Professional Documents
Culture Documents
Ethics
Table of Contents
Abstract
Introduction
o On the basis of Nature of Surrogacy Agreement
o On the basis of Nature of Fertilization
Historical origin
Fertility tourism in India
Legislations
Relevant case laws
Analysis of the current scenario
o Merits
o Demerits
Conclusion
Abstract
The purpose of this article is to trace the historical journey of surrogacy and
analyze its progress and position in a country like India where it used to be a
norm and a source of livelihood for some but is now banned commercially.
The author has given a brief introduction about what surrogacy is along with
its medical definition and has also mentioned how various religions look at it.
While it has been mentioned in some religious texts, not all communities
accept it wholeheartedly. The historical evolution of the surrogacy contract
worldwide has also been discussed. The author has then gone on to talk
about the phenomenon of fertility tourism in India along with its advantages
and disadvantages.
The author then moved on to the various legislations and guidelines which
have been passed in an attempt to regulate surrogacy, along with some
landmark cases and judgments which were an attempt to bring about the
welfare of the surrogate children and make surrogacy a part and parcel of
Indian society. The current legislation has been analyzed in detail, with both
the pros and cons being listed and in the conclusion, the author’s final
opinions and suggestions have been given.
Introduction
Surrogacy is a process in which a woman agrees to carry a baby for
somebody else like two homosexual people, single person or a couple who is
unable to conceive. After the birth of the baby, the birth mother hands over
custody and guardianship to the intended parent(s). The woman who carries
a baby for another person is referred to as a surrogate or birth mother. The
parent(s) of the baby born through surrogacy arrangement are called
commissioning or intended parent(s).
Historical origin
Although Indian society has not always been open about the idea of
surrogacy, it has been practiced even in ancient times.
In Islam, there is the concept of Maqasid al- Sharī‘ah or purposes of the Law
which are Hifz al- Dīn (Protection of Religion), Hifz al-Nafs (Protection of
Life), Hifz al- Nasl (Protection of Progeny), Hifz al-Aql (Protection of Mind)
and Hifz al- Māl (Protection of Wealth). This classification talks about the
basic necessities of human beings which need protection, preservation and
promotion. As Islam encourages reproduction, it supports treatment of
infertility and includes care for pregnant women. It further entails
preservation of lineage. Every child should know about and be related to both
his parents. Hiring a ‘womb’ for procreation is a very new concept in Islamic
jurisprudence and is not acceptable according to the ethics of Islam since
surrogacy involves the use of a donor sperm, a foreign element in the
woman’s womb which leads to mixing of lineage. According to Mufti Sheikh
Ahmad Kutty, an Islamic scholar, the introduction of male sperm into the
uterus of a woman he is not married to goes against the desires of Allah.
In a story in the Bible, Sarah the wife of Abraham was unable to have
children. She made her handmaid, Hagar, have a child with Abraham by
copulation. Here, Sarah got jealous and the surrogate mother refused to part
with the identity of the child. As a result, both the surrogate mother and the
child got ousted out of the house. Genesis 30 tells us the story of Rachel who
told her husband Jacob to sleep with her maid Bilhahin in order to produce
children and hence, build a family. Jacob subsequently goes on to have more
children with his concubines and both his wives, Leah and Rachel. Out of 12
sons, 10 are jealous of Joseph, the ‘special’ son of Rachel and they conspire
to sell him as a slave.
As both the stories above point out, a typical and exclusive sexual
relationship between a man and woman was God’s desire. Enlisting the help
of a surrogate mother led to a breakdown of the families and a dysfunction in
general. The general message was that not trusting God and taking things in
one’s own hands could cause chaos.
In 1975, Noel Keane, a lawyer brokered the first ever legal surrogacy
contract in history. Here, the surrogate mother did not receive any
compensation as per the agreement. After this, Keane established his own
infertility centre which arranged many surrogate pregnancies in the United
States. In 1978, Louise Brown was the first human to be born via in vitro
fertilization. Four years later, her younger sister, Natalie Brown, was also
conceived by IVF and became the world’s fortieth child to be conceived in
this way. In May 1999, Natalie was the first human born after conception by
IVF to give birth without IVF. Only a few months after the birth of Louise
Brown, Dr. Subhas Mukhopadhyay produced the world’s second test tube
baby ‘Durga’ in India. However, he was stopped from working further on in
vitro fertilization and was transferred to another area. He was also not
allowed to go to Tokyo to present a paper. Due to frustration and poor
health, Mukhopadhyay committed suicide on June 19, 1981.
