Ethical problems of surrogate motherhood. Moral and ethical issues of law enforcement of surrogate motherhood

The term "surrogate motherhood" means a method of transferring the fertilized eggs of a woman who, for one reason or another, cannot bear pregnancy, into the body of another woman - a surrogate mother. The child born by this woman is transferred to the genetic parents on the basis of an agreement. The surrogacy agreement can be commercial and non-commercial (altruistic). The first provides for material reward, the second does not involve any payment, except for reimbursement of expenses during pregnancy. Non-commercial programs are usually carried out in relation to relatives, their participants may not comply with the general requirements of reproductive legislation. Commercial programs are usually carried out with the help of intermediaries - firms that select surrogate mothers, legal parents, medical institutions.

In 1995, the program of "surrogate motherhood" began to be applied in the territory former USSR. The first child appeared in Kharkov, where the mother gave birth to him for her own daughter, who had a congenital absence of the uterus. There are no difficulties in this family, the mother, having given birth to a child, prudently moved away from the young family, exchanged an apartment, the child develops normally, there are no mental changes. It is rather difficult to calculate the number of children in the world born to surrogate mothers, the vast majority of such events are protected due to the confidentiality rule, there is evidence that about 1500 such children were born, there is evidence that there are already 250 thousand.

Now in Ukraine, about 1 million couples cannot have children due to infertility. In the world of such couples - 20% of the number of married couples. How many of them decide to resort to the help of a surrogate mother - of course, there are no such statistics. Parents who decide to take this step, just like surrogate mother, carefully protect from everyone the secret of the birth of a child. As a rule, a woman has to "depict" pregnancy, take maternity leave, etc. There are no laws regulating such a situation.

Program " surrogacy"gives a chance to have a child to women who have had their uterus removed or pregnancy is contraindicated for them. In these cases, the eggs and sperm of an infertile couple are used. The fertilized eggs of a woman who, for one reason or another, cannot bear pregnancy, are transferred to the body of another woman - a surrogate mother, and stay there during the entire period of pregnancy. It has been noticed that embryos take root in the uterus of another woman much better - the probability of pregnancy in this case is 30% or more (according to some sources, up to 70%). But to alternative method offspring ( we are talking about in vitro fertilization (in vitro) and surrogate motherhood), despite the change in mentality, the attitude is far from unambiguous.

American studies conducted in recent years have shown that people who decide to have a child with the help of a surrogate mother usually remain satisfied with their experience. The moral and legal problems associated with the practice of surrogate motherhood turned out to be more complex than the actual psychological ones. The United States has not adopted laws prohibiting surrogate motherhood, and sensational court decisions in Kentucky and Michigan have confirmed the legal force of the agreements concluded on this matter. 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.

Supporters of the use of surrogate mothers point out that for a family that is 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, potential hazards for a surrogate mother, but she is able to evaluate 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.

But it is important to say about the child: he can inherit genetic defects from the surrogate mother (if her egg was used). 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 contacts of the child 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?

The American Infertility Society Special Commission (1986) expressed about surrogacy “serious ethical concerns that cannot be resolved until sufficient data are obtained to assess the danger and possible benefits the procedure under discussion.

In view of these doubts, the mentioned society recommends the use of surrogate motherhood only as a clinical experiment, subject to the following conditions:

1. It is necessary to collect sufficient information about the psychological impact of the entire procedure on surrogate mothers, on married couples using them, and on children being born.

2. Special attention it should be ensured that the spouses and the surrogate mother give their voluntary consent to the procedure, having all the necessary information.

3. The father and surrogate mother must be carefully checked for infectious diseases and genetic defects.

4. 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. On the other hand, unscrupulous or not serious enough lawyers and doctors are sometimes so engrossed in 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.

The Bible mentioned an element of surrogate motherhood, when childless women, in order to maintain their prestige, resorted to the help of slaves who gave birth to a child from the owner, and immediately after the birth, the legal wife took him into her arms, thereby demonstrating her indisputable right to the baby. Despite this, the Christian religion takes a negative view of such manipulations associated with the donation of germ cells, as they violate the integrity of the individual and exclusivity. marital relations allowing intrusion by a third party.

