Surrogacy

Noonehasreallybeenabletothinkupasystemthatseemstoadequatelysolvethe
problemsthatarisewithinsurrogacy.
Surrogacy
Historicalbackground:Genesis16:1Sarah,Abrahamswifecouldntbearchildren.Useda
surrogate.TraditionalmethodAbrahamjustsleptwithadifferentwoman.
Partialsurrogacywhenthecommissioningfatherinseminatesthesurrogatemotherhimself.
Itcanbeaccomplishedwithoutexpertassistanceandthushardtocontrolandregulate
Fullsurrogacyanembryoiscreatedinvitro,usuallyusingthecommissioningcouplesegg
andspermandistransferredtothesurrogatemothersuterus.SinceinIVFisinvolved,full
surrogacyarrangementsintheULnecessarilyinvolvetreatmentinacentrelicensedunderthe
HumanFertilisationandEmbryologyActandregulatedbytheHFEA.
Surrogacysparkscontroversy.Peoplehaveverydifferentviewsonitsomecanbevery
derogatoryaboutitsellingyourbodyorsellingachild.
WarnockReport1984theweightofpublicopinionisagainstthepracticetheycertainly
didnotrepresentpublicopinion,theywereexperts.Noevidenceofundertakingasurvey.
Neverthelesstheysaidwithrealcertitudethatitwasinconsistentwithhumandignity.Saidit
wasdangerousanddegradingtothechildtobeboughtformoney.Saiditwasalsoanattack
onmarriage.
Earlycasesin1980s,e.g.BabyCotton(ReCbelow)followedby:
BabyCotton case Kim Cottonwas the first knownEnglish surrogate. She was given
substantialmoneytoanAmericancouple.Socialservicesintervenedhoweverafterbirth.
EventuallytherewasacaseofReC.thecourtreluctantlysaiditiswasprobablyinthechilds
best interests for the child to be adopted in this case. Allowed to take the child. But
parliamenthadtobedone.
Parliamentthuscameupwithsomelegislation.
Judicialdisapproval/caution
A v C [1985] Fam Law Rep 445 pernicious agreement wouldnt even allow the
comssioningfathercontactwiththechild.
ReC(AMinor)(Wardship:Surrogacy)[1985]FamLawRep846ultimatelypermittedbut
reluctantbabycottoncase.
Parliamentaryresponse
Choices: Ignore? (ProstitutionModelancillaryactivitiesmaybeprohibited) Prohibit?
(CriminalLawmodelpunitivesanctionswouldntwork.Notworthyofjailtimeandfine
wouldntbeadeterrencebecauseiftheyrepayingthatamountforthesurrogacy,charging
themanextrafewthousandwillnotharmthemtoomuchinthesenseofstoppingthemdoit.)
Regulate?(Adoptionmodelscreenandchoosecommissioningparents)
Whatcouldtheydo?Whichwouldtheychoose?

TookupWarnockReportparliamenttriedtobanit.However,whatwouldtherepercussions
beifsurrogacywasbanned?Ifprimaryconcerniswiththechildrenandthenwebanitandit
goesunderground,theyarenotprotectingthechildandthechildlosesout.Bettertohaveit
withregulation.
A) SurrogacyArrangementsAct1985quickresponsetoCottoncase
Policy=restrictanddiscourage
arrangementslegallyunenforceablemeantifthesurrogaterunsawaywiththechild,the
commissioningcouplehasnolegalredress.Equally,ifnomoneypaidsurrogatecannotgo
tocourt.Thereforemakingthelegalconditionsdifficultinordertodiscouragepeople.
noparticipationbypaidintermediaries AmericannursecametoUKandannounced
wantedtoetupafranchiseforsurrogacyshewantedtobethecocacolaofsurrogacybut
thiswasbanned.
noadvertisinghardertogetholdofsurrogatesideathatkeepingitwithinthefamilyunit
butwhatisnotbanneditPAYINGthesurrogate.SOCANTPAYINTERMEDIARYBUT
CAN PAY THE SURROGATE. HOWEVER, GIVEN THE ARRANGEMENTS BY
PARLIAMENT,YOUAREOFFEREDNOHELP.
SO IT IS NOT AN OFFENCE TO ENTER INTO A SURROGACY
ARRANGEMENT BUT THE AGREEMENT ITSELF IS NOT ENFORCEABLE.
SEENINSECTION1BOFTHSSURROGACYARRANGEMENTSACT1985.
HFEA1990s27whoisthemother?thewomanwhoiscarryingorhascarriedachild
asaresultoftheplacinginherofanembryoorofspermandeggs,andnootherwoman,isto
betreatedasthemotherofthechildthisworksforeggdonorsbutdefinitiondoesnotwork
forsurrogacy.Perhapsanattempttodiscouragesurrogacyagain.

