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Surrogate Mother Cares for Baby Abandoned Because of Down Syndrome

Posted by Sonia Allan, Biopolitical Times guest contributor on August 4th, 2014


Thai surrogate mother Pattaramon Chanbua holds baby Gammy
Thai surrogate mother Pattaramon Chanbua holds baby Gammy

Untitled Document

The story of baby Gammy and his "surrogate" mother, Pattaramon Chanbua, hit headlines around the world last week. Six-month-old Gammy, born with Down syndrome and a congenital heart condition, was conceived as a result of a commercial surrogacy arrangement between Chanbua, a Thai national, and an unknown Australian couple who abandoned him at birth.

Chanbua, a 21-year-old mother of two other children, was offered 350,000 baht (approximately US $11,000) to be a surrogate. She told an Australian ABC reporter that her family was struggling to pay off debts when she and her husband agreed to the arrangement:

The money that was offered was a lot for me. In my mind, with that money, one, we can educate my children, we can repay our debt.

When she became pregnant with twins, Chanbua was promised an additional 70,000 baht (approximately US $2000).  Then, at four months into the pregnancy, doctors discovered that one of the babies had Down syndrome.

According to reports, the Australian commissioning couple (the genetic parents of the children) said they did not want a baby with Down syndrome.  “They told me to have an abortion but I didn’t agree because I am afraid of sin,” Chanbua reports.

An abortion would have been illegal under Thai law unless the mother’s health was at risk.

On the birth of the children, Chanbua was paid the original amount, but not the extra money. The Australian couple took Gammy’s twin sister home with them, and left Chanbua and her family to care for Gammy. This put her in a desperate situation, unable to pay for his medical needs.

The Thai newspaper Thairath published Gammy's story last week, and an online campaign to raise money for his treatment was launched shortly afterwards. The story has been met with outrage and compassion from hundreds of people who have now donated close to $200,000.

A spokesman for Australia's foreign affairs department has expressed "concern" about the reports and said it is in consultation with Thai authorities over surrogacy issues.

The Thai government quickly announced that it will now be illegal to pay for surrogacy in Thailand, and that the practice can be undertaken only in circumstances in which the surrogate is related to the intended parents, and the intended parents are medically infertile. People who remove children from Thailand without the approval of the government would also be subject to Thai anti-trafficking laws.

Some agencies and lawyers who facilitate surrogacy arrangements have responded primarily with concern that hundreds of would-be-parents may be left unable to satisfy their longing for a family. They suggest that it would be better to permit commercial surrogacy in Australia.

These responses stand in stark contrast to the many people who see Baby Gammy’s plight as highlighting the extent to which commercial surrogacy arrangements can exploit and commodify women and children. Chanbua entered into the arrangement because her family was desperate and in debt. This was no "win-win" situation, whatever the outcome: rather, it was one in which surrogacy brokers and a relatively wealthy Australian couple took advantage of another family’s dire circumstances. Baby Gammy’s situation only serves to emphasize the extent to which money influenced and drove the transaction.

In my country, Australia, all states and territories prohibit commercial surrogacy arrangements. New South Wales, Queensland and the Australian Capital Territory also prohibit travelling to other countries to engage in such practices. The Australian government lists such prohibitions in its reports to the United Nations as forming part of our laws against the sale and trafficking of children and of meeting our obligations under international law. Some people who are travelling abroad and engaging in commercial surrogacy are breaking laws.

Should Australia as a consequence of such incidents now change its laws to permit commercial surrogacy? I would respond to this question with a resounding “no.”  While careful regulation of altruistic surrogacy arrangements allows an alternative avenue to having a family, introducing profit into such arrangements places women and children at risk. Baby Gammy is but one example of this. His twin sister—who may never know that he exists or the circumstances of her birth—is another. Pattaramon Chanbua is a third.

The majority of nations that have established laws on surrogacy prohibit commercial arrangements. However, because a few permit surrogacy (for example, India, Guatemala, Russia, the Ukraine, and some U.S. states), brokers, lawyers, and clinics continue to encourage people wishing to have children to "forum shop" to "realise their dreams.” The result has too often been complex situations for children, commissioning person(s), and women working as surrogates. In some cases, problems have arisen about legal parentage and citizenship for children; this has been the primary focus of many recent news stories.

But we should not lose sight of the significant international human rights issues reflecting social, economic and racial disparities between surrogate mothers and commissioning person(s), involving the exploitation and commodification of women and children. These are clearly illustrated by the baby Gammy case.