In addition, representatives of the church, while recognizing the importance of childbearing, do not consider it the only purpose of marriage. By defining marriage as "the sacrament of love," they see ethical value sexual relations spouses in complete and mutual dedication, 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 well-known Moscow priest and sectarian Oleg Stenyaev unequivocally answered why the church treats barren women in this way, for whom a child is the dream of a lifetime: “Life arises by the will of God, therefore other attempts are untenable. The birth of a child is a blessing of God, barrenness is a punishment for sins!” (quoted in "Orthodoxy and Problems of Bioethics", 2001). In addition, the clergy are very concerned about the possibility of resorting to new reproductive technologies and thus having children by same-sex couples. While categorically condemning homosexual marriages, the church considers them especially unacceptable for raising a child.

The Muslim religion has a slightly different approach to new reproductive technologies and, in particular, to the problem of surrogate motherhood. There it is welcomed as a way of giving birth to children, the value of which in Muslim countries remains ever-higher. In addition, since polygamy is allowed in Muslim countries, the husband's other wife can be a surrogate mother.

The procedure of surrogate motherhood is possible only with the following indications:

absence of the uterus (congenital or acquired);

deformation of the cavity or cervix with congenital malformations or as a result of diseases;

synechia (adhesions inside the uterus) of the uterine cavity, not amenable to treatment;

various diseases internal organs in which pregnancy is contraindicated;

unsuccessful repeated attempts of in vitro fertilization (IVF) with repeated receipt of embryos High Quality, the transfer of which did not lead to pregnancy. Requirements for surrogate mothers:

age from 20 to 35 years;

having a healthy child of their own;

mental and somatic health.

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 surrogate mother and child;

- the destruction of concepts denoting blood relations;

- maintaining the secrecy of the origin of the child;

– Negative influence 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 early toxicosis pregnant women is higher than in women who are genetically pregnant with their child. At 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 bearing 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 through C-section twins of his own grandchildren - a boy and a girl. 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 it’s not mine, because I didn’t carry 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 stranger 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?

Surrogacy is a phenomenon negative consequences for all involved in this transaction: for the surrogate mother, and for the child, and for potential parents. Is there a real alternative 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.

This reproductive technology raises ethical problems and heated debate even, apparently, to a greater extent than the IVF method.

The first successful case of surrogate motherhood was registered in 1981 in the USA. Although the very idea of ​​​​this method is quite ancient: there is evidence that even in Antiquity there were cases of a woman giving birth to a child for another family.

Surrogate motherhood, as a rule, is used for infertility of the family bed. The essence of this method is that the egg of one woman is fertilized artificially, and the resulting embryo is planted in another woman who bears it, gives birth and gives it to a married couple. In this case, one woman is called a donor (or genetic mother), and the other (bearing a child) is called a surrogate mother.

The so-called partial surrogacy is also possible, when a woman - a surrogate mother at the same time acts as an egg donor. In this case, she is also the genetic parent.

The main moral issues associated with surrogacy include the following.

• 1. Destruction of integrity family relations. Surrogate motherhood is becoming more and more accessible and widespread, which cannot but cause concern in terms of traditional ideas about family and family values.
• 2. The problem of establishing motherhood and mother's rights. IN various countries this issue is regulated in different ways. There are many cases when a surrogate mother refused to return the child to a married couple. Indeed, the situation when a child has two mothers at once creates sharp conflicts. By using legal regulation seek to solve or at least mitigate this problem.
• 3. Total number of parents. Theoretically, if using germ cell donation, it is possible to have a maximum five parents of a child (!). This is a female donor, a male donor, a surrogate mother and married couple- customer ( social parents). Obviously, this is a completely extraordinary situation.
• 4. Surrogate motherhood will provide an opportunity to become a mother at an unlimited old age. It undermines all traditional notions

about motherhood in general, and also poses a threat to the rights of the child, since it is unlikely that natural care and care for the child is possible in the presence of an elderly mother.