Parental order introduced as an amendment (see below) allows the commissioning

coupletotakeoverlegalresponsibilityofthechild.
Since1990whathashappened?...
Changingattitudesovertimeithasgainedmorepopularsupportovertime.
Reflectedinlegalresponse

Judicial approaches in cases of dispute: MRS JUSTICE THESIS HAS HEARD

SURROGACYCASESALLTHETIME.
AtthebeginningverynegativeAvC[1985]FamLawRep445perniciousagreement
wouldntevenallowthecommissioningfathercontactwiththechild.All3judgesinthe
courtofappealwereunanimousintheircondemnationofthearrangement.WithCumming
Brucecondemningitasakindofbabyfarmingoperation.

Re C (A Minor)(Wardship: Surrogacy) [1985] Fam Law Rep 846 ultimately

permittedbutreluctant)babycottoncaseasabove)

 ReP(Wardship)(Surrogacy) [1987]2FamLawRep421firstcaseinwhicha
judgesimplylookedatthecaseandsaidtreateditthesameasanyothercustodycase/family
dispute.Caseinwhichboththecommissioningparentsandsurrogatewantedtokeepthe
child.Thecourtweighedupthemeritsoftheparentsandwherethechildsinterestswouldbe
bestserved.Thesurrogatewasheldtobeparentalchoicebalancingexercise.Herewas
importantthatthesurrogatehadbeenwiththechildlonger.
ReP(Residence:Appeal)[2008]1FLR198tabloidcoverageforthiscase.Thisis
awomanwholivedinWestonSupermareherandherhusbandcouldnthavechildren
anymore.Sheseemedtolovechildren.Indeed,shehadactedasasurrogatebefore.Also,she
hadtriedtocollectababybeforewhohadbeenabandonedonthepier.Shecarriedachildfor
aDutchcoupleandliedandsaidshehadmiscarriedbutinsteadshejustwantedtokeepthe
child.Daughterthreatenedtoturnherinasabenefitfraud.Held:childtransferredto
commissioningcoupleasthesurrogateseeminglycouldntdistinguishbetweenfantasyand
reality.
HvS[2015]EWFC36againtabloidcoverage.Awomancarriedachildandtherewere
twomen(samesexpartnership)involved.Spermcamefromoneofthosemen.Therearetwo
differentversionsofwhatwasmeanttohappenthewomansaidshewasalwaysgoingto
raisethechildandtheydbeonthesceneandthemensaidthiswasfalseandshewasjusta
surrogate.Cametoshowthattherewasnoformalagreement.Childstillwithmotherwhen
casecametocourt.Judgesaidthesurrogatewasahomophobicwomanwhowastryingto
obstructtheirfamilylife.Saidshewasntsuitable.Shewasstillbreastfeedingat1yearanda
half.Overallfoundshedidnothaveagoodrelationshipwithchildwasnttreatingthechild
correctly.Held:childtransferredtosamesexcommissioningcoupleshowsamoreopen,
broadinquiryapproachfromthecourt.
Tentativestepstowardsregulationsomeofficialacceptance
Startingtobringinsomeassessmentofsurrogacy,despitetheirinitialattitudewhich
wascompletelyagainstthis.
HFEACodeofPractice(6thed.2004)
3.17:Useassistedconceptiontechniquestoachievesurrogatepregnancyonlywhere
commissioningmotherisunableforphysical/othermedicalreasonstocarryachild
orwhereherhealthmaybeimpairedbydoingso.
HFEACodeofPractice(8thed.2009)
8.4

Ifthechildisnottoberaisedbythecarryingmother(ie,inasurrogacy
arrangement),thecentre
shouldassessboththosecommissioningthe
surrogacyarrangementandthesurrogate(andthesurrogatespartner,ifshe
hasone)incasethereisabreakdowninthesurrogacyarrangement.

