Students should appreciate these key issues:
  • Ethical and legal issues surrounding the status of the embryo and fetus, and areas of contention and debate including possible maternal-fetal conflict
  • Ethical, legal and professional aspects of contraception, artificial reproductive technologies, termination of pregnancy and neonatal care
  • Ethical issues associated with preimplantation/prenatal testing and embryo selection, genetic testing and screening after birth
  • Human Fertilization Embryology Act 2008, Surrogacy Act 1985, Abortion act.

Surrogacy is the arrangement whereby a woman carries and delivers a child for another couple. The rearing parents may arrange a surrogate pregnancy due to female infertility or other medical issues which may make pregnancy or delivery impossible.

It is now possible for a child to have upto 5 parents: a genetic father, a genetic mother, rearing father, rearing mother and gestating mother.

Legal issues

Human Fertilisation and Embryology Act 2008 (major update from HFEA Act 1990)1
  • Regardless of contractual obligations, surrogacy arrangements are not legally enforceable within the UK
  • Relationship between surrogate mother and child is recognised under the HFEA 2008 Act (Section 30). The surrogate mother retains legal right of determination for the child (even if genetically unrelated).

The Parental Orders (Human Fertilisation and Embryology) Regulations 20102

  • After birth, a parental order is required, otherwise the surrogate mother remains the legal mother of the child (order must be applied within 6 months of birth)
  • Applicants can be in civil partnerships or "living as partners in an enduring family relationship" (so unmarried couples can apply)
  • Child must be at the applicants home
  • Either or both of the couple should be resident in the UK
  • Applicants should be 18 years old or over
  • No commercial arrangements should take place

Surrogacy Arrangements Act 19853

  • Under the Act commercial arrangements are illegal (only expenses can be paid for)
  • Surrogacy contracts are unenforceable
  • This Act was amended by HFEA 2008 so that surrogate mothers can keep the child if they change their minds
  • No advertisements regarding surrogacy arrangements can take place

Ethical issues
  • The right of the family to have children
  • Reservations regarding ethical acceptability falls under 2 main considerations, exploitations of women and commodification of children. 4
  • The potential health risks of the surrogate mother in pregnancy and childbirth
  • The virtues of the "work" of carrying a child for an infertile couple, should be paid (for the risk of short-term or long-term well-being). 4; otherwise could be seen as exploitative
  • The risk of commercialisation of surrogacy
  • The risk of "compassionate familial surrogacy". The Ferreira-Jorge surrogacy in South Africa involving a 48 year old surrogate mother (and genetic maternal-grandmother to the triplets born), could be seen as "forced" to accept the pregnancy even when risk to herself is greater at the extremes of reproductive age. 4
  • Issues have been raised that infertile couple should adopt rather than bringing more children into the world
  • Human Fertilisation and Embryology Act 2008
  • The Parental Orders (Human Fertilisation and Embryology) Regulations 2010
  • Surrogacy Arrangements Act 1985 (c.49)
  • Bromham DR, Journal of Assisted Reproduction and Genetics 12 (8) 1995 "Surrogacy: Ethical, Legal, and Social Aspects"
  • Royal College of Obstetricians and Gynaecologists: Male and Female sterilisation Guidelines 2004
  • Recommendations on Ethical Issues in Obstetrics and Gynaecology (FIGO 2000)