Ethical aspects of surrogate motherhood. Legal and ethical problems of surrogate motherhood in Russia

Moshkovich Yu.I.

Master student, Southern Institute of Management (Krasnodar).

Under the scientific editorship of Cand. legal Sciences Lameikina E.Yu., Associate Professor of the Department of Civil Law of the SCF FGBOUVPO, Russian Academy justice.

MORAL AND ETHICAL ISSUES OF LAW ENFORCEMENT OF SURROGACY MOTHERHOOD

annotation

The article deals with the moral aspect of law enforcement surrogacy, an analysis is given of various points of view on the problems of using this type of ART, examples are given possible ways overcoming the dangers involved in the use of surrogate motherhood.

Keywords: assisted reproductive technologies, surrogate motherhood, legal regulation.

Moshkovich Yu.I.

Undergraduate, Southern Institute of Management (Krasnodar).

Under edition scientific Candidate of Juridical Sciences Lameykina E.Yu., associate professor of civil law of SKF FGBOUVPO, Russian Academy of Justice.

MORAL AND ETHICAL ISSUES LAW ENFORCEMENT OF SURROGATE PARENTHOOD

Abstract

The article considers the moral aspect of enforcement of surrogacy, analyzes different points of view on the problems of using this type of IVF, are examples of possible ways to overcome the dangers of prisoners in the application of surrogate parenthood.

keywords: in vitro fertilization, surrogacy, legal regulation.

Throughout the history of mankind, children have been considered one of the main goals of marriage. It is with their birth and upbringing that our dreams, cares and hopes are connected. But not everyone is given the opportunity to experience the joy of fatherhood and motherhood, since, according to medical statistics, 20% of all married couples do not have a natural ability to have children.

WITH medical point Surrogacy is one of the most effective ways to overcome the inability to bear children. However, this is the most legally and ethically controversial method of assisted reproductive technologies (ART). And in different states the issue of using this method is solved in different ways.

Despite the widespread use of surrogate motherhood, according to the survey, from 18 to 28% of the population (depending on age and region) consider this method unacceptable and immoral, and 24% do not have their own opinion on this issue due to the fact that they are little aware of essence of the problem.

In general, modern reproductive technologies are an equation with several unknowns. On the one hand, reproductive technologies make it possible to overcome the problem of infertility, and it would be absurd to neglect them. On the other hand, the development of modern biomedical technologies is taking such leaps and bounds that society does not have time to comprehend what spiritual, moral and social consequences their spread can lead to. Therefore, today surrogate motherhood, as well as new reproductive technologies in general, is a tangle of problems: legal, religious, moral and ethical.

Most of the controversy arises around the use of surrogate (substitute) motherhood, the essence of which lies in the fact that a woman, through artificial insemination, agrees to carry and give birth to a child for a married couple who cannot have children for health reasons.

Opponents of surrogacy believe that it turns children into a kind of commodity, creating a situation in which rich people can hire women to carry their offspring; they also argue that motherhood becomes contractual work, so that the desire for profit may prevail here over considerations of benefit to the contracting parties. In addition, many feminists think that this practice will encourage the exploitation of women, and some church groups see it as a dehumanizing, immoral trend that undermines the sanctity of marriage and the family.

There are also fears that some surrogate mothers may be psychologically traumatized by the need to give up “their” child after establishing the connection with him that was created during the 9-month pregnancy and childbirth (even if at first it seemed to the woman that she could part with such a child without any special experiences).

First of all, the opponents of surrogate motherhood include the church, which believes that its implementation entails neglecting the deepest emotional connection that is established between mother and baby during pregnancy. In addition, representatives of the church, while recognizing the importance of childbearing, do not consider it the only purpose of marriage. Defining marriage as a "sacrament of love", they see the ethical value of the sexual relations of spouses in full and mutual self-giving, where the soul and body become one. At the same time, such unity is not limited to the reproduction of the human race. The Orthodox Church, accepting the idea of synergy, i.e. co-creation of God and man in the transformation of the world, at the same time rejects any claim of the latter to replace the Creator of the universe. Therefore, if the husband is infertile, and medicine is not able to help him, the wife should accept him as he is, without trying in one form or another to find a substitute for him.

The moral issues of surrogate motherhood cannot leave spiritual leaders indifferent. The jubilee Bishops' Council, held in Moscow in August 2000, unequivocally defines the attitude Orthodox Church to surrogate motherhood: “Manipulations associated with the donation of germ cells violate the integrity of the individual and the exclusivity of marital relations, allowing them to be invaded by a third party. “Surrogate motherhood”, that is, the carrying of a fertilized egg by a woman who returns the child to “customers” after childbirth, is unnatural and morally unacceptable even in cases where it is carried out on a non-commercial basis. This technique involves the destruction of the deep emotional and spiritual closeness that is established between the mother and the baby already during pregnancy. “Surrogate motherhood” traumatizes both the pregnant woman, whose maternal feelings are trampled on, and the child, who may subsequently experience a crisis of self-consciousness.

The Muslim religion approaches the solution of the problem of surrogate motherhood somewhat differently. Since polygamy is allowed in countries that profess Islam, the other wife of the husband can be a surrogate mother.

The practice of substitute motherhood is also criticized for the possibility of commercialization. It lies in the fact that this method can be used as a means of exploiting women as paid incubators producing children for wealthy customers. And there are many such facts. Recently, a criminal organization dealing with the transfer of children abroad was exposed in Moldova. Mothers "donors" already during the period of pregnancy knew where the babies would be sent. In Hungary, a criminal case was initiated against the geneticist Endre Zeisel, who, along with his partner, who is in America, was also engaged in a similar “business”.

The prohibition of the use of surrogate motherhood for commercial purposes is stated in the Brussels Declaration of the World Medical Association (1985). In addition, this method can only be applied in state and municipal system health care and only in cases where the customer, for health reasons, cannot bear and give birth to a child on her own.