8.12

Ifthechildwillnotberaisedbythecarryingmother,thecentreshouldtake
intoaccountthepossibilityofabreakdowninthesurrogacyarrangementand
whetherthisislikelytocauseariskofsignificantharmorneglecttoany
childwhomaybebornoranyexistingchildreninthesurrogatesfamily.

ChildrenandFamiliesAct2014
Adoptionleaveandpayextendedtoparentswithanewbabyborntoasurrogate

Parentalstatusofsurrogateandcommissioningcouple:
HFEA1990and2008:motherhoodisgestational
Workswellinthecaseofeggdonation
butharshapplicationincasesofsurrogacysurrogateispresumedtobemother
herhusbandispresumedtobefather
Remedy:aParentalOrder:s.54oftheHumanfertilisationandEmbryologyAct2008first
introducedasanamendmenttothe1990Act

transfers legal parentage from surrogate (and husband) to

commissioning couple. PARENTAL ORDER WAS DESIGNED
TODEALWITHSURROGACY.

Whenacourtmakesaparentalorder,theRegistrarGeneralwillre
registerthechildsbirth.Aswithadoption,itwillnotbepossible
forthepublictomakealinkbetweenentriesintheregisterofbirths
andtheparentalorderregister,butonceachildreachesadulthood,
shewill,afterbeingofferedcounselling,haveaccesstoheroriginal
birthcertificate.The2008actcontainstherulesgoverningaccessti
parentalorders.
Legalrequirementsinclude:
oneparentmustbegeneticallyrelated(usuallythemanbutnotexclusively)
parentsmustbeUKresidentsover18
Re A (Foreign Surrogacy: South Africa) [2015]
EWHC1756foundtheyhadaUKdomicilesowasgranted
couplesonly(notavailableforsinglepeople) mustbemarried,orcivilpartners,orin
anenduringfamilyrelationship
civilpartnersandcohabiteescanapplyalso
the2008actextendseligibilitytosamesexandunmarriedcouples
InAvPanunusualissuearoseinthat,althoughtheapplicationforaparentalorderforB,
whohadbeenborntoasurrogatemotherinIndiahadbeenmadebyMrandMrsAtogether,
Mr A had died before the hearing. The question foe the court was whether the word
applicantscouldbeconstruedsoastorequiretwopeopletomaketheapplication,butnotto
requirethattherebetwolivingapplicantsatthetimeofthemakingoftheorder.ThesisJheld
thatitcould,andinmakinghisdecision,shetookintoaccountthatafailuretomakeanorder
in these circumstances would interfere with the familys articles 8 rights, and that that
interferencecouldnotjustified.ThesisJdidnotacceptthatmakingaparentalorderinthis
case would offend against section 54s clear intentionto avoid circumstances where a
single person could apply for a parental order or enter into surrogacy agreement as the
commissioningparent.Though,ofcourse,section54doesnotdeterminewhocanenterinto
surrogacyagreements,onlywhoiseligibleforparentalorders.
consentofsurrogate(6weeksafterbirth)
mustapplywithin6monthsofbirth
Theonlyexceptiontotheconsentrequirementiscontainedinsubsection7whichsuggests
thattheremightbeanexceptiontotheneedforconsentwhereapersoncannotbefoundoris
incapableofgivingconsent.ThisprovisionwasinvokedforthefirsttimeinReD(Minors)
(Surrogacy)inwhichtwinshadbeenborntoanIndiansurrogatemother,asaresultofan
arrangemententeredintobyaBritishsamesexcouple.Theyhadtakenspecialistlegaladvice
beforeenteringintotheagreementandwere aware of the needfor the surrogate togive