• 5. The commercialization of childbearing leads to the fact that a surrogate mother, bearing a child for a fee, becomes a commodity, a woman - an incubator.
• 6. Moral and psychological problems child - they can be quite sharp if he learns about his origin.

In a number of countries (for example, in Germany, Austria, France) surrogate motherhood is prohibited. The international ethical recommendations of the CE committee on bioethics and artificial methods of childbearing are to limit surrogacy and apply it only for reasonable indications. The rights of a surrogate mother must be protected (in particular, she must be provided with the right to keep the child to herself). The practice of commercial surrogacy is considered ethically unacceptable.

Surrogacy is allowed in Russia, including for a fee. A surrogate mother can be a woman aged 20–30 years (including a married woman) who has at least one healthy child of her own and a medical certificate on the state of health. A surrogate mother cannot be an egg donor at the same time (i.e. the so-called partial surrogacy is prohibited).

The status of parents after childbirth by surrogate motherhood in our country is determined as follows. According to the Family Code of the Russian Federation. Married persons who have consented to the implantation of an embryo to a surrogate mother are registered as parents, but only with her consent. After the recording is made, the surrogate mother does not have the right to dispute motherhood.

As surrogacy poses complex legal challenges, more and more important role their solution today is played by the preparation of carefully thought-out contracts and qualified legal assistance.

Opponents of surrogate motherhood and other assisted reproductive technologies argue that in case of infertility there is always an alternative to the use of these methods: after all, there are many children in orphanages without parents who are waiting for adoption (adoption) and dream of a normal life. family life at home with loving parents.

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 moral aspect law enforcement of surrogate motherhood, 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 to feel 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 view of surrogacy is one of the most effective ways overcoming infertility. 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 in the role of 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 removed from the law on the use of surrogacy, which allowed sisters and cousins genetic parents 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 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 that is childless due to the inability of the wife to conceive or bear a fetus, this is the only way to 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 a war, but I can make a difference in the world by helping couples become complete family» .

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 that case arbitrage practice was not so unanimous in her 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 by 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.

1. 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.
2. 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.
3. The father and surrogate mother must be thoroughly checked for infectious diseases and genetic defects.
4. 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. main reason This is that, despite the high cost and complexity 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. Alexandrov 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 regulation public 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 for legal regulation of such relations.

Literature

1. Afanaseva A.I. Surrogacy // Family law. - 2009. - No. 8. – From 23-29
2. Voevodin L.D. The legal status of the individual. - M.: Publishing house of Moscow State University, Publishing group INFRA M-NORMA, 1997. - 304 p.
3. Mayfat A.V. “Surrogate motherhood” and other forms of reproductive activity in the new Family Code RF // Legal world. – 2000.- № 2. S. 32-37
4. Svitnev K.N. Assisted reproductive technologies: Legal conflicts. // Legal issues in healthcare. - 2011. - No. 5. - P. 52-61
5. Pestrikova A.A. Surrogate motherhood in Russia: monograph. – Samara: Samar. Humanite. Acad., 2008. - 180 p.
6. 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
7. 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
8. Shevchuk S.S. Some problems of legal regulation of the application artificial methods reproductions”// Lawyer. - No. 9. - 2002. - P.18-25

There is a range of ethical issues that are less visible than the above, but no less important.

Surrogate motherhood is a special case of IVF technology, the ethical problems of IVF automatically apply to surrogate motherhood 14 .

1. The problem of "extra embryos" and the possibility of their destruction, sale, abuse. The “extra” embryos obtained as a result of ovarian hyperstimulation do not have a legal status in Russia and many other countries. That is, living human beings are at the complete disposal of a private clinic, where they can be frozen and stored indefinitely or implanted in any mother without the consent of the biological parents. In this case, there are no significant legal obstacles to the transfer of the embryo to other persons, there is no serious control by the state.