Reducing the risk of commercialization of surrogate motherhood can also be facilitated by the fact that relatives of an infertile couple who will treat the child with genuine love can act as substitute mothers. For example, in Australia in 1994, a number of restrictions were lifted from the law on the use of surrogacy, which allowed sisters and cousins of genetic parents to become substitute mothers. In the state of North Carolina (USA), the sister of a woman who herself was unable to bear a child was impregnated with her husband's sperm and in May 1994 gave birth to a child. Before making such a decision, the couple had been treated for infertility for six years. Englishwoman Edith Jones was transplanted with an embryo created by the fusion of the egg of her daughter, 22-year-old Susanna, and the sperm of her husband, 23-year-old Creech Langston. The first case of a mother carrying a child instead of a barren daughter was registered in South Africa in 1987. The first case of surrogate motherhood was registered in 1985 in America. Elderly woman was carrying a child to her daughter, as the latter had an inoperable tubal obstruction. And in Russia, the first child appeared in 1991 in Kharkov, under the supervision of professors V.I. Grishchenko and F.V. Dakhno. In this case, the mother gave birth to a child to her own daughter, who had a congenital absence of the uterus.

Supporters of the use of surrogate mothers, of course, see this practice in a completely different way. They point out that for a family childless due to the inability of the wife to conceive or bear a fetus, this the only way get a child who will be genetically “own” for her husband. They also note that such a procedure, which allows the birth of a desired child, is, in fact, not so different from adoption.

In their opinion, this is not the commercialization of childbearing, but a deeply human act of love and cooperation. This act is, of course, associated with potential dangers for the surrogate mother, but she is able to assess them and can consciously take risks; thus, the decision to enter into a contract will not be more risky for her than for many other women who choose not entirely safe activities for themselves.

Supporters of surrogacy do not consider it a form of exploitation of women; they argue that a woman who voluntarily decides to become a surrogate mother receives sufficient material compensation for performing this role, as well as moral satisfaction from the benefits brought to society.

As one surrogate mother in northern California points out, "I can't feed the hungry, I can't stop the war, but I can make a difference in the world by helping couples become whole families."

A study conducted by Dr. Betsy H. Aigen showed that more than 40% of the 200 surrogate mothers surveyed, when concluding a contract, did not proceed from material interest, but primarily wanted to help childless couples find “their” child. In addition, as Judge Sorkov notes ( Australia), there are two arguments in favor of the fact that surrogacy contracts are not contracts for the sale of children.

Firstly, when concluding the contract, the parties have already agreed that the child will be transferred to the spouses-customers (the intended parents), and secondly, the intended parents can establish a genetic relationship with the child and thereby prove their parental rights on him. Of course, one cannot disagree with these conclusions, but it must also be taken into account that when using surrogate motherhood, genetic materials of both the surrogate mother herself and anonymous donors can be used.

Foreign practice has considerable experience in the application of this institution, although it cannot be characterized as unambiguous. And at present, the issue of surrogate motherhood is of great relevance abroad.

The first lawsuit related to a dispute between a surrogate mother and spouses took place in the United States in 1988. The case, known as In re Baby M, involved a court decision to give the baby to a surrogate mother who refused the $10,000 reward and decided to keep the baby. After this incident, the jurisprudence was not so unanimous in its decisions, despite the dominance of judicial precedent in the system of Anglo-Saxon law.

In some states, surrogate motherhood is completely prohibited (France, Germany).

Surrogacy is illegal in France and the Supreme Court of Appeal (Cour de Cassation) ruled that it is contrary to adoption law and violates the non-alienability clause human body. Any attempt to carry out artificial insemination of a woman who is ready to abandon her child after his birth (surrogate mother) is considered a crime, or to implant in her human embryo. The punishment is borne by the physician, but not by the intended parents or the surrogate mother.

In other states, only commercial agreements on surrogacy are prohibited and consideration is not allowed lawsuits under such agreements. These states include: Canada, Israel, Great Britain, the state of Victoria (Australia), the states of New Hampshire and Virginia (USA).

Finally, third countries restrict the use of reproductive technologies in connection with surrogate motherhood (Denmark, Norway, Sweden) .

According to doctors, there is no bank of surrogate mothers in Russia. If the spouses want to have a child and are ready to go through surrogate motherhood, then they are forced to look for a woman who is ready to help them.

Things are different in the USA. The site http://www.eggbank.com/ is a huge database offering data on 300 egg donors. The database allows you to choose a donor based on specific criteria, such as ethnic origin, religion, eye and hair color, height, weight, place of residence, etc. You can also learn about the requirements for surrogate mothers. Here are 12 questions to help you choose a clinic or program. For example, the time the clinic has been in existence, the number of pregnancies achieved, the number of doctors on staff, the programs offered by the clinic, psychological and medical testing of surrogate mothers, the presence of a trust account. Here you can also find out what to do if the surrogate mother requires additional funding, what kind of testing the surrogate mother undergoes, the emotional support of the donor and the recipient, the cost of services.

Relatively little has been said about the child in such situations. A child can inherit genetic defects from a surrogate mother (with the exception of rather rare cases when an “in vitro” fertilized egg from the same woman is implanted in her uterus, instead of which another had to be hired to carry the fetus). Some of these defects, unfortunately, cannot be detected. modern methods. It is also possible that the fetus is damaged as a result of the carelessness of the surrogate mother - for example, if she uses drugs during pregnancy or does not eat well enough. Just as important, but still unanswered, are the questions of the psychological adaptation of the child. If the child is explained (or he accidentally finds out) that he was born not by his mother, but by another woman, will this not become a source of problems or painful experiences for him? And if the child’s contacts with this woman continue after his birth (this happens when the surrogate mother is a relative or a person close to the family), then how can this affect the child in the future?

It is not surprising that with so many questions, a special commission of the American Infertility Society expressed serious ethical doubts about surrogacy, which cannot be removed until sufficient data are obtained to assess the dangers and possible benefits of the procedure under discussion.

It is necessary to collect sufficient information about the psychological impact of the entire procedure on surrogate mothers, on the couples using them, and on the children being born.
Particular attention should be paid to ensure that the spouses and the surrogate mother give their voluntary consent to the procedure, having all the necessary information.
The father and surrogate mother must be carefully checked for infectious diseases and genetic defects.
Payment for the services of specialists - doctors, lawyers, etc. - should be limited to their usual fees; they should not receive commissions for the selection of participants and the organization of the entire procedure.