consent6weeksafterthechildrensbirth.Theclinicprovedtobeunhelpful,andthecoupleto
relyuponthisexceptioninsection54.BakerJacceptedthat,inthiscase,allreasonablesteps
hadbeentaketofindthesurrogatemother.Therewasevidencethatthesurrogatemotherhad
agreedtogiveconsentbeforethatconsentwaslegallyvalid,anditwasclearlyinthetwins
bestintereststhataparentalordershouldbemade.
ReX[2014]EWHC3135directiveratherthanmandatory
paymentofsurrogateforreasonableexpensesonly ReC [2002]EWHC157*(12,000
here ) the court has the power to authorize payments other than expenses reasonably
incurred and in 1998 the Brazier Committee was unable to find any case in which an
applicationforaparentalorderwasrefusedonthegroundsthatanunacceptablylargesumof
moneyhadchangedhands. ***InReC(applicationbyMrandMrsXunders30ofthe
HumanFertilisationandEmbryologyAct1990)forexample,thecouplehadpaidawoman,
whowasinfactclaimingbenefits,12,000forherlossofearnings.Despitefindingthatthe
couplehadmadeanunlawfulpayment, WallLJneverthelessjudgedthataparentalorder
wouldbeinthechildsbestinterests.
InReX&Y(foreignsurrogacy)acaseinwhichaBritishcouplehademployedaUkranian
surrogatemother,ithadtobeconcededthatthepaymentsof235eurospermonthtothe
surrogatemotherduringpregnancyandalumpsumof25,000eurosonthelivebirthofthe
twins,toenablehertoputdownadepositforthepurchaseofaflat,significantlyexceeded
expensesreasonableincurred.
InReS(parentalorder)thecommissioningcouplehadpaid23,000dollarstoMaCalifornian
surrogatemotherwhowasthegeneticmotherofachildconceivedusingMrXssperm.Some
ofthismoneywastocoveraccommodationcosts,whichMwouldhaveincurredinanyevent
andwasnotthereforeanexpenseassociatedwiththepregnancy.HedleyJsetoutsomeofthe
considerations relevant to decisions about whether to give retrospective approval for
surrogacyagreementsthatwouldnotbelawfulinEnglandandWales.Firstthecourthadto
ensurethatthepurposeofthearrangementwasnottocircumventlawsinEnglandandWales.
Secondlythecourthadtobeastutenottobeinvolvedinanythingthatlookedlikepayment
foreffectivelybuyingchildrenoverseas,andthirdlyithadtobecarefultoensurethatthe
sumspaidwerenotsuchastooverbearthewillofthesurrogate.Inthiscase,HedleyJfound
thatthepaymentmadetoMdidnotoffendanybroadissueofprincipleinrelationtothe
buyingofchildrenandwasnotgreatlydisproportionatenorwasittaintedbybadfaith.Itwas
thereforeinthebestinterestsofthechildrenthataparentalordershouldbemadeandthe
unlawfulpaymentwasnotabartomakinganorder.
courthaspowertoauthoriseretrospectively^^^
*manysubsequentinternationalcasesbelow
HFE(ParentalOrders)Regulations2010appliesAdoptionandChildrenAct2002s.1:
Childs welfare= formerlyfirst now paramount consideration so
althoughthereispublicpolicyconcernsaboutalotofmoneygoingouttosurrogates,the
courthastoputthechildfirst.
Generalprinciplesofinterpretation:
Weighpublicpolicyconcernsagainstthebestinterestsofthechild
paramountcyofbestinterestsunlessclearabuseofpublicpolicy
Adoption

