Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Sunday, May 14, 2017

A Revision Whose Time Has Time

"There is an altruistic element to it, but I've honestly in my career never met someone who is willing to do that for free for a stranger."
"But there may be a sizeable number willing to do it if at least they're compensated for wages and some of their time."
Dr. Jeff Roberts, president, Canadian Fertility and Andrology Society

"It sounds like the [society] would like to open the door to a sort of fee-for-service system, where money is promised and people line up to sell their eggs or sperm or gestational capacity."
"People who find themselves in difficult financial circumstances will do this ... for the purpose of defraying their debt or paying for university tuition."
Juliet Guichon, professor, University of Calgary

"The fact they're being paid under the table makes them feel guilty, makes them feel part of something clandestine and hidden."
"They may not feel free to claim their rights and receive the health care they may need."
Vardit Ravitsky, professor, University of Montreal
An employee at a clinic prepares a sample of sperm and an egg for the process of fertilization under the microscope on May 25, 2016 in Barcelona.
An employee at a clinic prepares a sample of sperm and an egg for the process of fertilization under the microscope on May 25, 2016 in Barcelona. LUIS GENE/AFP/Getty Images

Canada enacted a law in 2004 allowing surrogates and donors of eggs and sperm reimbursement for expenses related to their cooperation with people anxious for parenthood acting as surrogates or egg or sperm donors. It is, however, illegal for anyone to directly charge for these services; they must be voluntarily given without recompense. A Royal Commission had studied the complex issues involved and extensive debate in Parliament concluded that Canadians remained opposed to the "commodification" of human sperm, eggs and wombs.

Now, the Canadian Fertility and Andrology Society is interested in spurring the federal government to overtime that ban of compensating people for their contribution to the parenthood of others. Their contention is that at the time the law was passed, this was an emerging technology, one that people were uncertain of, and insisted on precautionary measures  being put in place. Since that time, women in Canada have gone to great lengths inconveniencing themselves by charitably carrying someone else's baby to term.

These women can legitimately claim expenses related to their voluntary pregnancies, but they may not receive payment for that service. But although it remains a criminal act to pay a fee for the acquisition of eggs or sperm, fertility brokers and others in the system beak the rules with a measure of impunity. That being the case, since it is illegal, donors and surrogates have no real self-interested incentive to become involved -- other than those rare individuals who charitably offer themselves regardless.

Many Canadians who are anxious to become parents, but cannot themselves through natural means acknowledge the indefinite wait that is imposed upon them by the criminalization of the means. And many visit other countries to hasten the process where it is not illegal to acquire sperm and eggs, and to rent out a womb, as it were. Sherry Levitan, a member of the society's board suggests that maximum allowable payments could be set by the government, reasonable rates that are not outrageous.

She points out the unfairness of Canadians' disadvantage "in terms of managing their own fertility care". One bio0ethicist who has studied the situation extensively and is viewed as an expert is in support of permitting payments to be made; but her perspective is that it should be done in a manner that is seen to be fair to the donors, the surrogates and the children that result; not particularly for the purpose of benefiting the parents per se.

As Professor Ravitsky points out, the criminal ban has led those transactions to take place within the atmosphere of a grey market. She points out how unfair it is that women are expected to provide eggs or to become surrogates out of a sense of charity for others, while lawyers and brokers and owners of clinics profit from the situation. The Assisted Human Reproduction Act which makes it a crime to buy the services of surrogates or donors remains in effect for the time being, administered by Health Canada.

In agitating for change, the Canadian Fertility and Andrology Society, while standing to gain if it does proceed, has failed to address one additional issue. And that is, quite simply, when pregnancies ensue the universal health care system in the country picks up the medical costs. At the present time there are Canadian women offering, at no charge to foreign prospective parents, to lend themselves to the enterprise of surrogacy. Those foreign parents-to-be get quite a bargain. They pay the surrogate mother only her expenses related to the pregnancy in recognition that this is the law in Canada.

The surrogate mother uses the universal health care system to look after all the medical requirements involved. And this is a medical cost that the Canadian taxpayer picks up. There should be a provision distinctly addressing this situation; that should foreign parents-to-be use the services of a Canadian surrogate, they should be financially liable for the health services given that surrogate during the course of her pregnancy, and the baby's delivery.

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