Despite such recommendations, in some cases surrogacy will undoubtedly be organized under less stringent conditions (and less professionally). It is now clear that for some women who offer their services as surrogate mothers, the main incentive is money, and this may push them to provide false information about their health or life circumstances. There are cases when infertile couples, looking for a woman suitable for such a role, tried to persuade one of their relatives to agree to this. On the other hand, unprincipled or insufficiently serious lawyers and doctors are sometimes so carried away by the prospect of making good money on the selection of surrogate mothers that they are not able to act only in the interests of their clients. And yet, as hundreds of previously childless couples can testify, the benefits of this way of overcoming infertility are invaluable.

Despite the presence of conflicting opinions about surrogate motherhood, this method will be actively developed further. The main reason for this is that, despite the high cost and difficulties from the moral, ethical and legal side, it remains in demand. For many childless couples, the birth of a genetically own child, even if carried by another woman, is more desirable than the adoption of a completely different baby. And although last way family planning is more humane and the only acceptable from the point of view of the church, it is hardly possible to unequivocally condemn the spouses who decide to resort to the services of a surrogate mother. As for the surrogate mothers themselves, there can be many reasons pushing them to such a decision. But at the same time, they themselves bear the greatest psychological burden, and receive a lot of money not only for the strength and health spent on someone else's child, but also for the moral trauma they receive, which will remain with them for life.

One cannot but agree with the opinion of I.F. Aleksandrov that the further development of family and civil law should follow the path of advanced coordination and interaction, joint filling of gaps and still unsettled relations at the junction of two branches of law, joint resolution of emerging more global problems in the regulation of social relations. Such an area in the 21st century can become the area of human reproduction, where general theoretical, family law, civil law, moral and legal ethics and human rights issues, as well as other areas of human activity intersect. Today there is an urgent need legal regulation such relationships.

Literature

Afanaseva A.I. Surrogacy // Family law. - 2009. - No. 8. – From 23-29
Voevodin L.D. The legal status of the individual. - M.: Publishing house of Moscow State University, Publishing group INFRA M-NORMA, 1997. - 304 p.
Mayfat A.V. “Surrogate motherhood” and other forms of reproductive activity in the new Family Code RF // Legal world. – 2000.- № 2. S. 32-37
Svitnev K.N. Assisted reproductive technologies: Legal conflicts. // Legal issues in healthcare. - 2011. - No. 5. - P. 52-61
Pestrikova A.A. Surrogate motherhood in Russia: monograph. – Samara: Samar. Humanite. Acad., 2008. - 180 p.
Svitnev K.N. Review of law enforcement practice in cases related to challenging the refusals of the registry office to register children born as a result of the implementation of surrogate motherhood programs // Family and Housing Law. - 2012. - No. 1. - P.12-15
Khritinin D.F., Gardanova Zh.R., Kulakova E.V. Borderline mental disorders in women with infertility in the program of "surrogate motherhood" in the framework of treatment by in vitro fertilization // Mental disorders in general medicine. - 2008. - No. 4. – pp. 6-8
Shevchuk S.S. Some problems of legal regulation of the application artificial methods reproductions”// Lawyer. - No. 9. - 2002. - P.18-25

Surrogate motherhood is a technology that affects not only medicine, but also many areas of public life - ethics, morality, religion, law. There can be no unambiguous attitude to this topic: it is too complex and controversial. It is not surprising that the problems of surrogate motherhood, despite its legal existence in Russia and other countries, are hotly discussed at various levels.

The ethical issues associated with ART, including surrogacy, are one of the most contentious issues bioethics. Both supporters of the technology and its opponents have arguments in defense of their position.

Arguments for"

For a family in which a woman suffers from irreversible infertility, surrogacy is, without exaggeration, the only way to have children. From this point of view, this process is not the commercialization of childbearing, but an act of assistance, for which, moreover, the surrogate mother receives compensation.

Moreover, this technology allows you to prolong the lineage even in the event of the death of genetic parents. Widely known, for example, is the case of Natalya Klimova, who used the frozen sperm of her son who died of cancer, a donor egg and a surrogate mother to give birth to her grandson.

It is incorrect to talk about the exploitation of a woman, since one of the basic principles of participation in the program is voluntary desire.
Statistics prove that the demographic situation is deteriorating, and the world is rapidly aging. Thus, according to UN forecasts, by the middle of the 21st century, the number of people over the age of 60 will exceed the number of children under 15. At the same time, the number of infertile couples is also increasing. Surrogate motherhood greatly contributes to the solution of the demographic problem.

Arguments against"

Surrogacy is the only way to become parents for irreversibly infertile couples

Surrogate motherhood reduces the role of the mother to the function of an incubator, moreover, a commercial one, which is operated for profit. Opponents of the method also cite international legislative acts as arguments - for example, articles of the Convention for the Protection of Human Rights, the Convention on the Elimination of Discrimination against Women.
The method is based on positioning the child not as an independent person, but as an object of a transaction (despite the fact that the object is not a child, but the process of implantation and gestation).
Surrogate motherhood is a violation of the child's right to family identity, since it has been proven that in infancy he has a strong psychophysiological connection with the woman who carried and gave birth to him.
The technique poses a threat to the health of the surrogate mother - both physical and mental. Complications are possible not only due to strong impact hormonal means, but also because a woman is carrying a genetically alien fetus, and therefore rejection reactions are intensified.
According to some perinatal psychologists, mental abnormalities are possible in a child, since he receives a genetic heritage from two parents, but at the same time, nutrition and blood in the prenatal period from another woman.
Surrogate motherhood affects the psyche of parents, who may look for similarities in a child with a surrogate mother, especially in adolescence, when there are difficulties in relationships.
Business on surrogate motherhood in the speeches of public figures is often equated with child trafficking.

Attitude of religious organizations

Since the described technology affects not only medical problems, but also moral and even philosophical ones, various religious organizations also formulate their attitude towards it.