Thereareseveralreasonswhyacommissioningcouplemightnotbeabletoapplyfora
parental order. If they do not apply within the sixmonth time limit, perhaps because of
immigrationdelays,forexample,orthesurrogatemotherrefusestoconsenttothemakingof
anorder,theonlyinwhichthecommissioningcouplecanacquirelegalparenthoodisthrough
adoption.
Theprocessisonerous.Inordertobeeligible,theAdoptionandChildrenAct2002mustbe
satisfied and potential adopters must endure rigorous scrutiny by social workers over a
prolongedperiodoftime.Ifthesurrogatemotherdoesnotwantthechildbutforsomereason
thecoupleareineligibleforaparentalorder,adoptionwillusuallybeinthebestinterestsof
thechild.Butwherethesurrogatemotherhaschangedhermindandanadoptionapplication
ismade,thesituationislessstraightforward.Undersection52(1)oftheadoptionandchildren
act2002,thechildslegalparentsmustconsenttoheradoption,unlesstheycannotbefound
orareincapableofconsenting,orthecourtissatisfiedthatthechildswelfarerequiresthat
theirconsentbedispensedwith.
ReMW(Adoption:surrogacy) thequestionofwhetheramothersconsenttoadoption
shouldbedispensedwitharosehere.Wasfeltthatshouldbebecauseitwasinthechildsbest
interests.
In contrast in Re P(Minors)(Wardship: surrogacy) the childrenhadbeen living withthe
surrogatemothersincebirth,andSirJohnArnoldheldthatthisfactoroutweighedthematerial
andotheradvantagesofbeingbroughtupbythecommissioningcouple.
Changesinsurrogacypracticeovertime
1) NonprofitUKorganisations
butstillnopaymentpermitted,includingfordrawinguparrangements
seecommentinJPvLP&Others[2014]EWHC595(Fam)
2) Increaseduseofsurrogacyforsinglemenandsamesexmalecouples
Homosexualspouses/partnersmayobtainparentalorder(HFEA2008)
Singlemenmaynot
BvC(SurrogacyAdoption)[2015]EWFC17
ReZ(AChild:HFEAct:ParentalOrder)[2015]EWFC73
3) Riseinsurrogacytourism mostpopulardestinationsincludeUSA,India,
Ukraine,Thailand
(althoughlawsbecomingmorerestrictiveinsomeofthesejurisdictions)
ReXandY(ForeignSurrogacy)[2008]EWHC3030(Fam)maroonedstatelessand
parentless
Hedley J had to extrapolate from HFEA, Adoption legislation: most
uncomfortablechoice
Principles:
(a) was sum paid disproportionate to reasonable
expenses?
(b)wereapplicantsactingingoodfaithandwithout
'moral

taint'?
(c)wereapplicantspartytoanyattempttodefraud
theauthorities?
Itisalmostimpossibletoimagineasetofcircumstancesinwhichbythe
timethecasecomestocourt,thewelfareofanychild(particularlyaforeign

child)wouldnotbegravelycompromised(attheveryleast)byarefusalto
makeanorder.
L(AMinor)[2010]EWHC3146HedleyJnotwithstandingparamountcyofwelfare,
court should continue carefully to scrutinise applications for authorisation
unders54(8)
ReIJ(achild)[2011]EWHC921(Fam)Ukrainianlaw:Britishcommissioningcouple=
parents
Englishlaw:Ukrainiansurrogateandhusband=parents
HedleyJagainapprovedpaymentinexcessofexpensesretrospectively
RePM[2013]EWHC2328(Fam)$48,000toUSsurrogacyagency(includedmedical
expenses)
mustexaminepaymentstothirdparties(e.g.agencies)aswell
Therealityisthereisalegalcommercialframeworkwhichisdrivenbysupplyand
demand(TheisJ)
Problems:
1) Useoftheparentalorderestimated2000surrogatebabiesbornoverseasevery
year.
However, only 241 applications were made for Parental Orders in 2014.
Dontrealisetheyneedaparentalorder.
Parentsdontrealisetheyneedanorder:

ReAandB(Children)(Surrogacy:ParentalOrders:TimeLimits)
[2015]EWHC911
Ordernotpossiblebecauseoffailuretomeettheconditionsofs54
JPvLP(above)commissioningcouplehadseparated
BvC(above)singleman
2) Disputes:
(a) commissioning parents refuse the child (Thai/Australian case of
Gammydidntwanttotakehomethechildwhohaddownsyndrome.)
(b)surrogatedecidestokeepthechild(HvSabove)

Judicialcomments
aminefield;atrekthroughathornforest(TheisJ)
fullofperils(EleanorKing,J)
Reproposalforagovernmentreviewofsurrogacylaw:
Itisnopartofthecourtsfunctiontoexpressviewsonthatsaveperhapsto
observethatsomeoftheissuesthrownupinthiscasemayhighlightthe
wisdomofholdingsuchareview.(HedleyJXandY)
The lack of a properly supported and regulated framework for
arrangementsofthiskindhas,inevitably,ledtoanincreaseofthesecases
beforetheFamilyCourt.(RussellJinHvS)
Proposedreformsofthelawincludedpaymentsandregulation:

