Bio-Law III - donor conception and surrogacy Flashcards

(30 cards)

1
Q

Donor Conception

A

use of donated gametes (eggs and sperm) or embryos for insemination. 2023 donor conceived children in UK had access to info about donors for the first time

informal priv arrangements not regulated - treated as natural conception

clinics - screened for HIV and hereditary diseases
Require a licence s. 4(1)(b) 1990 Act
Consent – central – schedule 3 of 1990 Act

Main issues:
- i. Anonymity
- ii. Payment of Donors
- iii. Parentage and Donor Gametes

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2
Q

Donor Anonymity

A

Before April 2005 – gamete donation was anonymous
- Clinic had to keep a register of information about donors but info would be like ethnicity, height, eye colour etc but nothing identifiable

Donor conceived and born before April 2005:
- Access to non-identifying information
- If they were born following fertility treatment
- Donor’s ethnicity, origin, occupation

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3
Q

Removal of Anonymity

A

Secretary of health saw at time where couples were told not to tell children about donor conception as there was a stigma and child was deemed illegitimate

R (On the application of Rose) v Secretary of State of Health

donor conceived and denied donor info but arg part of personal identity
whether childs right to genetic info protected by A.8 - court didn’t need to make a decision, gov decided but she couldn’t find out as before anonymity lifted

On 1 April 2005, with the implementation of the Human Fertilisation and Embryology Authority (Disclosure of Donor Information) Regulations 2004, UK law lifted donor anonymity.

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4
Q

Access to donor information

A

inds born via sperm, egg or embryo donation after 01/04/2005 able to track their donors

age 16 they could find donor

2023 - first year young adults donor conceived could request identifying details about the original donor.

- Name, date and place of birth of donor, appearance and last know address

- How many siblings?

- Donor may know that enquires are on foot – but not identity of child (s. 31ZC)

If the donation took place in a licenced clinic, donors are not legal parents and will have no legal or financial responsibilities.

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5
Q

Payment of Donors

A

Uk - criminal offence - s.41 HFE act

Compensation for expenses

- Fixed sum for sperm donors - £35 can only donate 10 times
- Egg Donors - £750 er cycle for travel costs, for money you lose not a gift 

Egg Sharing Schemes: A woman who needs IVF may agree to donate the half of her harvested eggs in return of free or reduced fees for her IVF treatment.

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6
Q

Establishing parentage

A

in 2008 the act was revised to consider different family forms e.g. same sex couples so 1990 act needed to be amended

The new parenthood provisions apply only to children whose mothers treated with donated sperm after April 2009, and they have not been incorporated into the 1990 Act, like the other 2008 amendments.

Instead, they are to be found in the free-standing HFE Act 2008!

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7
Q

Establishing maternity

A

ommon law and under both the 1990 Act and the 2008 Act,

- woman who gives birth to child is the legal mother (common law, 1990 Act (s. 27), 2008 Act (s.33(1)) no exception, whoever gives birth = legal mother e.g. surrogate = legal mother - gestational 
- Regardless of genetic connection
- Cannot be regarded as mother merely because of egg donation - 2008 Act (s. 47)
- Irrelevant if egg donation took place abroad
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8
Q

Establishing Paternity

A

married couples - presumption of paternity within marriage - s. 38(2) (2008 Act) – s. 28(5) 1990 Act - Can be rebutted by genetic evidence – sperm donor

and S. 35(1) of 2008 Act (s. 28(2) 1990 Act) : Consent to treatment - went to clinic with husband/partner and now giving birth that man is father as he consented to treatment

f not married need to both consent to treatment in order to be father

not married or in CP, lesbian couple, if did not consent to treatment she will not be mother

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9
Q

Agreed Fatherhood

A

Before April 2009-the man who she was treated together is the father

After April 2009 (the couple unmarried/not in a civil partnership but the man will be the legal father) – ‘agreed fatherhood conditions’ - s. 37 HFEA 2008 may be with friend and he says he is consenting he will be father - can take any man unless in prohib rel e.g. your father or brother - helps mother use a male model for child she is conceiving

- Man gives notice as to his consent to being treated as father of any resulting child
- Woman also given consent for man to be treated as father
- No withdrawal of consent or variation
- Parties are not in the prohibited degrees of relationship with each other!
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10
Q

Same sex couples

A

Parentage (Same sex couples) 1990 Act:
- no provision for female partner to acquire parenthood
- Even if she provided the eggs she would still be treated as a legal stranger to the child