On August 16, 1986, going by the scientific records, ‘Harsha’ became the
first human test-tube-baby of India. T.C. Anand Kumar, Director of Institute
for Research in Reproduction (IRR) of Indian Council of Medical Research
(ICMR) was credited for this achievement. In 1997, when he went to Kolkata
to attend a Science Congress, all the research documents of Mukhopadhyay
were handed over to him. After scrutinizing those documents and having
discussions with Durga’s parents, he became certain that Mukhopadhyay was
responsible for the creation of the first human test-tube-baby in India. By
T.E. Anand Kumar’s efforts, Mukhopadhyay was credited as the architect of
the first Indian test tube baby in a document related to the subject of
artificial intercourse in ICMR.
The couples flew to Anand for the in-vitro fertilization and again for the birth.
Most couples ended up paying the clinic less than $US10000 for the entire
procedure, including fertilization, the fee to the mother and medical
expenses. Counseling used to be a major part of the process. The women
would be told to think of the pregnancy as ‘somebody’s child coming to stay
at their place for nine months’. According to Dr. Patel, while none of the
mothers had a difficult pregnancy or any medical complication, the clinic is
diligent in its medical investigations and does not take any risks.
However, this practice was criticized on many grounds. Critics believed that
the surrogates were often exploited as they were made to go through the
struggles of pregnancy for very less money. An argument against this
criticism was that this practice benefited both the parties- it gave one party
the chance to have their own child and the other to earn a sum of money
which they might not have been able to earn otherwise. From a liberal point
of view, it could be argued that it highlighted the woman’s right to autonomy
over her body which also included informed consent to volunteer her body for
any activity or cause whether it was physical labor, sexual services, organ or
tissue donation, or commercial surrogacy.
On the other hand, in a low-income country like India, where these women
mostly came from poor families and were not completely aware about their
rights, it was rational to argue that their consent came from a sense of
desperation and helplessness Due to their financial and educational
backwardness, this consent could also lead to exploitation. In addition to low
compensation, there were also the physiological side-effects of pregnancy
like migraines and back pain, diabetes, high blood pressure, or permanently
impaired fertility and death in extreme cases. There was also a risk of the
surrogate getting emotionally attached to the child. Postpartum concerns
included scarring and body pain from cesarean sections, as well as
postpartum depression. Additionally, there was also a chance of disapproval
from their communities and rejection by their husbands. These types of risks
were seldom discussed when the consent of the surrogate was obtained so it
was debatable whether the consent was informed or not.
Economically, one common argument against medical tourism was that the
traveler spent his or her money in a foreign country instead of their home
jurisdiction. Their expenditure included both medical and travel expenses.
This was a very large amount, resulting in loss of income for the home
country. Also, for a nation like India, the potential financial benefits arising
out of this lucrative industry were tremendous. However, while it is the
Indian citizens who funded medical resources and infrastructure, it was the
foreign clientele that reaped the rewards. This was one of the most common
criticisms of medical tourism: that those who pay taxes within the nation
should be the ones to benefit from the efforts of doctors whose education
and infrastructural support were taxpayer-subsidized.
Legislations
The Law Commission of India submitted the 228th report on surrogacy in
India and made the following observations, based on which the Indian
Council of Medical Research (ICMR) framed its guidelines in the year 2005
and drafted Assisted Reproductive Technologies (ART) Bill in 2008:
Although this Bill is still pending, the Parliament passed the Surrogacy
(Regulation) Bill in 2018 which has the following features:
In another case, there was a German couple, Mr. and Mrs. Balaz, who had
come to India for the purpose of conceiving via surrogacy. They entered into
a surrogacy agreement with a woman from Gujarat. However, the body of
Mrs. Balaz was not in a condition to even produce ova. So the process of
fertilization was brought about with the sperm from Mr. Balaz and donation
of ova by an anonymous woman. When the surrogate mother gave birth to
twin boys, there was a question regarding their nationality. Here, the court
held that since the wife had neither donated the ova nor carried the embryo
inside her body, she was not the biological mother.
On the other hand, the surrogate mother had carried the embryo inside her
for 9 months and nurtured the babies through the umbilical cord; she was
considered the biological mother. Keeping in mind the right to privacy of the
egg donor, there was no discussion regarding her identity or her right over
the child and it was held that merely donating ova did not make her the
biological mother. Since both the surrogate and egg donor were Indians, the
twins were also conferred Indian nationality. Mr. Balaz was shown to be the
father in the birth certificates of the twins and since the surrogate was an
Indian national, the twins were entitled to get Indian citizenship under
Section 3(1)(c)(ii) of the Citizenship Act, 1955.
In one case, the issue was provision of maternity leave for female lecturers
under the Maharashtra Civil Services (Leave) Rules, 1981. The petitioner had
given birth to a baby boy through surrogacy and after the birth, applied for
maternity leave. However, the Joint Director of Higher Education, Nagpur had
communicated that this leave is not available in case of birth via surrogacy.