e.g.Brazieretal:Surrogacy:ReviewforHealthMinistersCm4068(1998)
ButHFEA2008littlechangetobasicstructure
Advocacygroups(e.g.BrilliantbeginningsNatalieGamble(fertilitylawspecialist)
suggestreforms
AccesstoAssistedConception
HumanRightsAct,Art.12:
"Menandwomenhavetherighttomarryandtofoundafamily..."
Does the "right" extend to all means of founding a family? It certainly wasnt
intended to extend to assisted conception when was passed. What about single
men/individuals?Doesthisprohibitthis?
Doesitmeanthateveryonemustbepermittedaccess?
Doesitentailapositivedutytosupplymeans(e.g.viatheNHS)?Ifwehavean
obligationtoallowit,dowehavetopayforit?
Possiblebarrierstoaccess:
1) cost of private treatment (for IVF, 48000/cycle) MONEY IS
MASSIVEOBSTACLE
2) allocationofNHStreatmentresources
tothosemostlikelytosucceed(e.g.agerestrictions)
ongeographicalbasis(postcodelottery)differentcriteriaimposed
tothoseseenasmostneedy(e.g.withnoexistingchildren)
3) restrictionsimposedbyclinicsonsocial/ethicalgrounds
(e.g.married/heterosexualcouplesonly,bodymassindex)
4) restrictionsrequestedbygametedonors(asabove)
PublicFundingofInfertilityTreatment
About40%currentlyNHSfunded
NICEguidelines:
offer3cyclesofIVFtocoupleswithgreatestchanceofsuccess(i.e.<39)
aboutofPCTsfulfilthis
muchofIVFhastocomefrompeoplesownpocket(48,000)
WarnockReport,paras.2.52.13recommendationsoneligibilityfortreatment

Equality Act 2010 discrimination prohibited in protected areas (marital status,

sexuality,disability)

HFEA1990,s.13(5)
"Awomanshallnotbeprovidedwithtreatmentservicesunlessaccounthasbeen
taken of the welfare of any child who may be born as a result of the treatment
(includingtheneedofthatchildforafather) andofanyotherchildwhomaybe
affectedbythebirth."

HFEA 2008 italicized phrase has been replaced by including the need for
supportiveparenting
Possibleinterpretationsofs.13(5):
Tomorrowschildren:(HFEA)Nov2005
Identified4maininterpretationsofthewelfareprinciple:
1. Thewelfareprincipleshouldberemovedbecausetheautonomyofthe
prospectiveparentsshouldalwaysoverridetheabilityofthirdpartiestopreventa
childfrombeingborn.
2. Theinvolvementofamedicalteaminassistedconceptionmeansthatcertain
thirdpartieshavesomeresponsibilitytowardsthechildtobeborn.However,the
importanceofpatientautonomymeansthatclinicsshouldonlyrefusetoprovide
treatmentwherethereisevidencethatthechildislikelytosufferseriousphysical
orpsychologicalharm.
3. Theinvolvementofamedicalteaminassistedconceptionmeansthatcertain
thirdpartieshavesignificantresponsibilitytowardsthechildtobeborn.
Consequently,clinicsshouldnotprovidetreatmentunlesstheyaresatisfiedthat
thewelfareofthechildtobebornwillnotbeaffectednegatively.
4. Thewelfareprincipleshouldbestrengthenedsothatthechildswelfareisthe
paramountconsideration
whendecidingwhetherornottohelpanindividualorcouple.
HFEA8thCodeofPractice:
8.3Thecentreshouldassesseachpatientandtheirpartner(iftheyhaveone)before
providinganytreatment,
andshouldusethisassessmenttodecidewhetherthereisa
riskofsignificantharmorneglecttoanychild
8.7Thoseseekingtreatmentareentitledtoafairassessment.Thecentreisexpected
toconsiderthewishesofallthoseinvolved,andtheassessmentmustbedoneina
nondiscriminatoryway.Inparticular,patientsshouldnotbediscriminatedagainston
groundsofgender,race,disability,sexualorientation,religiousbelieforage.
Factorstotakeintoaccountduringtheassessmentprocess
8.10 Thecentreshouldconsiderfactorsthatarelikelytocauseariskofsignificant
harmorneglecttoany
childwhomaybebornortoanyexistingchildofthe
family.Thesefactorsincludeanyaspectsofthe
patientsorpartners:
a)pastorcurrentcircumstancesthatmayleadtoanychildmentioned
aboveexperiencing
seriousphysicalorpsychological
harmorneglect,forexample:
i)previousconvictionsrelatingtoharmingchildren
ii)childprotectionmeasurestakenregardingexisting
children,or