2008 Act – change in law

- Equalizes the civil partnership – same position as married couple S. 42 HEFA 2008
- Agreed Female Parenthood – s. 44 HFEA 2008
- The difference is terminology: the partner is not an agreed ‘mother’ but a ‘second legal parent’ maybe to not confuse motherhood as mother who gives birth = legal mother
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11
Q

Single mothers

A

Single women or women who do not wish anyone to be the child’s second parent, or women whose husbands or civil partners did not consent to the treatment:

- If a woman receives treatment on her own and does not want anyone to be her child’s second parent (or if her partner does not consent to her treatment), she will be the only legal parent. Can be only legal parent - does not require a second parent for child to be conceived 

- Transgender parents: The statutory scheme does not specifically address this.

- If their gametes were stored before the gender re-assignment surgery their sperm or eggs (or embryos) might be treated as a third party (donated) material. - own sperm/egg may be considered as donated sperm/egg

Anonymity used to be the norm when donated gametes (sperm and egg) were used in treatment. But since 2005, donors have had to be identifiable.

There are different rules apply to parentage: birth mother is always the legal mother, whereas establishing parenthood is more complicated.

Donors whose sperm, eggs and embryos are used in a licensed clinic cannot claim legal parenthood. - if donors go through clinic then protected by law of parenthood claims, no financial resp etc

In establishing fatherhood intention to parenthood (formalised by CONSENT) is a key principle in AHR regulation. Ppl can agree to be parents

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12
Q

Surrogacy

A

warnock report - woman (the surrogate mother) becomes pregnant with the intention that the child should be handed over to the commissioning couple after the birth.

can be surrogate inseminating herself with intended fathers sperm or IVF

Partial surrogacy: the surrogate mother’s eggs are used, so she is both genetic and gestational mother - norm not in licensed clinic

Full (gestational) surrogacy: The eggs of the commissioning mother or of donor’s is fertilised and implanted into the surrogate - 100% carrying other ppls material - HFEA clinic

gestational mother (surrogate) is always the legal mother of the child.

birth of the child, legal parenthood needs to be transferred to the commissioning couple (or intended parents) through parental orders or adoption. - once baby = born you have 2 methods to get baby - PO = main route

350% growth in UK and international surrogacy over the last 12 years -67 to 280*

Surrogacy is not illegal in the UK, but it is not possible to enter into a legally-binding surrogacy agreement. The surrogacy agreement is unenforceable. - surrogate can always change their mind or couple can change their mind

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13
Q

Arguments for and against surrogacy

A
  • The situation if potentially harmful for children, in that it is liable to produce litigation over them.
    • It is also harmful to the gestational mother who gets attached to the baby (but the UK studies show that the dispute rates are very low)
    • Surrogacy exploits surrogates. It is seen as a form of reproductive slavery. It is seen inconsistent with human dignity and demeaning to women. (This view assumes that woman have natural bond with the babies they carry, given up a baby is unnatural, and one would do so only if they were desperate for money.) You may agree or disagree! - women treated as baby vessels/incubators
    • Paying of surrogates is close to ‘baby selling’ (one may say that payment to surrogate is not buying children but recompense for a risky, time consuming and uncomfortable process).
    • Reproductive autonomy: If a woman wishes to become a surrogate mother why should she not allowed to be? Some ppl really like being pregnant but not have baby
    • Surrogacy is inevitable and an old practice. If it was outlawed, this would lead to a black market.
    • It widens the variety of family forms (eg gay couples, single man) - could never have genetic babies and helps infertile women as well
    • Although some people argue that surrogacy is always ethically problematic, it is now more commonly argued that surrogacy has the potential to be exploitative.
    • Rather than banning the practice altogether we can focus on ensuring that the interests of the parties involved are protected. Can be exploitive but with regulation can be prevented
    • Concerns over the potential exploitation have often crystalised around cross border surrogacy arrangements.
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14
Q

Surrogacy overseas

A

india = most popular destination - surrogates = little or no control over contracts and made to live in hostels due to stigma and desire to control bodys - now banned in india, nepal and thailand

now in cambodia - The US is popular for those who can afford ($130,000). In Georgia and Ukraine this might cost between £30-50 K. - US law are very careful about surrogacy contracts and women get paid - very well regulated

inevitable and ban unlikely to be effective - concern should be informed consent and not subject to oppressive and exploitative contractual terms.