One Australian surrogacy facilitator referred to the “market” in remarks about baby Gammy that were reported in a major newspaper. The use of this term is telling in itself. While this case has raised the need for further discussion, let me suggest that the discussion should not address how to support such a market, or to introduce or broaden the market to Australia. Rather, it should focus on how to protect the rights and welfare of children and women in line with established global human rights standards. In my view, this includes taking a strong stance against commercial surrogacy.

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Sonia Allan is Senior Lecturer in Law at Macquarie University. Her research focuses on wide-ranging health-related ethical, legal, human rights and regulatory issues. She has worked extensively in advocating for women and children in situations in which assisted reproduction has been used and researching the regulation of new biotechnologies. Her latest major work is The Patient and the Practitioner: Health Law and Ethics in Australia, co-authored with Meredith Blake (2014).





California Set to Prohibit Sterilization of Prisoners

Posted by Jonathan Chernoguz on July 24th, 2014


prison bars

Last month, the California Senate unanimously approved bill 1135, which bans the sterilization of inmates as a form of birth control. The bill will soon be put before the Assembly and could become state law this year. If it passes and is signed by the Governor, the sterilization of prison inmates will be permitted only in cases of life threatening emergencies or when medically necessary.

Evidence of unauthorized sterilizations in California prisons emerged through the persistent efforts of Justice Now and an extensive investigation by Corey Johnson of the Center for Investigative Reporting. State Senator Hannah-Beth Jackson, vice-chair of the California Legislative Women’s Caucus, spearheaded the request for a state audit and authored SB 1135.

According to the California State Auditor, more than 39 out of the 144 bilateral tubal ligations performed on inmates from fiscal years 2005-06 to 2012-13 were done without lawful consent. Even more alarming, there is no evidence that the inmates’ physician signed the required consent form for 27 of the sterilization procedures.

The audit additionally says that “the true number of cases in which Corrections or the Receiver’s Office did not ensure that consent was lawfully obtained prior to sterilization may be higher.” In other words, there could be even more victims of sterilizations who are unaccounted for because they are still unaware that the procedure was performed.  

With the SB 1135 approved unanimously and on its way to the Assembly, it’s easy to forget about California's murky history with sterilizations. During the twentieth century, dozens of U.S. states had laws permitting explicitly eugenic sterilization. Some 20,000 procedures were performed between 1909 and 1963 in California, the highest number in any state.

This history was raised in the legislature in 2003. Governor Gray Davis issued an apology, and a state resolution was passed that

urges every citizen of the state to become familiar with the history of the eugenics movement, in the hope that a more educated and tolerant populace will reject any similar abhorrent pseudoscientific movement should it arise in the future.

Yet the resolution presents no outline for making this idealistic “urging” a reality.

When I learned of the continuing sterilizations in California, it seemed to me that the 2003 apology and resolution were empty. As an effort to truly help prevent “any similar abhorrent pseudoscientific movement to arise,” I worked on a petition to incorporate the history of the eugenics movement into California schools’ curricula. The approval of Senate Bill 1135 would also help challenge the re-emergence of eugenic ideologies, as well as prevent abuses in California’s prisons.

Previously on Biopolitical Times:





French Luminaries’ Open Letter on Surrogacy

Posted by Marcy Darnovsky on July 24th, 2014


Sixty French personalities, including prominent politicians of the left and center-left, senior scholars and mainstream feminists, have signed an open letter urging President François Hollande to affirm his opposition to surrogacy contracts and to reinforce the country’s legal prohibition against them. The letter, published on July 14 in Libération and posted as a petition on Avaaz.org, was a response to last month’s European Court of Human Rights (ECHR) ruling that France must grant children born abroad via contract pregnancy arrangements official recognition of their parentage.

The European Court ruled in late June on cases brought by two French families whose children were conceived with their fathers’ sperm and third-party eggs, and carried and delivered by surrogates in California and in Minnesota. The children have been living with the parents in France, but without legal recognition of their parental status.

Signers of the petition include the former President of the European Commission Jacques Delors, former Socialist Prime Minister Lionel Jospin, former Minister of Women's Rights Yvette Roudy, and former head of the French Communist Party Marie-George Buffet.

The letter reminds President Hollande of his commitment against surrogacy contracts, known in French as GPA (gestation pour autrui), and asks him to "fight against the soliciting of French clients by surrogacy agencies.” It characterizes surrogacy contracts as “contrary to the principle of respect for the person, both the woman who carries the child [and] the child who is commissioned.” And it highlights the difficult situation created for France by the ECHR ruling, which in effect offers affluent French citizens a way around their own country’s laws. If the ECHR decision is accepted, the letter says, there will “effectively be a market in babies” in France, though only some will be able to afford it:

Mr. President, how will you explain to French women and French men that if they have money, they can go buy a baby abroad and register him or her as their son or daughter with French civil status, while if they are not wealthy enough, they will be subject to the ban that would remain applicable to surrogacy contracts made in France? 