Orthodox Church sharply condemns the method, even in the absence of a commercial component, as stated in the Fundamentals of the Social Concept of the ROC. This document indicates that surrogate motherhood destroys the spiritual integrity of the individual and damages physical health.
In general, the opinion of the Orthodox Church corresponds to the view Catholicism. True, if a priest of the Russian Orthodox Church can refuse to baptize a child born as a result of this program, then Catholics are not so categorical, although in general the technology is sharply condemned.
IN islam any relationship is prohibited, except for the relationship of a husband and wife. So, IVF is allowed only if genetic material is used. legal spouses and not donors. Since surrogacy involves the use of third party services, it is prohibited.
Position Judaism another: only extramarital affairs are condemned, but in no way alternative ways works for posterity. However, it is pointed out that the use of this method is possible only as a last resort, when all other methods have been tried. Moreover, the Torah tells the story of Rachel, Jacob's wife, who, desperate to have a child, turned to another woman for help.

Position of the European Society of Reproduction

According to ESHRE recommendations, surrogacy must be non-profit

To reduce the degree of public controversy, the European Society for Human Reproduction has formulated basic ethical principles regarding surrogacy.

Its only possible form should be non-commercial, altruistic assistance to childless families. At the same time, they must compensate for the costs of medical care, medicines and others.
Participation in the program is entirely voluntary and conscious.
A surrogate mother must understand the moral responsibility and take care of the child during pregnancy. Potential parents are equally responsible for it. Obligations come into force from the moment of signing the contract.
Termination of pregnancy is justified only if there are medical indications for it.
When choosing a method of childbirth, a surrogate mother must be guided primarily by the interests of the child.
The child has every right to know how he was born.

Problems of legal regulation of surrogate motherhood

After the adoption in 2011 of the law "On the protection of the health of citizens in the Russian Federation", the legal status of surrogate motherhood received legislative formalization. One of the main advantages of this document is the consolidation at the legislative level of the concepts that are used in the field of ART. However, the Russian, concerning the described problem, is imperfect. Criticism is usually caused by the following gaps:

There is no consensus on the nature of the treaty. Some researchers believe that it should be attributed to the group of insignificant transactions, since it violates the foundations of morality. Others are of the opinion that it cannot be classified as civil law contracts and, therefore, the application of civil law governing contractual relations is impossible.
The definition of surrogacy as a method of infertility treatment is not fully understood, because it does not correspond semantic meaning the word "treatment", because after the application of this method, infertility does not go away.
The main goal of the procedure is not reflected - the transfer of the newborn genetic parents. The need to obtain consent from the surrogate mother casts doubt on the strength of the contract that was concluded with the customers.
Very often, a clause is included in the contract, according to which customers have the right to refuse a child if he is born sick. In this case, the woman who gave birth to him turns out to be powerless (unless otherwise prescribed in the contract and if she fails to prove that she was not guilty of what happened): the child remains with her, so she must reimburse the customers for the costs.
Obviously, there is some contradiction between the theory and practice of surrogate motherhood. For example, the position of single fathers who use surrogacy services using donor eggs is unclear. The law does not describe such situations, but in practice, courts are increasingly ruling in favor of single fathers.

The first such case was the decision of the Babushkinsky Court of Moscow in 2010, according to which the regional registry office was obliged to register a child born to a surrogate mother for a single man.

Debate on the ethics of surrogacy

Today, at the state level, the issue of significant restrictions in the implementation of surrogate motherhood technology is being considered. For example, there are proposals to ban its use for single women and men, as well as to ban commercial contracts. It is assumed that only a relative (with documented kinship) will be able to bear a child for a childless couple free of charge. Whether they will be accepted - time will tell. Be that as it may, today surrogacy is the only way for irreversibly infertile couples to become parents.

L.B. Lyaush, Senior Lecturer, Department of Biomedical Ethics, Russian National Research Medical University. N.I. Pirogova

In Art. 55 federal law dated November 21, 2011 "On the basics of protecting the health of citizens Russian Federation» presents the legal procedure for the use of surrogate motherhood (hereinafter referred to as SM), a method that is far from the principles of ethics and morality. The use of the SM method is associated with a number of ethical issues:

– a threat to the mental and physical health of the surrogate mother and child;

- the destruction of concepts denoting blood relations;

- maintaining the secrecy of the origin of the child;

- negative impact on the psyche of potential parents;

– commercialization of motherhood (womb rental);

- buying and selling of children.

Threat to the mental and physical health of the surrogate mother and child.

The risk of pregnancy complications in a surrogate mother with early toxicosis of pregnant women is higher than in women who are genetically pregnant with their child. In a normal pregnancy, half of the fetal genotype belongs to the mother, and the surrogate mother bears a completely genetically alien fetus. Rejection reactions, which are expressed by weakness, loss of appetite, vomiting, weight loss, apathy, anxiety, suspiciousness, irritability, in surrogate mothers can be physiologically much more pronounced than in a woman carrying her own child.

The defenders of SM constantly, speaking of sympathy for a woman who has lost the opportunity (or initially did not have) to bear her own child, or about the unique happiness of those who have found motherhood with the help of surrogate motherhood, are silent about another woman - a surrogate mother. As a rule, a surrogate mother during and after the transfer of the child to the parents-customers, i.e. after she is separated from her child, she experiences severe psychological trauma. A surrogate mother can become deeply attached to the child she is carrying due to the close biological connection with him during his maturation. Breaking the connection with the mother who endured the tego leads to deep psychological trauma for the child as well.

Moreover, we can expect a fundamental change in the psychological status of a woman who carries a child and knows that he will never belong to her. The impossibility of realizing the natural needs of a pregnant mother causes stress, depression, and psychopathic reactions are harmful to both the woman and the child. Under the influence of stress, the brain of a surrogate mother releases fewer endorphins, the amount of which determines the speed metabolic processes and the work of all organs of the body of a pregnant woman, and, consequently, the state of the body of the child. According to the obstetrician-gynecologist and perinatal psychologist E. G. Novosyolova, stress during pregnancy increases the risk of both psychological impairment of the child in the future and can lead to physical pathologies of development.

E. Sgrecha and V. Tambone note that the obvious manipulation of the bodily nature of a child who receives genetic heritage from two specific persons and at the same time blood, nutrition, intrauterine life support from a third person - a surrogate mother, in the future may have consequences on the mental level .
The comparison of a surrogate mother with a nurse and the assertion that this kind of “help” is not only acceptable, but also an expression of altruism, is extremely doubtful, since the intensity of the relationship between the surrogate mother and the fetus and between the nanny and the child is fundamentally different.

The destruction of concepts denoting blood relations.

