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 all news by reading this, will have to take a stand on the issue of surrogacy, better known under the item of debate surrogacy .

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 reasons of financial gain. The French ban was passed in 1994 and again in 2004 However there have been cases of surrogacy in France, authorized by law since no variance there, do not derogate because 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 to monitor these children since then, which could allow legislators to decide in full knowledge and avoid the fantasies of both sides. (Shift 24/06/2009: The Express returns to 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 mother).

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

Among the supporters 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 included more we find, the "father" of the first French test tube baby, the doctor Rene 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 some associations that advocate the legalization of this practice to defend the interests of a few wealthy." It is bitter, strong, too, perhaps.

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, holding discussions to advance his ideas, defend his point of view (as the synthesis of the Board State shows) increase its visibility and participation in the construction of the decision on this complex subject.

Arguments.

  1. . « Donner » son corps le temps d'une grossesse pour qu'un couple puisse accueillir son propre enfant est un acte altruiste de haut niveau. Accepting an act of generosity. "Donate" his body time to pregnancy for a couple can receive their 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 offered by relatives of the woman who can not carry his child's mother, sister, friend ... http: // www. dailymotion.com/video/x6hb3u
  2. Avoid reproductive tourism. Several countries in the world accept the 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 to establish 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. . Comme le suggère l'affaire Mennesson , recourir aux mères porteuses à l'étranger n'est pas sans poser problème lors du retour en France des parents biologiques avec leur enfant. Avoid civil status issues. As suggested in 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 this child? The child of his mother under French law? Who is his mother according to the law? She who gives birth the child. QED. But the interest of the child, he of having 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 other principles that 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 be forbidden a consenting person? Under q ual ethics or moral? Would it not deny the interest of scientific progress in the medical field to 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 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 syndrome Mayer-Rokitansky-Kuster-Hauser . In total, it is estimated, according to 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 the biological and psychological pressures) that women of childbearing age would. This partly explains fertility levels in our country, and this 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 for this development, but one third of them do not object. Now we know the laws that lead to meaningful changes can not be made without the consent of a significant portion of the population. For at least two reasons, first, because it enables supporters of this development to have supports and relays in public opinion, secondly, because it 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, in terms of public opinion, the game is not over for supporters of legalization. However, they have won their first bet: that to the public square the issue. It is no longer taboo. This is a first essential step in the recognition of surrogacy.
  7. This has been done, it is done. The argument seeks to show that such practices are ancient and still current, despite the ban, are somewhat specious in terms of the morality of the public debate, but it is a fact. In France, as I mentioned in the introduction, this has been tolerated for four years a reality. And even today, without that we know how many people are involved, this practice course. Except in centers in the country at least by citizens traveling abroad.
  8. And the father in all this? Often seen as the issue of surrogate mothers affects mostly women. It is true that there is no father-carrier and for good reason. However, "women can not have children on their own." At one point at least, a little before fertilization while the man is required. By his presence, and his ejaculation, or in absentia, having frozen his own sperm or donating his sperm in a CECOS. Or in the case of a couple of potential parents, a man and a woman so under the law, if we have seen the power of the wish, desire or need, 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 have. If this woman he wants for mother of his children can not accommodate the gestation of their child, not where it undergoes a double punishment. That of seeing his wife suffer and the right not to be a father.

Arguments against.