The letter does recognize that the legal status of children born as a result surrogacy arrangements abroad should be addressed:

It is conceivable to find technical solutions to improve the legal situation of children living on French soil without succumbing to what is a triumph of the child-making industry, and without costing them the status of human being by recognizing the surrogacy contracts that designated the child as a thing.

The letter has been covered by French newspapers across the political spectrum (Libération, Le Monde, Le Figaro, Valeurs Actuelles) but has apparently not reported in English language publications; an unofficial translation is here.





Making Sense of the BRAIN

Posted by Jessica Cussins on July 24th, 2014


Untitled Document

More than a decade after the historic completion of the Human Genome Project, the ethical, legal and social issues (ELSI) are far from being sorted out. The role of genetic information in the courtroom, in research projects, in for-profit companies, at all stages of pregnancies, and in insurance companies is being negotiated across multiple planes on a daily basis. With so many competing interests, reaching consensus on responsible usage can feel like a pipe dream. Nonetheless, important strides have been made in several of these areas through recommendations, regulations, and tireless advocacy.

Are there lessons to be learned from these struggles that might help ease the growing pains of the upcoming projects to understand the brain?

The brain projects are certainly shaping up to be no less momentous or controversial.  According to the 1.2 billion pound, ten-year undertaking in Europe known as the Human Brain Project,

Understanding the human brain is one of the greatest challenges facing 21st century science. If we can rise to the challenge, we can gain profound insights into what makes us human, develop new treatments for brain disease and build revolutionary new computing technologies.

The BRAIN Initiative in the United States (called the cousin of Europe’s Human Brain Project) is no less ambitious. It is set to receive $4.5 billion in federal funding over the next 12 years.

These projects will help make sense of what is probably the least understood part of the human body. The origins of our thoughts, memories, desires, actions, and emotions could become less elusive and provide important keys for helping people deal with neurological disorders.

But already at this early stage, extensive criticisms have been voiced. Most strikingly, the conceptual starting place of even being able to successfully map the brain in an intelligible way has been questioned. New York University research psychologist Gary Marcus recently pointed out in a New York Times op-ed that we don’t even know what a good theory of the brain would look like because “[b]iology isn’t elegant the way physics appears to be.” He continued,

We know that there must be some lawful relation between assemblies of neurons and the elements of thought, but we are currently at a loss to describe those laws... The problem with both of the big brain projects is that too few of the hundreds of millions of dollars being spent are devoted to spanning this conceptual chasm.

Additionally, the methodology and reach of the projects have been criticized. There are now over 700 signatories to an open letter to the European Commission from the European neuroscience community. The letter states that the signing parties will boycott the Human Brain Project unless it is amended to be more open, inclusive and flexible.

There are also huge ethical concerns that need to be addressed more comprehensively in both projects. Nature called them “a laundry list of ethical issues,” including “the responsible use of cognitive-enhancement devices, the protection of personal neural data, the prediction of untreatable neurodegenerative diseases and the assessment of criminal responsibility through brain scanning.”

Another risk worth noting is how the influx of resources and excitement for a single element of human biology can overshadow other important factors and encourage biological determinism, even when such a focus is inappropriate or even harmful. Chipping away at the genetic determinism caused by the HGP has been a challenge. In these brain projects, we have an opportunity to learn from such experiences and not start completely from scratch.  Otherwise, in five years time, the “gene of the week” phenomenon could simply become the “neuron of the week.”

Other relevant lessons to remember include appropriate boundaries surrounding patents on the human body, the failures of privacy protection, harm of misinformation in unregulated direct-to-consumer models, the problem with trying to modify things we don’t yet understand, and discrimination against certain kinds of bodies. We really don’t need any more examples of how the “science of the day” can be used to justify harming or devaluing certain groups of people.

Opening up our brains for examination is going to stir up not only these issues, but also completely novel ones. We need to learn from past mistakes and be ready to deal with new issues as they arise. For now, it is heartening to see the amount of discussion taking place around the world about these complexities. Hopefully those at the forefront will not merely be defensive about their “grand vision,” but also realize that incorporating both scientific and social complexity in at the early stages is the best route forward for everyone.

Previously on Biopolitical Times:





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