2. Incest, which can be provoked by IVF. Thanks to IVF, one male donor can be the biological father of hundreds of children who do not know about their relationship. The probability of their meeting and marriage is not zero, but 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.

3. If the surrogate mother refuses to transfer the child to the biological parents, there are two options. If the law is on the side of the biological parents, the newborn will be forcibly removed. If the law is on the side of the surrogate mother, 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. 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.

4. Exploitation of the female body, which entails not only psychological trauma to the surrogate mother, but also physical damage to her health. Possible Complications childbirth, the impossibility of breastfeeding, depreciation of the body, loss of health, emotional shock, risk to life, all this is a payment for dubious "earnings".

5. An unnatural way of conceiving children, for which there is no convincing evidence of harmlessness. If the embryo is stored frozen, it retains its properties for further development, but freezing does not stop all biochemical processes occurring in the embryo. During storage, the fertilized egg experiences the usual background radiation exposure. The probability of a mutation increases, which is very difficult to detect immediately, since many hereditary diseases are transmitted by recessive genes and do not appear immediately, but only in subsequent generations.

6. From the point of view of Christian ethics, which underlies European civilization, the embryo is a person. That is, when the embryo is transferred, an act of buying and selling a living person takes place.

In the beliefs and culture of many peoples, there is an idea that infertility is sent by God. The opinion that infertility is God's punishment or the lot of fate is still widespread among infertile people today. Childlessness or infertility (as well as the birth of a child in a family and its subsequent upbringing) is a test from the Lord. Accept this test with meekness and humility, trusting in the mercy and goodwill of the Almighty, who knows that the lot of God-fearing and steadfast people in faith is beyond human understanding.

The Fundamentals of the Social Concept of the Russian Orthodox Church give a clear description of the concept and practice of surrogate motherhood as "unnatural and morally unacceptable." “This technique,” ​​says the document, “involves the destruction of the deep emotional and spiritual closeness that is established between mother and baby already during pregnancy. Surrogate motherhood traumatizes both the pregnant woman, whose maternal feelings are violated, and the child, who may subsequently experience a crisis of self-consciousness ... 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 "16.

According to the head of the Department of Biomedical Ethics of the Russian National Research Medical University. N.I. Pirogov Professor Irina Siluyanova 17 “a surrogate mother, by “renting” her body and selling her motherhood and the child born to her, destroys the great “physics” of love, on which the whole metaphysics of human relations is built. After all, cruelty, aggression, rudeness, crime - something that is growing catastrophically in our society - do not arise by themselves. They are a consequence of the destruction of the morality of human relationships based on love.

At the same time, discussions on strengthening the family are intensifying in Russian society. In support of this thesis, let us turn to a study by VTsIOM 18. In the opinion of the majority of Russians (59%), it is necessary to encourage and promote the image of an extended family consisting of several generations (parents, children, grandparents). At the same time, representatives of the older generation (62% aged 45 and over) showed more enthusiasm in this matter than the youth (54% of 18-24 year olds). More than a quarter of respondents (29%) do not yet support this initiative.

Our fellow citizens are also in favor of strengthening measures aimed at reducing the number of abortions: 67% of the survey participants suggest making it necessary for minors who decide to take this step to have written consent from their parents or legal representatives. Women are more categorical on this issue than men (71% and 61%, respectively).

More than half of the respondents (63%) agree with the provision on the permission to use the services of surrogate mothers only for couples suffering from infertility. A quarter of respondents (24%) do not agree with this proposal.

Our fellow citizens are ambivalent about the interference of representatives of the Russian Orthodox Church (ROC) or other traditional religions in the sphere of family policy. 49% of the respondents support the inclusion of religious figures in the commissions for minors. Every third survey participant (33%) evaluates this proposal negatively. The introduction of the examination of draft laws in the field of family relations by representatives of the church is approved by 47% of respondents, while 34% are against it.