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15
Q

Is surrogacy legal?

A

regulated under Surrogacy Arrangements Act 1985 and certain provisions of HFE Act 2008.

It is not illegal to enter into surrogacy arrangement, but there are a series of criminal offences connected with surrogacy:

-  It is unlawful to negotiate or arrange surrogacy arrangement on a commercial basis 
- It is unlawful for anyone to advertise surrogacy services
-  It is unlawful to make an offer that constitutes a reward or profit for the gestational mother although she can be offered payment of expenses. - cannot be offered money but can pay for maternity clothes etc
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16
Q

Non- Enforceability

A

surrogacy arrangements is organised by an individual or a non-commercial body and there is no payment, surrogacy is legally permitted even though not enforceable.

If the parties wish to use a licensed clinic to assist the conception, the HFEA Code of
Practice requires clinics to take into account the possibility of a breakdown in the surrogacy arrangements and whether this is likely to cause a risk of significant harm to the resulting child or existing children in the surrogate’s family. Clinic must make a judgement and whether surrogate is fit e.g. if have triplets under 2 years old probably not the best surrogacy candidate

Child’s welfare is paramount.

17
Q

Legal Framework for Surrogacy

A

Warnock Report 1984 – para.8.17
surrogacy = always harmful than benefits - not best arrangement and shouldn’t be encouraged

18
Q

Commercialisation

A

Surrogacy Arrangements Act 1985, as amended - HFEA 2008 consider same sex couples and other families

Not unlawful but unenforceable

- S. 1A Surrogacy Arrangements Act 1985: “No surrogacy arrangement is enforceable by or against any of the persons making it”

Aim of the 1985 Act – prevents commercial involvement

- S.2 and 3 Surrogacy Act, 1985, as amended
- 2008 Act – non profit making bodies can charge a fee ppl can get poor advice from non profit orgs compared to well paid lawyers 

In practice – commercial involvement may be authorised subsequently by courts (retrospective authorisation of illegal payments have been allowed)

19
Q

Restrictions on Access to Surrogacy

A

Welfare Principle – s. 13(5) HFEA 1990

- Before treatment services provided– account of welfare of any child born/existing children
- Clinics may impose specific standards e.g. surrogacy shouldn’t have young children, surrogate must have had a child before 

Gaps in Framework:

- Private Arrangements
- Overseas Surrogacy both of these are not regulated 

Difficulties with ban on commercial involvement

- Limited professional advice not many medical lawyers giving advice 
- Misinformation
20
Q

H v United Kingdom

A
  • The girl (H) born in 2016 argued that UK laws breached her right to respect for her private life under article 8 of the ECHR.
    • H lives with her biological father, and his same-sex partner, and is in regular contact with the surrogate and her husband.
    • Her birth certificate states the surrogate mother, and the surrogate mother’s husband, are her “mother” and “father”. Father = presumed father as married
    • By 2016 a judge in family court ordered both couples have parental responsibility.
    • The girl argued that automatic registration of the husband of the surrogate mother as her “father” on her birth certificate were outdated and violated her right to her identity, specifically her right to have an accurate birth certificate. ECHR ruled that the case was “manifestly unfounded”. Vio her right to have an accurate birth certificate
    • How come this happened? - mother did not want to give up legal motherhood and gay couple didn’t apply for PO
21
Q

Surrogacy and parenthood Mothers

A

legal mum can be the gestational mum who gave birth (surrogate mother)
-legal mother could be the genetic mother whose eggs were used (in full surrogacy)
-legal mother could be the one who intends to raise the child (either mums)

When a child is born as a result of a surrogacy agreement who is the mother?

- The mother is ALWAYS the gestational mother (SURROGATE -who carried the child) law assumes this gestational period is creating a link but not always case
- The commissioning mother (CM) is NOT the mother, even if her eggs were used.
- Legal mother could be the one who intends to raise the child (either mums).
22
Q

Surrogacy and Parenthood

A

Legally, in the UK the surrogate is the legal mother
◦ S. 33 HFEA 2008
◦ “The woman who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child”

◦ S. 47 HFEA, 2008
◦ Woman not to be treated as mother merely because of egg donation

Any treatments that baby needs after birth - surrogate must decide as she is legal mother

23
Q

Paternity: The application of rules is confusing

A

ommon Law:

- Position of surrogate’s husband man presumed to be father unless no consent 
- Man registered on the birth certificate - s. 111 Adoption and Children Act 2002
- Rebuttable presumption DNA evidence HFEA rules trump common law.