In 1991, Arlette Schweitzer became the first surrogate mother in the United States for her own daughter's embryo. She gave birth via caesarean section to twins of her own grandchildren - a boy and a girl. A similar case was in South Africa: the egg of a young woman (with a congenital absence of a uterus), fertilized by her husband's sperm, was transplanted into the uterus of her mother - a future grandmother. In the examples given, one woman is both a grandmother and a mother. Similar situations give rise to confusion, blurring of concepts (mother, grandmother, son, grandson), which traditionally serve to designate blood ties. In a situation of loss of meaning and unambiguity of concepts, children can become victims of a personality crisis due to insufficient clarity of their origin and relationship with one or another family member. How will the news affect the child that the grandmother is brought to him by his mother at the same time? How to explain this situation to a child, and will he be able to clearly explain it to teachers and classmates without becoming a target for ridicule?

Preservation of the secret of the origin of the child.

No less significant is the problem of keeping the secret of the origin of the child. Those who have been involved in one way or another with the SM situation admit that they are literally torn between the need to keep a secret and the desire to open it. A specialist in the field of biomedicine I. Brek, asking the question: “What is preferable for a child?”, Answers: “Without a doubt, do not end up in such a situation.”

Negative impact on the psyche of potential parents.

The negative impact on the psyche of biological parents can be caused by the following reasons:

– fear for the termination of the contract by the surrogate mother or her disappearance;

- the woman's fears associated with the bearing of her child by another woman (but is she doing something unprofitable to the child, has she loved him more than I?);

- the lack of a guarantee that after the birth of a child, biological parents will not subconsciously look for similarities in him with the woman who carried him, especially if, for example, problems arise in adolescence (“Is this really my child? Or maybe everything “It’s not mine, because I didn’t wear it?”).

Commercialization of motherhood ("womb for rent").

If the surrogate mother is the mother (or relative) of a barren woman, the absoluteness of the altruistic motives of the act is beyond doubt. This is a case of non-profit surrogacy. If the surrogate mother is an outside woman, then this is a case of a commercial service. Commercial offers for potential surrogate mothers today are already openly placed in newspaper headings for job offers or newspapers. For example, in the newspaper "Where to go to work?" an announcement was posted by the Moscow clinic of reproduction "VITA NOVA" inviting women aged 20 to 35 years as surrogate mothers and egg donors for "guaranteed compensation up to 900,000 rubles."

Purchase and sale of children.

The object of the sale and purchase agreement is not only the biological ability to bear children of the surrogate mother, but also the child himself. If the object of sale and purchase was only the process of bearing a child, then the amount specified in the contract would have to be paid to the surrogate mother at the very beginning of pregnancy as a “guarantee” for the child to stay in the uterus. But the fact that part of the money is paid only at the end of pregnancy, after childbirth, indicates that such an agreement has as its ultimate goal the delivery of the produced "product", i.e., the purchase and sale of children. If, for example, a child has developmental defects, customers can refuse it: why pay the entire amount for a “product” that does not meet all the requirements?

Surrogate motherhood is a phenomenon with negative consequences for everyone involved in this transaction: for the surrogate mother, for the child, and for potential parents. Is there a real alternative to this phenomenon? Yes. This is such an opportunity open to many childless couples as the adoption of a child left without parents. In this case, everyone "wins": parents, getting a long-awaited child, and children - loving parents.

Sechina I. Surrogacy: for money, but under the heart / Neskuchny Sad, No. 4 (75), April 2012, p.53.

Ibid., p.54

Elio Sgrecha, Victor Tambone. Bioethics. Textbook. M.: BBI, 2002, p.250.

Protopresbyter John Brek. The sacred gift of life. M .: "Pilgrim", - 2004, S. 260.

Sechina I. Surrogacy: for money, but under the heart / Neskuchny Sad, No. 4 (75), April 2012, p.54.

Surrogate motherhood is a complex and controversial topic. Despite the fact that it is not prohibited in Russia, they are somehow embarrassed to talk about it, since this reproductive technology raises more questions than it answers. We will talk about the pros and cons of surrogate motherhood in this article.

What it is?

Surrogate motherhood is an officially recognized assisted reproductive technology that allows couples with total female infertility or complete inability to bear a child to have their own genetically “own” child. Previously, couples in which a woman could not become a mother for medical reasons or due to congenital or acquired anomalies in the development of organs reproductive system(uterus, vagina, ovaries), had only two options - to take the child from orphanage or live a life without children at all.

Surrogate motherhood, which in fact has been known since the time of Plutarch, but received a “second wind” only in 1980, gives an infertile couple a chance to have a child related by blood and genes. Apart from couples, "customers" of surrogate mothers are single women with gross uterine pathologies or other diagnoses that are absolutely incompatible with pregnancy and childbirth, as well as single men who have "ripened" to conscious paternity.

Fertilization occurs by IVF. Doctors receive a woman's egg, a man's sperm. Fertilization is carried out in the laboratory, after several days of cultivation, the embryos are transferred to the uterine cavity of a surrogate mother - a healthy, past necessary examinations women of reproductive age.

It is she who bears and gives birth to a baby (or babies), but they are not her family. After childbirth, the woman undertakes to give the born baby to its biological parents.

For IVF within the framework of the surrogacy program, donor germ cells can also be used - a single man can use oocytes from a cryobank, and a single woman can use donor sperm. However, the surrogate mother herself has neither a legislative nor a moral right to give her own eggs for fertilization, because in this case the child will be biologically native to her, and this can complicate the outcome - the surrogate mother will refuse to give the baby, she will become attached to him.

On the recommendation of the World Health Organization, the term "surrogate mother" has been replaced by "gestational courier". This is more logical and correct, since a newborn can have only one mother - his biological mother, who will raise and educate him.

Becoming a gestational courier is very difficult - the requirements for a woman's health are very high. In addition to being healthy, she must have children of her own. It is also not easy for infertile couples and single Russians and Russian women to find such a woman to carry a child: despite the abundance of reproductive agencies, clinics that have their own databases of surrogate mothers, special forums and communities on the Internet, a good, responsible and decent gestational courier today is a real find.

The gestational courier "works" on a paid basis. The amount of the fee is not regulated by anyone and depends on the agreement of the candidate with the biological parents.

