Tuesday, December 21, 2004

draft law reform submission:

My situation:

I am making a submission to this inquiry because it personally affects me.

I am 38 years old. I was married in May 2000. We discovered we were infertile, most likely because of blocked fallopian tubes. At the end of 2002 my husband and I underwent IVF procedures that resulted in the birth of a son in November 2003.

We have eight embryos in storage at the IVF clinic, and intended to begin trying for a second child using those in early 2004.

In November 2004, on my son’s first birthday, I was diagnosed with a hormone-receptor-positive breast tumor and associated invasion of my lymphatic system.

I am currently undergoing chemotherapy, and my oncologist strongly recommends that as part of my treatment I become menopausal and not attempt further pregnancies. Research on whether pregnancy can trigger recurrences is inconclusive, particularly in the case of hormone-positive cancers.

We would not consider having another child for at least two years, when the likelihood of a recurrence will be significantly lower.

Even then, pregnancy would require me to stop taking hormone-blocking medication and to expose my body to hormones which could trigger or accelerate a recurrence of the cancer, threatening my life and depriving my husband and son of their wife and mother.

Technically, I am capable of becoming pregnant and carrying a pregnancy, but it would be dangerous.

In our situation, being fortunate enough to have stored embryos, working with an altruistic surrogate would be the perfect solution to the problem. One friend, who has completed her family, has already offered to carry out that role, although we have not discussed it seriously.

The current regulations in Victoria would make it practically impossible for us to have a child in this way, leaving me effectively either barred from having further children or forced to risk my life to do so.

I believe that changing the law to bring it into line with the best international practice described by the Commission’s review, and to show compassion for people in our situation, should happen as a matter of urgency.

My points on the consultation paper are below.

My submission is limited to the area I feel I have considered adequately, being altruistic full or gestational surrogacy, where the embryo is composed of gametes from the intended parents and/or sperm/ovum donors.

Surrogacy per se:

Altruistic surrogacy should be legal, and primarily a matter between the surrogate and the intended parents. It is a massive commitment of physical and emotional resources, and one that the individual should be able to choose freely. There is a precedent for this in egg donation, which is a smaller commitment, but of the same nature. Victorian women are more than capable of, with appropriate guidance, making the correct decisions in these matters in the best interests of any potential children.

Who should be eligible to access surrogacy:

I believe this point should be broadened to include prospective mothers for whom it is unsafe to carry a pregnancy to term. In its current form, the discussion paper only addresses those who are unable to become pregnant. There are many other women for whom it’s possible, but unsafe, to become pregnant; as in my case because of a risk of cancer recurrence, or as the result of abdominal surgery and other conditions.

Compensation for altruistic surrogates:

As a prospective parent, I would be ethically unable to use a surrogate if I was not allowed to compensate her for her financial losses, which could be considerable.

I believe that if any compensation at all is allowable for any kind of assistance with having children, then the actual amount is irrelevant.

If, for instance, it’s not illegal to pay an egg donor’s taxi fares to a clinic, it shouldn’t be illegal to make the same payment for a surrogate. And if that’s considered reasonable, it doesn’t make sense to bar the same kind of compensation for potentially thousands of dollars in medical bills, childcare costs for a surrogate, lost income and so on.

Compensation in non-monetary forms can and probably does already occur, for instance providing services such as housecleaning, shopping and food, particularly in the later stages of a pregnancy.

There may be a need for a formal process regulating compensation (eg channeling it through an officer of some kind) to prevent it becoming outright payment.

Who can be a surrogate:

The paper has already pointed out the anomaly where an infertile woman may act as a surrogate. This makes it more likely that the surrogate may have health problems of her own or her pregnancy may be higher-risk due to increased age and other conditions. The current regulations seem to increase the pressure for less suitable surrogates by “locking out” younger, fertile women.

Formalising arrangements:

Some kind of written agreement is probably desirable.

Counselling prior to a surrogacy arrangement does seem important, both to make sure all parties make the right choices, and to prevent surrogates being pressured into surrogacy.

Many infertility clinics already have excellent, well qualified counselling staff who might be able to fill this role. Good counselling and strict screening should minimise any problems over “custody” after the birth of a child, at least to levels lower than already exist in the state’s family court system.

Personally, I believe that children born of surrogacies should be able to access information about their origins, in the same way as children of donor gametes are, but I don’t feel strongly that this should be regulated, and the use of counselling and similar measures will probably make such rules generally unnecessary for altruistic surrogacy.

Birth certificates should be allowed to be issued in the intended parents’ names.

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