The petitioner challenged this in court. The petitioner cited a Government
Resolution dated 28.07.1995, which talks about granting maternity leave to
the adoptive mother in the same manner as is available to a natural mother.
The court said that maternity leave is provided to ensure a healthy and
relaxing environment for both mother and child. It is a social justice
provision for women.
This provision is there to ensure that there is sufficient time for mother and
child to bond. It is said that being a mother is one of the most rewarding
jobs on the earth and also one of the most challenging. A commissioning
mother would have the same rights and duties towards the child as the
natural mother. A woman cannot be discriminated against on the grounds
that she has given birth to a child through surrogacy. Though the petitioner
had not given birth to the child, it was in her custody after birth and a
newborn baby cannot be left with people other than the mother during the
initial, most formative years. A mother would also include a commissioning
mother or a mother securing a child through surrogacy. Any other
interpretation would go against the objective of providing maternity leave to
a mother.
In one case, an American couple had travelled to India for the purpose of
surrogacy. They had already purchased 8 embryos which were in the custody
of the hospital in Pawai after completing all the necessary requirements.
However, after the embryos were brought and kept at the hospital, they
came to know that they are now barred from entering a surrogacy
agreement in India due to a change in policy. They requested the court to
allow them to take back the embryos to any other country where the
surrogacy is allowed. They were then informed that the same cannot be
permitted as export of embryos has also been prohibited. The court directed
the petitioners to file their application before the Director General of Foreign
Trade (Export Cell) through their counsel and the authority was directed to
make a decision within 3 weeks of receiving the application.
In another case, it was held that those foreigners who had already started
the surrogacy process when the ban on commercial surrogacy was
announced were permitted to continue the process, provided they had
completed all the necessary formalities. The Government of India is
supposed to fix the stages up to which the ban is to apply.
The Supreme Court also reiterated that a woman who has given birth via
surrogacy is entitled to maternity leave and this case also talked about
granting paternity leave of 15 days to the father of the surrogate child.
Merits
By imposing a ban on egg donation and sale of embryos, this will help
in curbing child trafficking and other unlawful practices.
In commercial surrogacy, many poor women are exploited and are
made to go through with the pregnancy at very low rates. In such
cases, since the woman lacks awareness and finances, she is not fully
aware of what she is being made to do and the consent obtained is not
with complete knowledge.
In this industry, it is often the middlemen who execute the surrogacy
agreements and take a large amount of money paid by the parents,
and only about 25% of the sum goes to the surrogate mother. This Bill
is needed in places in places like Gujarat, where ‘baby farms’ exist, i.e.
underprivileged women are collected and distributed as surrogates to
potential parents.
By including the provision that the intending couple should be married
for at least five years, it is ensured that there is no marital discord and
the couple is in a position to provide a stable home to the surrogate
child and there shall be no custody battles for the child later on.
By barring live-in couples from going through commercial surrogacy,
the Bill ensures that only those couples who have a stable, long-term
relationship and can provide a secure and permanent home to the child
are allowed to go through with surrogacy.
Those women who volunteer to become surrogate mothers often face
ridicule and social boycott from the other members of their village or
community. By passing this will, that ridicule can be avoided.
This Bill promotes adoption. There are many children in orphanages
that need homes and they can only be adopted till the age of 15 so
adoption can be an option for those couples who already have children
and those who are past the age limit set by this Bill.
Demerits
Landmark Judgments
Conclusion
From being mentioned in the ancient texts to becoming an accepted practice
and a source of income for a country to being regulated with stringent
guidelines, the practice of surrogacy has gone through many changes which
reflect the position of society at that point of time. This was a practice which
was very common during the ancient times yet misused as we can see in the
example of Kunti who got a boon which was very inappropriate for her age.
Between the years 2002 to 2018, India had become a hub for commercial
surrogacy and this practice was unregulated since there was no legislation
governing surrogacy. However, commercial surrogacy was banned in 2018
and a lot of regulations were put in place. However, instead of banning an
idea totally, regulations should be made so that the idea doesn’t become
exploitative or doesn’t get misused. A woman should be saved from
exploitation but she should be the final decision-maker as far as her body is
concerned.
If we look at how abortions were carried out before they were made legal,
we would realize that there is always a loophole in each and every law which
can be exploited and would render the purpose of that particular legislation
useless. Instead of making surrogacy exclusive for infertile married couples,
the State should ensure that everybody gets the chance to procreate and
those who help them in doing so get their due, financially or otherwise. A
country’s laws reflect the attitude of its people and every nation should aim
to move forward with the times, instead of going back in time by making
regressive laws. The practice of surrogacy has been marred by a lot of
controversy and the issue of what should be allowed morally. The current
legislation, while well-meaning, shows a myopic view of what is better for
women and an ugly bias towards homosexual and live in relations. It does
not reflect the current times and is full of arbitrary rules which need to be
done away with.