Because the provisions governing the ascription of legal fatherhood in HFE Act 1990 and 2008 were designed to apply to sperm donation they lead to some odd results when applied to surrogacy:

◦ Surrogate’s husband - s. 28 of 1990 Act, s. 38 2008 Act is the father of the child
◦ Unless he can show he did not consent to treatment
◦ If surrogate is married to another woman or in a civil partnership there will be an assumption that her spouse or civil partner is the child’s second parent.
◦ If surrogate is single, and if commissioning father’s sperm was used, he will be the father of the child under the common law.
◦ Commissioning parent whose gametes were not used in the child’s conception could become the child’s father or second legal father, along with the surrogate through agreed parenthood conditions.
◦ Surrogate’s partner – agreed fatherhood – unlikely to apply

24
Q

Parental Orders

A

Parental Order Conditions: s. 54 of HFE Act 2008

◦ One party must be genetically related to child (either sperm, eggs or both should come from the CC)
◦ Applicants must be a couple (married, civil partnership, or living as partners)– surrogacy was not available to a single applicants (this has changed)
◦ Child must be living with the CC commissioning couple
◦ The surrogate must consent to the order (it is extremely rare granting PO without her consent)

Re D And L

Twins were born in India. The (anonymous) Indian surrogate could not be found to give consent and the High Court ultimately waived the need for consent after significant effort to find her failed. Also retrospective authorisation given for the making of payments for the surrogacy: ‘the twin’s welfare unquestionably will be enhanced by the making of parental orders”.

Parental Order Conditions: s. 54 of HFE Act 2008
◦ No money or benefit other than expenses have been exchanged
◦ CC should be over 18
◦ The applicants must have applied within the first 6 months of the birth
◦ The order will be in the welfare of the child. This to be the paramount consideration of the court.