environment

iii)violenceorseriousdiscordinthefamily

b)pastorcurrentcircumstancesthatarelikelytoleadtoaninability
tocarethroughout
childhoodforanychildwhomaybe
born,orthatarealreadyseriouslyimpairingthe
careofanyexisting
childofthefamily,forexample:
i)mentalorphysicalconditions
ii)drugoralcoholabuse
iii)medicalhistory,wherethemedicalhistory
indicatesthatanychildwho
maybebornis
likelyto
sufferfromaseriousmedicalcondition,or
causeseriousharmtoany
above.

iv)circumstancesthatthecentreconsiderslikelyto
childmentioned

8.11Consideringachildsneedforsupportiveparenting,centresshouldconsiderthe
followingdefinition:
Supportiveparentingisacommitmenttothehealth,wellbeinganddevelopmentof
thechild.Itispresumedthatallprospectiveparentswillbesupportiveparents,inthe
absenceofanyreasonablecauseforconcernthatanychildwhomaybeborn,orany
otherchild,maybeatriskofsignificantharmorneglect.Wherecentreshaveconcern
astowhetherthiscommitmentexists,theymaywishtotakeaccountofwiderfamily
andsocialnetworkswithinwhichthechildwillberaised.

Refusingtreatment
8.15Thecentreshouldrefusetreatmentif:
a)anychildwhomaybeborn/existingchildofthefamilylikelytobeatriskof
significantharmorneglect,or
b)itcannotobtainenoughinformationtoconcludethatthereisnosignificantrisk.
HFEA 1990, s. 38 (1): conscientious objections of medical staff general or
specific?
Whatoftheconscientiousobjectionsofgametedonors?
JudicialreviewofdecisionstorejectprospectiverecipientsofIVF:
ExparteHarriott[1988]1FLR512womanwhotriedtogoforIVFand
clinicturnedherdownsayingitwasdowithherhusbandssperm.Howeverturned
out it was because she was socially unacceptable a she had convictions for
prostitution.Thecourthoweversympathisedwiththeclinic.Saidtherearebalancing
factorswhichgobeyondmedical/clinicaldecisionshavetothinkofallfactorsandas
longastheywerentunreasonableinthesensethatnootherclinicwouldhavedone
thesame,thencantfindtheminbreach.

ExparteSeale[1994]NewLJ1552;Times18/10/94womanwasturned
downbecauseshewastooold.Theyhada35agecutoffandshewas36.Howeverthiswas
allowed because clinics were allowed discretion and make decisions in light of financial
decisions.
ExparteMellor [2000]2FLR951prisonerwantedDIforwifeorIVF
Tracy had been working in prison service and had met Mellor (Mellor was a
murderer).Tracymarriedhiminprison.Theywerelongingtohavechildren.Bythe
timehegotoutshewouldbe31andthatwouldbetooold.CouldtheyuseDonor
insemination? Court said had to wait until released one of the rights that an
individualwasdeprivedofinprisonwastherighttohavekids.

Butsee DicksonvUK [2008]1FLR1315Dicksonwasinprison.She

wantedIVF.Courtsaidnohadtowaituntiloutofprison.TookthecasetoEurope.
Europeancourtsaidtherewasntablanketbanandthusgotcompensation.

