child to leave his biological mother. The senate of the working group that 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 own. Usually, 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 maternity or hospital, or the kitchen, or in the pool, see the child, praise the mother, the father of the child, evoke its resemblance to so and so, give gifts, take him in his arms. At birth the child already has nine months. He is given, it was given a name, an identity. He was welcomed into his family with open arms. It is the future. There is hope. How then accept that for three days, three long days, a couple or in the feverish expectation of a change of mind of the woman in labor? What anguish! What suffering of waiting! Finally, what about visiting enforceable law that could apply the surrogate mother? She still carried the child, fed, spoken, perhaps even whispered words of love. And if that is not the case, as studies have proven the importance of the peace of the mother during the pregnancy and the presence of the father, why this child would deprive it, from the Initially, beyond the vicissitude of torque lives of these attentions.
  5. This requires a contract that does not qualify. Use a surrogate mother assumed a contract between the two parties, the carrier and recipient, with commitments from both sides, the rights, duties. From a philosophical point of view, this assujétion, the alienation of man by man is not admissible. This is already happening in labor 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 the fair at rest, alcohol Strawberry rolled cigarette the Russian cigarette? Selection of surrogate mothers should be able to guarantee upstream partly serious candidate but can not ensure full loyalty of the parent carrier vis-à-vis its commitments.
  6. And if the biological parents refuse the child? This question is rarely asked. We can assume that a couple who engages in this process knows why he is undertaking, weathered his reflection, tried everything outside of this process. But what if during the time of pregnancy parents separate? Does the common law on parental authority that applies? How to decide?

The issue of the opening of surrogacy for gay couples is not an issue here. Because it is assumed that it is the biological child, from the gametes of a couple, therefore differentiated between men and women, which would be carried by the surrogate mother.

We see from reading these arguments gathered that this issue is complex 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." Everyone will make his opinion , Sylviane Agacinski is clearly against, but in any case, our country is clearly ahead of the issue of public debate around this theme.

Mikaël Cabon

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

The woman 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 have just published an article on the issues on the blog Lobbycratie. . A major issue for our society like that of research on stem cells, [...]

  2. Eric75 said:

    Surrogacy (where the woman carrying the child has no genetic connection with the increased embryo) often amalgamated with traditional surrogacy (where the woman has a child of her own genes) began in 1984 California. Following the fear of conflicts over custody and parentage of children born by this action, but also to respond to the risk of commodification of the female body, commissions have studied laws to frame 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 might be called "moral panic" disappeared. And since the practice of surrogacy is growing continuously under conditions which are no longer disputed, no authority is also income legalization.
    It is unfortunate that the effectiveness of these legal provisions had not been evaluated by the French institutions which are expressed on the GPA or fluttering like against-examples or "less-called ethics" of the few countries such as Belgium and India, where there is no legal framework.

    The child's interest 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 kinship, and that ultimately is used as a "right" of the child not to be born, so passive eugenics to couples who can not bear children. The very history of humanity should prevent us from limiting the relationship to one of the biological, gestation, at the expense of transmitting a genetic and especially the social fact: mother or father is the one who behaves as such under the definition given 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 absence of uterine determinism. The assertion that the GPA would be synonymous with abandonment falls under this reductive approach of kinship. If we followed this definition of abandonment, it would return to France in the legalization of embryo donation to be consistent. But this is not because a child is desired and expected continuously by a couple can not be considered abandoned. The attachment is not a biological function but a psychological construction.
    Claim gestational biological primacy is often an expression of defiance, a refusal of the intrusion of thought medicine as a form of mechanized reproduction. Contrary to the image of Epinal childbirth under the sole protection of Mother Nature, we must remember that half a century, advances in reproductive medicine, whose fantasized representations are the specimen and incubator, allowed to end in our rich countries to the scourge of child mortality and the dead women in childbirth.
    Infertile couples never boast of "right to a child" but the "rights 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 delete the secrets related to the birth.

    Exploitation or empowerment of women?
    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" almost exclusively by those who claim to respect the dignity of women. This desire to caricature denies the autonomy of women and denigrates the principle of the gift.
    The dignity of woman would it not be better met if we understood that in surrogacy, it seeks to act as fair and reasoned way possible, respecting others? The fundamental challenge for society - but also for women - is to ensure they are properly informed of the intended approach, and that their expectations are not at odds with those of the intended parents. To get to this logic of exchange and mutual respect, we must admit that for some women, pregnancy is a fulfilling life period.

    Infertile couples want a genuine debate to take place on the issue of altruistic legislative framework that puts an end to the prohibition of surrogacy in France. Our country can no longer hide behind moralizing caricatures while the GPA already exists on the national clandestinely ground, with all the risks that implies lack of supervision.

    We can not continue in France to act as if nothing had changed since the debates before 1994, as if we still had no recoil as if the good practices do not exist. France, the country of human rights, neither can continue to deny the existence and rights of children born through surrogacy overseas.

  3. Claire says:

    It's great fun to read this article in the light of the proposal of gestation legalization law for others filed on 27 January 2010 by 70 senators. We realize that almost all of the arguments against surrogacy are false.

    Thus, as is this bill, we can do the GPA without commerce, without contractual regime, giving a clear status to the surrogate mother, establishing a lineage that protects the child of an (unlikely) withdrawal of the parents ...

    This leaves only the argument that the medical profession would not accept this technique. What is wrong! Just read the survey "questionnaire results Medically Assisted Procreation (GEFF, BLEFCO and CNGOF, SFG and FNCGM, 2 October 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.
    Wanting to have a child at any price (at any price ... to trade in child conception yuck) when 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's really a rich mentality and selfish. Somali women are trying to save children from starvation, then the belly location ... Would rather welcome these children and to adopt them momentarily to save the history. It is in this sense that I wrote that the GPA is a selfish rich stuff. "

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

    Otherwise, I am annoyed by the fact that you mix two different words to me: "Surrogate mother" and "surrogate".
    In most documents, the use of "surrogate" mask the profound differences that there are between surrogacy (the woman who carries the child also provides her egg) and surrogacy said GPA (wife carrying the child has no genetic link to the child). Indeed, recent studies have reported many molecular exchanges between mother and child. These exchanges are regulated by mitochondrial DNA says. Unlike nuclear DNA, which is transmitted by a combination of nuclear DNA of parents, mitochondrial DNA is transmitted only by women. Thus, in case of surrogacy, the woman who carries the child transmits its genetic heritage to the child, and intrauterine exchanges are governed by its own mitochondrial DNA. The contribution of the infertile woman is in this case as in purely social adoption. 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 mitochondrial DNA of 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 recognition with the child, but even participates uterine life through its mitochondrial DNA. To simplify, there are two women involved in pregnancy.

    These biological details seem very important. With this light, I think it's best:
    - To maintain the prohibition of surrogacy because of likeness and development of links between the woman and her unborn child.
    - To legalize surrogacy which allows a biological continuity between the child and the infertile couple, even during pregnancy. And moreover minimizes the risk of suffering of women in recovering the child to his parents for the child does not look like him.