Both those who want to use the services of a gestational courier, and those who are thinking about the “career” of a surrogate mother, should carefully weigh the pros and cons, the pros and cons, since this decision can have serious consequences.

Advantages

Undoubtedly, gestational couriers are needed and useful: many couples and single men and women get a long-awaited and hard-won chance to become parents. The need to have and raise our own children is inherent in each of us. genetic level, this is a normal requirement of the civilizational process. And sometimes a surrogate mother is really the only way out of the situation.

The Ministry of Health of Russia clearly indicates the indications for such assisted reproductive technology: this is the absence of the uterus, malformations of its development, post-traumatic changes, as well as a large list of diseases and conditions in which a woman cannot bear on her own due to big risk own death. Single men do not need to testify.

Today, about 17-20% of families in Russia suffer from infertility. Of these, about half require reproductive assistance. According to statistics, about 5-7% of such families cannot cope without a gestational courier.

Previously, with a diagnosis of infertility and a blue seal across the certificate, a woman would simply be sent home. Today she has a chance. If she decides that surrogacy is perfectly acceptable for her, she can have a healthy, strong child of her own.

For surrogate mothers themselves, an agreement on the provision of services to an infertile couple is a way to improve their own difficult financial situation. Services on average in Russia cost from 1 to 3 million rubles, and this may be a new apartment if a woman with a child has nowhere to live, or an urgent need to resolve the issue of expensive treatment of one of the relatives. Situations are different. married women with the consent of the spouse, they also become surrogates, and, believe me, each of them has very good reasons for making such a decision.

You may wonder why society has a predominantly negative opinion about surrogate motherhood, because all parties benefit from it. Probably, the dispute between supporters and opponents of this assisted reproductive technology will never end, because both of them give very strong arguments in favor of their opinion. If it were possible to put them on the scales, with a huge degree of probability the scales would remain in balance. Therefore, the decision to enter the surrogacy program is equally difficult for both gestational couriers and their “customers”.

Flaws

Both surrogate mothers and future biological parents face ethical problems at the decision-making stage. Most often, confess to relatives and friends that a couple needs the help of a stranger and stranger woman they are ashamed. Many biological mothers feign pregnancy, wear special pads on the stomach, so that everyone around, even relatives, could not even think at what cost this happiness came - to be a mother.

Bioethics does not allow the attending physician to divulge this secret ever to anyone.. Only three people know about the big secret - the husband, the wife and the female gestational courier. However, the human factor cannot be ignored; information leakage should still be feared.

Those who want to become parents need to keep their eyes open - there are quite a few scammers on the Internet who take an advance payment and disappear. Also, often biological parents may encounter facts of manipulation: a woman, having become pregnant, begins to blackmail her “customers” by having an abortion or starting to smoke and drink alcohol if she does not increase her fee or fulfill some other conditions. Sometimes it may turn out that a woman refuses to give up a child after childbirth, because she will get used to it in a long nine months.

Biological parents may come across a woman who has health problems and provided fake medical certificates, in which case the baby's health will also be at risk. An irresponsible surrogate mother may refuse or forget to take medications prescribed by a doctor on time, will miss consultation visits, will not adhere to a diet, and proper nutrition during pregnancy. In general, the list possible problems very big.

The female gestational courier herself can also become a victim of dishonest "customers". She may not be paid after giving birth, refuse to pay for any unforeseen expenses associated with pregnancy, if they are not specified in the terms of the contract. Spouses who are biological parents can divorce at the moment when they are carrying a baby for them, and then the child will become a victim of family squabbles or be abandoned altogether. The surrogate mother will face the question of what to do with the baby and who will pay her now.

The attitude of "customers" to the "performer" is not always correct and adequate. It is not uncommon for biological parents who want to control every step of the gestational courier, install surveillance cameras everywhere, including the bathroom and toilet, do not allow them to freely leave the house to go somewhere on their own. personal affairs. These actions, of course, are justified by fears that the surrogate mother will violate the terms of the contract and harm the baby. Not every couple in this situation can stop in time and understand where the boundary of the reasonable passes, where their rights end and the freedom of another person begins.

The relationship between the gestational courier and the biological parents should be regulated by an agreement in which everything should be specified to the smallest detail, all situations should be foreseen so that the interests of the two parties are taken into account as much as possible and suit everyone. It is better to entrust such work to specialists - lawyers of agencies that mediate between surrogate mothers and "customers", or lawyers of clinics where couples are observed. But even a very precise and competent agreement does not guarantee that everything will go smoothly and that there will be no difficulties or misunderstandings at any of the stages.

Another ambiguous point is whether to tell the child, when he grows up, how he was born. Bioethics forbids this for both physicians and the gestational courier. But there may be a leak of information, besides, some parents consider it their moral duty to tell this family secret to their grown child.

Psychologists believe that such a truth can cause problems with self-identification in a person, especially if this person has not yet reached the age of majority or has just barely crossed this age limit.

moral questions

Most likely, it will not be possible to achieve the blessing or approval of the clergy of almost all religions for surrogate motherhood. In most beliefs, this reproductive technology is severely condemned and rejected as immoral. Spouses who want to have a child at any cost violate the basic rule of any faith - with patience and humility to accept what is given by the Almighty.

Orthodoxy believes that spouses who refuse to accept their infertility as a given are already violating the Law of God. However, the attitude of the Church towards IVF is generally more loyal, but only on the condition that doctors use the sex cells of the wife and husband to obtain embryos. Donor material, surrogacy are methods that, according to Orthodox priests, violate the great sacrament of Christian marriage, and also completely devalue motherhood, turning it into a commercial transaction. In this case, the child becomes the subject of sale and purchase, and human life is priceless, this is exactly what the main fundamental principle of the Russian Orthodox Church says.

Admirers fully agree with Orthodox priests Islam. Not a single mullah will give his blessing to spouses who will report their desire to hire a surrogate mother for the birth of offspring. Muslim women who themselves want to become gestational couriers are very rare, since the punishment for such a sin in Islam is significant - the whole family, friends and relatives can turn away from a woman.

Catholicism completely prohibits all reproductive assisted technologies, whether it be IVF, ICSI, intrauterine insemination or surrogacy.