Moretheory&academicarguments:
Issurrogacyacceptable?
Somecommentatorshavearguedthatsurrogacyraisesmoredifficultethicalissuesthanother
assistedconceptiontechniques.First,ElizabethAndersonarguesthatitisnotinthebest
interestsofthechildtodiscoverthathergestationalmothergaveherawayinreturnfor
money,shortlyafterherbirth.Shealsomaintainsthatthesurrogatemothersownchildrens
senseofsecuritymightbeunderminedbywitnessingtheirmothergivingawayachildto
whomshehasjustgivenbirth.
Shesays:commercialsurrogacysubstitutesmarketnormsforsomeofthenormsofparental
loveandtheytherebytreatthechilditselfasakindofcommodity,whichmaybeproperly
boughtandsold
Secondly,itisoftenarguedthatsurrogacyisexploitative.Thisclaimhasanumberof
differentstrands.Itmight,forexample,bearguedthatthecommissioningcoupletreatthe
surrogatemotherasameanstoanend,thusviolatingtheKantianimperative.Elizabeth
Andersonagainwouldsubscribetothisview:theapplicationofcommercialnormsto
womenslaborreducesthesurrogatemothersfrompersonsworthyofrespectan
considerationtoobjectsormereuse
Ofcourse,aswehaveseenbeforeinthisbook,theKantianimperativejustwarnsagainst
treatinganotherpersonsolelyasameanstoanend.Providedthatthesurrogatemotherisalso
treatedasapersoninherownright,employinghertocarryababyforninemonthsdoesnot
necessarilyoffendtheKantianimperative.
Adifferentsenseinwhichsurrogacyisaccusedofbeingexploitativeistheclaimthattherisk
ofaccrualexploitationofpoorsurrogatemothersbywealthycommissioningcouplesis
toogreat.Richardarnesondisagreesandclaimsthatbanningsurrogacyinordertoprotect
poorwomenformchoosingsurrogacyisbothpaternalisticandelitist.
LoriAndrewsfurtherpointsoutthatwhilemoneymayinfluenceawomansdecisiono
becomeasurrogatemother,itisseldomheronlyreason.

Itisalsosometimesarguedthatitissimplynotpossibleforawomansconsenttobearachild
forsomeoneelsetobefullyinformedandentirelyvoluntary,eitherbecausebefore
conceptionitisdifficultforawomantoknowwhethershewillbeabletohandoverachildto
whomshehasgivenbirth,orbecausesheisunabletoresisttheofferofasubstantialsumof
money.Againstthis,StephenWilkinsonarguesthat,providedawomanisgivensufficient
informationthereisnoreasontopresumethatsheisnecessarilyincapableofagreeingto
becomeasurrogatemother.
Itisinterestingthattheconcernaboutsurrogatemothersfeelingpressurizedintoentering
surrogacyarrangementsappearstoderiveprincipallyfromtheexistenceofafinancial
incentive.Socialandemotionalpressuretoagreetobearachildforadistraughtfriendor
familymemberisseldompresentedasanequivalentobstacletoapotentialsurrogatesfree
andautonomousdecisionmaking.
Thethirdobjectiontosurrogacyflowsfromtheargumentthatreproductionshouldnotbe
commodified.Margaretjaneradinarguesthatconvertingprocreationintoaneconomic
transactionwouldhaveanegativeimpactuponchildren,womenandsocietyasawhole.
JaniceRaymondalsoobjectstosurrogacy,butarguesthataltruisticsurrogacyarrangements
arejustasdemeaningforwomenascommercialexchanges.
Shouldsurrogacycontractsbeenforceable?
IntheUKsurrogacycontractsareunenforceable.Thosewhoareinfavouroftheir
unenforceability,suchasRosemarieTongandKatherineBartlett,arguethatitwouldbe
unconscionabletoforcethesurrogatemothertohandoverherchildafterbirth.
Argumentsagainsttheenforceabilityofsurrogacycontractsoftenamounttotheclaimthatan
orderforspecificperformancewouldbeoppressive.Surrogacyarrangementsare,however,
akintocontractsforservices,inwhichanindividualagreestosurrendersomeportionoftheir
libertyinreturnforsomething,suchasanincome,thatmaybemorevaluabletothem.Ina
contractforservices,ifeitherpartyweretofailtofulfiltheirobligationsundertheagreement,
theordinaryremedywouldbedamages,notspecificperformance.
Thelawsfailuretoenforcesurrogacycontractsinevitablycontributestotheirinsecurity.It
couldevenbearguedthattheircompleteunenforceabilitymaypersuadewomentobecome
surrogateseveniftheyarenotsurethattheywouldwanttogiveupthechildafterbirth.
Givingthesurrogatecompletefreedomtowithdrawfromthecontractandkeepallofthe
moneythatshehasbeenpaidmightalsoprovideanopportunityforextortion.Once
conceptionhasoccurred,thecommissioningcouplemaybevulnerabletothreatsfromthe
mother.