  1. There is no GPA without trade. This 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 surrogate mothers on behalf of foreign or domestic super-rich who "buy" the opportunity for a little less than 10,000 euros. In Ukraine, it takes 15,000 euros. In North America, about 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. You can choose the area of ​​production and guarantees that come with it. The argument is without question but it remains theoretical. No one 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're not talking about buying children but 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 he supported, Fertilization in vitro, artificial insemination ... are difficult to meet. For reasons of ways in the few medical centers offering these services or because of a strong shortage of donor gametes. Thus, the agency Biomedicine states 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 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 health minister, author of a remarkable book on bioethics, asserts against for reasons explained 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 against the anti-abortion sign an appeal, it is difficult to change laws Bioethics without their consultation or their consent. The pressure group that is, even if his forehead is not always united, represents a strong power of influence especially as many parliamentarians come from their ranks and therefore less sensitive to their arguments by atavism .
  4. The status of the surrogate mother is a fuzzy legal perspective. Who is the woman who gives birth to a child who is not biologically his? Who is this child to this woman giving birth? It is not clear measure psychological effects for the woman who gave birth to leave her child to her mother-biological. The working group of the senate who has examined the question 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, to see the child, praise the mother, the father of the child, discuss his resemblance to so and so, give gifts, take her in his arms. At birth the child was already nine months. Is given, it was given 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 expectation of a change of mind of the woman in labor? What anguish! What suffering of waiting! Finally, what about the right of access opposable might ask the surrogate? She still carried the child, fed, talked, perhaps even whispered words of love. And if that is not the case, as studies have shown the importance of the peace of the mother during the pregnancy and the presence of the father, why this child should he deny, from the Initially, beyond the vicissitudes of the lives of couples, these attentions.
  5. This implies a contract that does not qualify. Use a surrogate requires a contract between the two parties, the carrier and recipients, with commitments from both sides, 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 break, alcohol to strawberries, rolled cigarette Russian cigarette? Selection of surrogate mothers should be able to guarantee upstream partly serious candidates but could 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 is undertaking, weathered its reflection, 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 a surrogate mother.

We see from reading these arguments together that this issue is complicated by its possible consequences. It also confronts us with our assumptions. As Sylviane Agacinski said, "In this field, France is not late, she is ahead." Everyone will make its 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 surrogates?" - Kewego
Sylviane Agacinski and François Olivennes discuss this thorny issue.

The woman who is in the photo illustration on the home page of this article is not a surrogate. This photo is taken from the database of the United States Department of Agriculture.
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Comments

  1. [...] To surrogate mothers in France, I have 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 carrying the child has no genetic link to the embryo worn) often amalgamated with surrogacy (where a woman bears a child from his own genes) started in 1984 California. Following the fear of conflict around 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 for certain practices which premiered was passed in 1985 in England.
    Followed Australia, Israel, New Zealand and the American states (mostly by jurisprudence). 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 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 heritage and above all, 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 the lack of determinism uterine. The claim that the GPA would imply abandoning falls within this narrow 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 who 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 primate gestational often an expression of defiance, a refusal of 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 child mortality countries and that of women died in childbirth.
    Infertile couples never claim a "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 the secrets related to the birth.

    Exploitation or empowerment of women?
    The female carrier of the child to others 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 willingness 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, respecting others? The fundamental challenge for society - but also for the 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. In reaching 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 issue of altruistic legislative framework that puts an end to the ban on surrogacy in France. Our country can no longer hide behind moralistic caricatures while GPA is already on French soil in a clandestine manner, 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 prior to 1994, as if we still had no recoil as if good practices did not exist. France, the country of human rights, can no more continue to deny the existence and rights of children born through surrogacy abroad.

  3. Claire said:

    It is great pleasure 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, it can make the GPA without commerce, without contractual regime, giving a clear status to the surrogate, establishing a lineage that protects the child of a (unlikely) desistance parents ...

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

    That 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 all costs (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 that way and trauma to the surrogate mother. It's really a mindset of rich and selfish. Somali women are trying to save children from starvation, then leasing belly ... Would rather welcome these children and their adoption story momentarily to save them. It is in this sense that I wrote that the GPA is something rich selfish. "

    And presto, 4 lines of what is believed about the GPA but also the adoption.

    Otherwise, I'm annoyed by the fact that two different words are mixed to me: "Surrogate Mother" and "surrogate mother."
    In most documents, use of the word "surrogate" obscures the profound differences that there are between surrogacy (the woman who carries the child also provides the ovum) and surrogacy said GPA (wife carrying the child has no genetic relationship to the child). Indeed, recent studies show many molecular exchange between mother and child. These exchanges are regulated by mitochondrial DNA said. Unlike nuclear DNA, which is transmitted by a combination of nuclear DNA from the 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 their own mitochondrial DNA. The contribution of the infertile woman is 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 she even participates in uterine life through its mitochondrial DNA. To simplify, there are two women involved in the pregnancy.

    These biological details seem very important. Viewed in this light, I think it's best:
    - Maintain the ban on surrogacy because of similarity links and development between the woman and her unborn child.
    - Legalizing 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 defer the child to his parents because the child will not look like him.