Judaism we are more tolerant of gestational couriers, however, in Israel they will never carry out an IVF protocol if the surrogate mother is one of the relatives (which is not at all prohibited in Russia). A country in which IVF is fully paid for by the state, where any reproductive methods are supported, severely restricts related "services", because the rabbis consider this incest, which is a serious offense.

The most tolerant attitude towards gestational couriers is shown only by Buddhism, because his admirers believe that the most important thing is that everyone be happy, and if surrogate motherhood is the only way to achieve this happiness, then why not.

The biological parents of the baby can also experience a mental crisis, since women in such couples are tormented by guilt for the fact that it was not she who gave birth to the baby, but the other, while husbands feel somewhat embarrassed in this situation.

Opponents of surrogacy put forward the following arguments: the program itself is contrary to the laws of nature, it rapes the souls of all participants, and the consequences can be the most unexpected. Unfortunately, divorce often happens. After the successful completion of the treatment course, discharge with balloons and flowers from the maternity hospital, the biological parents part after a while, because the secret they carry turns out to be too heavy, and the spiritual burden is too heavy.

Families of gestational couriers, if a woman has a husband, having received the necessary amount of money for the birth of a baby, also in most cases break up. Most men, even if the participation of the spouse in the program was confirmed by their consent, cannot accept in the depths of their souls the fact that the wife agreed to it at all. Conflicts begin, reproaches follow more and more often, as a result - a divorce.

conclusions

If you are faced with a difficult choice - whether to accept participation in the program, think carefully about whether you are ready for possible risks, as well as changes that do not necessarily have a happy ending. In many ways, probably, the clergy are right, who point to such important aspects human life as voice of conscience. Each of the participants in the surrogate motherhood program will have to answer to himself first of all.

The inadmissibility of violating the sacrament and intimacy of the union of two is difficult to dispute. Those who have vehemently tried to do this realize very soon how wrong they were. From this point of view, it is easier for a couple, as they are advised in most cases, to take a child from an orphanage, a baby left without parents or an abandoned baby. Conscience will be light and calm. But the desire to have own children is also impossible to dispute.

When making a decision that will definitely change your life, take your time, think, put everything in order. And when you decide, act without hesitation. Any decision is yours.

Since surrogacy itself is a modified IVF technology, more precisely, its special case, then ethical issues IVF remains relevant for surrogacy as well.

This is, first of all, the problem of "extra embryos" and the possibility of their destruction, sale, abuse, as well as a number of others that have been the subject of discussion for several decades and, I must say, they have not been resolved. IN Lately suddenly there was a question of incest, which can be provoked by IVF. Thanks to IVF, one male donor can have hundreds of children. Theoretically, the number of potential children from one donor may exceed the entire population of the earth. In practice, indeed, one father has hundreds of children, and legally they are not his offspring. Moreover, these children - brothers and sisters - do not know about their mutual relationship. If at the beginning of the spread of IVF there were only a few of them, now there are thousands. The probability of meeting and marriage is far from zero, and in the second generation it becomes even more likely. At the same time, no one bears any responsibility for the possible consequences, and they can be very serious.

In the case of surrogate motherhood, the children born are the children of the mother (legally) who carried them and gave birth, but in different countries laws may vary. Suppose the law leaves the right to a child only to biological parents. Then the “incubator mother” will give birth to a child to whom she has no rights. That is, the newborn will be seized by force. If the law leaves the mother the right to refuse the transaction immediately after birth, a difficult conflict will arise with the biological parents, who will be forced to live the rest of their lives with the idea that their child lives in an unknown place, in an unknown family. They won't have the slightest claim to it. A surrogate mother who finds herself in such a position can be understood. To bear a child, to hear how his heart beats, to give birth in agony, and then to give it away ... At this moment, maternal feeling wakes up, love for this child, as for his own. In any case, the surrogate mother finds herself in a state of emotional and physiological stress caused by the removal of the child. Possible mastitis, breast cancer, reproductive diseases. The potential conflict of interests of the biological and surrogate mother is inherent in the procedure of surrogate motherhood itself and is insoluble, dead end. Until now, even in countries where surrogacy is allowed, there is no legal scheme to settle them. At the same time, it should be borne in mind that even if the parties "dispersed" on a peaceful basis, the possibility of claims, proceedings, claims for damages has not been exhausted. Can a surrogate mother sue the clinic if she gets breast cancer? Who will be responsible for possible damage? Are there complex relationships between all parties of the surrogate motherhood process, mothers (there are two of them, no matter how absurd it may sound), fathers, parents, their families, a clinic, individual doctors, etc.? What happens if a sick child is born? What are the relationships and responsibilities of all parties in case of breach of contract? If a sick child is born? The clinic finds a way out - it is in enslaving conditions, obviously losing for a surrogate mother.

Despite the incessantly sounding talk in favor of women's rights, liberals for some reason fall silent when we are talking about surrogate motherhood, but in vain. It is difficult to imagine a more sophisticated and cruel form of exploitation of a woman than surrogate motherhood. Formally, this is not slavery, but a voluntary service, however, there are all signs of a violation of the rights of both the woman and the child. Possible complications of childbirth, impossibility breastfeeding, depreciation of the body, loss of health, emotional shock, risk to life, all this is a payment for dubious "earnings". In surrogate motherhood, the rights of a woman - a surrogate mother are violated for money and voluntarily, but this fact does not compensate for her possible losses, damage to her personality and freedom.

"The Uncertain Fate of the Extra Embryos". Just like with IVF, extra embryos can be destroyed, but this is not the only ethical issue of IVF and surrogacy. "Extra" embryos obtained as a result of ovarian hyperstimulation do not have any legal status in Russia and many other countries. Thus, human beings whose life has already begun are at the complete disposal of a private clinic. They can then be frozen and stored indefinitely, or implanted into any mother without the consent of the biological parents. Moreover, in this case there are no significant legal obstacles to the transfer of the embryo to other persons, and there is also no possibility of serious control by the state. Moreover, the clinic may not inform about the presence of extra embryos and emerging ethical problems, so as not to puzzle clients. Couples who have gone for artificial insemination are unaware of such a possibility as the appearance of their biological children in other families, including abroad. Moreover, their children may be the subject of sale and purchase. Given the questionable business of surrogacy clinics, you can be sure that their management is not weighed down by excessive morality.