25
Parental Orders – Time limit
Re X (A Child) The couple applied two years and two months after the birth of the child, well over the 6 month limit in section 54. The court was willing to overlook and make an order but there was a difficulty: The couple had arrived in England having used a surrogate mother in India. If the court did not make a parental order the child would be living with the couple without any proper legal authorization. It was in child’s welfare to make an order. Held: the court was not prevented from making a parental order merely because the application was made after the expiration of the six-month period specified in section 54(3). In childs welfare to make order
26
Parental Orders- Couples requirement
Originally, only available for married couples ◦ S. 54, 2008 Act – civil partners/cohabitees ◦ “two people who are living as partners in an enduring family relationship and are not within prohibited degrees of relationship in relation to each other” s. 54(2)© ◦ Single people cannot apply for parental order: Re Z (A Child: Human Fertilisation and Embryology Act: Parental Order) [2015] EWFC 73 ◦ Human Rights Implications?
27
Parental order (single parent)
The child, Z, had been conceived with the applicant father's sperm and a donated egg using an unmarried surrogate mother in Illinois. Genetic link The father obtained a declaratory judgment from the appropriate court in Minnesota, relieving the surrogate mother of any legal rights or responsibilities for Z lawful arrangements - no exploitation The issues that arose in the case were, firstly, whether it was open to the court to make a parental order under section 54 (1) of HFEA Act 2008 on the application of one person. Secondly, could section 54(1) be 'read down' in accordance with section 3(1) of the Human Rights Act 1998 so as to enable the court to make a parental order in favour of one person? (Article 8 and 14 ECHR) The fundamental argument of the father was that the requirement of s 54(1) constituted a discriminatory interference with a single person's rights to private and family life. It was therefore inconsistent with Articles 8 and 14 of the European Convention. The legislation was contrary to Article 12 of the Convention which protects the right to found a family. The law and the government policy was to enable single persons to be eligible to adopt; and that it was artificial, disproportionate and discriminatory to distinguish between adoption and surrogacy on the basis of the complexity or sensitivity of surrogacy. Case was rejected on the basis that "the principle that only two people – a couple – can apply for a parental order has been a clear and prominent feature of the legislation throughout.“ Subsequently, the government conceded that sections 54(1) and (2) of the HFEA 2008 are incompatible with the rights of the father and child under Article 14 in conjunction with Article 8, in so far as they prevent the father from obtaining a parental order on the sole ground of his status as a single person, as oppose to being part of a couple. On 3 January 2019, The Human Fertilisation and Embryology Act 2008 (Remedial) Order 2018 passed which now allows single persons to apply for parental orders: This is a remedial order made under section 10 of the Human Rights Act 1998, which amends section 54 HFEA so that it is compatible with the European Convention on Human Rights. See: https://www.bindmans.com/knowledge-hub/blogs/uk-surrogacy-law-embraces-single-parents/ A brief but informative analysis of the single parent provision can be found here: https://www.barcouncil.org.uk/static/2a7bef2e-5747-4938-81f5d994d6fa6295/elizabethanderson23-essay.pdf
28
Parental Order - Payments
S. 54(8) no money/benefit exchange BUT court may authorise payments ◦ Generally, the court will grant parental order even if payments made Re X and Y (Foreign Surrogacy) [2008] EWHC 3030 (Fam): A couple had made a surrogacy arrangement with a Ukranian woman who gave birth to twins using anonymously donated eggs fertilised by the male applicant’s sperm. ◦ The couple paid €235 per month and lump sum of €25,000 on birth ◦ Hedley J. made this judgement in open court to highlight the situation where children : “marooned stateless and parentless whilst the applicants could neither remain in the Ukraine nor bring the children home” ◦ Held: consent has been given and payment was acceptable. Hedley J: “The difficulty is that it is almost impossible to imagine a set of circumstances in which by the time the case comes to court, the welfare of any child (particularly a foreign child) would not be gravely compromised (at the very least) by refusal to make an order” Re L (A Minor) [2010] EWHC 3146 (Fam) A US commercial surrogacy agreement case where Hedley J gives reasons for making a Parental Order pursuant to Section 54 of the HFEA 2008 in favour of the applicants in respect of a child known as L. While the surrogacy agreement the applicants entered into in Illinois, USA was wholly lawful in that jurisdiction, it was unlawful in the UK because no payments other than reasonable expenses are lawful in this jurisdiction and the payments made by the applicants in this case went beyond reasonable expenses. Hedley J: Only in rare cases that court would withhold an order“...It underlines the court’s earlier observation that, if it is desired to control commercial surrogacy arrangements, those controls need to operate before the court process is initiated i.e. at the border or even before” Jackson: UK’s prohibition on commercial surrogacy is therefore completely ineffective (p. 851)
29
Law Reform
The law has struggled to adapt to changes in attitudes, a growing demand for surrogacy arrangements, and an increasing number of overseas surrogacy arrangements. There are a number of issues in the law that may be in need of reform: * Surrogacy and the single parent: There is no power for the court to make a parental order in favour of a single person (as opposed to a couple), which recently led to a High Court declaration of incompatibility with the Human Rights Act 1998 in the case of Re Z (A Child) (No 2) [2016] EWHC 1191 (Fam). *Parental orders: * Conditions for making a parental order are unnecessarily restrictive. * There is potential uncertainty caused by surrogates (and sometimes their husbands) being entered as parent(s) on the birth certificate of a child born as the result of a surrogacy arrangement. * Currently, parental orders can only be obtained after the birth of the child and upon an application to court by the intended parents. In one case, the effect of the law “was that the children were marooned stateless and parentless”; *In 2019, Law Commission of England and Wales and the Scottish Law Commission started a consultation to consider the current regulation of each aspect of surrogacy arrangements, as well as the application of the welfare (of the child) principle in surrogacy arrangements. *The final report alongside the draft Bill were published in 2023 and can be found https://lawcom.gov.uk/project/surrogacy/
30
Key proposals for law reform
*No commercial surrogacy. Surrogacy will continue to be altruistic. *Surrogacy arrangements will continue to remain unenforceable. *Permitted payments include medical and wellbeing costs, those to recoup lost earnings, pregnancy support, and travel. Prohibited payments include those made for carrying the child, compensatory payments, and living expenses such as rent. *Creating a new surrogacy pathway that will allow, in many cases, the intended parents to be the legal parents of the child from the moment of birth. *Surrogacy registry for children to trace their surrogates. *Introducing safeguards such as counselling and independent legal advice to reduce risk of arrangements breaking down. *Reforms to parental orders: allowing the court to make a parental order where the surrogate does not consent, if the the child’s welfare requires this. *Allowing international surrogacy arrangements to be recognised here, on a country-by-country basis.