Although the status of the embryo is subject to debate, a special status is recognized for the embryo. In any case, it is clear that when we are dealing with an embryo, it is not a part of the body or an organ, it is not a sex cell and not a tissue culture. From a purely biological point of view, he has the same genotype as an adult who can grow out of this cell. From the point of view of Christian ethics, which underlies European civilization, an embryo is a person, although it cannot have documents such as a passport, certificate or birth certificate. However, in essence, when transferring an embryo, let latent form(under the guise of providing services), there is an act of buying and selling a living person.

In itself, IVF, and even more so surrogate motherhood, are completely unnatural ways of conceiving and giving birth to children. So far, there is no convincing evidence of their harmlessness. Negative Consequences can be very different. In addition, if the embryo is stored frozen, its lifespan is extended indefinitely at the request of those who this moment owns it. The age will be greater as long as the storage lasted. Of course, freezing stops most biochemical processes, but not completely. During storage, the fertilized egg is exposed to normal background radiation exposure and the likelihood of mutation increases. The presence of a mutation is very difficult to detect, since many hereditary diseases are transmitted by recessive genes and do not appear immediately, but only in subsequent generations.

Commercialization of childbearing. No matter what words about the high significance of motherhood hide behind new technology surrogate motherhood, it remains a commercial service, that is, a service that is provided for money and for the sake of money. With the development of this technology, the mechanisms of market regulation are activated according to the scheme money - goods - money. A product is a set of services and the child himself. In this process, human life and the person himself becomes an object of trade, acquires the properties of a commodity. Demand creates supply and supply creates demand. In this scheme, there is no place for ethics, human relationships, the value and uniqueness of life. There are things that cannot be bought or sold. If a society crosses this line, then it becomes different - a society where you can buy human life. Some kind of “nurseries” have already appeared, where mothers from poor countries give birth to children, earning their living. It is impossible not to see the analogy with the human "farms" that existed in slave America. In fact, there was new form trafficking in one's body, similar to prostitution, which deeply humiliates the dignity of a woman, although in both cases everything happens as if voluntarily. Moreover, we still do not know what abuses this industry, for which there are no moral barriers, can come to. Interestingly, a lot of money is involved in reproductive technologies. The commercial price of the service for surrogate motherhood starts from 10 thousand US dollars and this is not the only expenses. One IVF attempt costs about two thousand dollars. At the same time, the problem of orphanhood in the country has not yet been resolved. Thousands of children without parental care are waiting for adoptive parents, and the adoptive parents themselves receive negligible assistance from the state, not to mention normal children born in normal families. naturally. Often the parents of a child who needs an operation that can be saved are faced with the need to find astronomical sums for life-saving operations. Insurance companies refuse to pay bills while citizens pay the corresponding taxes and compulsory insurance premiums. These two phenomena - millions circulating in the reproductive technology industry and orphans - are present at the same time in the same country - in the neighborhood.

Desacralization of motherhood and the destruction of the family. In all cultures, especially European and Christian, motherhood is considered sacred and respect for motherhood is deeply embedded in the moral system of society. No wonder the image of the Mother of God with the Child is one of the most revered. The transformation of motherhood into a business, the sale of children and one's own body dehumanizes the institution of motherhood, turns it into a craft. All the unethical aspects of reproductive technologies have been concentrated in the surrogacy industry, which is gaining momentum. Commercial childbearing is a blow to the family, and the consequences of this blow will affect reproduction, and the negative effect will far exceed the number of births that extravagant parents will receive.

Possible abuse. The possible consequences of the abuse of reproductive technologies, in particular, surrogate motherhood, have not yet been studied. Surrogate motherhood exists in a legal vacuum, and unresolvable incidents arise during its implementation. Thus, mistreatment of female incubators is already taking place, they are being subjugated to the surrogate motherhood clinic, which exists semi-legally. For money, a bonded contract is signed, which deprives the mother of her rights. The business of commercial motherhood has rapidly internationalized. If surrogacy is prohibited in one country, you can go to another. Rich countries can exploit the poor, etc. Business has a pronounced penumbral character and it is not clear what will happen when a criminal gang takes control of it. Surrogate motherhood opens the way to eugenics - the supposed "improvement" of the human race. At one time, such "breeders" found themselves in the dock in Nuremberg. It is well known how they "improved" the human race and what it all led to. Indeed, a physician without moral principles, who abuses his knowledge, is likened to Nazi doctors. The technology of surrogate motherhood, the work of clinics for the provision of surrogate motherhood services, is a kind of “black box” for society. We do not know exactly what is happening there and how it is happening. For example, it is stated that a woman provides services to a surrogate mother for free, purely for humanitarian reasons. And we are invited to believe it ... It is clear that we are talking about cash, the transfer of which is not licensed, not taxed and not recorded as a commercial activity. In our country, they are trying (so far unsuccessfully) to restore order and control over children adopted abroad. What can we say about children taken abroad in this way, through the export of surrogacy services?

It can be assumed that soon companies that make money from surrogacy (as in the case of IVF) will request government funding. This absurd undertaking will turn taxpayers into huge sums that would be better spent on arranging orphans in foster families.

Another major ethical question: to hide or not to hide? No state requires parents who have used surrogacy to tell their children about it. This will be seen as an interference with personal life and violation of family autonomy. The problem parents face is that they have to decide whether or not to lie to their child. Children are sure to ask questions like “where did I come from?” How to answer them if surrogacy was used? As a rule, biological parents do not advertise the fact that their child was carried by a surrogate mother, but there are exceptions. The most famous "biological parents" of the country were the popular singer Alena Apina and her husband, producer Alexander Iratov. Desperate to find the desired child in the usual way, they used the services of a surrogate mother. An intelligent provincial woman with a higher education, a mother of two children, decided to carry her daughter Ksyusha to the singer for a very substantial reward. After Alena took little Ksyusha from her surrogate mother, the women did not see each other and do not support communication.

Equally well-known in business and social circles, Olga Slutsker, president of the World Class fitness center network, resorted to the help of an American woman, Lucy, who became a surrogate mother for her son Misha. There were very warm relations, they became very close during the period of gestation and continue to be friends with families.