25 April 2022
Assistant Professor at the National University of Ireland, Galway
The Health (Assisted Human Reproduction) Bill 2022 was published in March 2022, and is currently being considered by the Irish Parliament. Part seven provides for the regulation of altruistic, domestic surrogacy arrangements. However, it does little to encourage intended parents to enter into such arrangements, because it proposes a complex, hybrid pre and post-birth model for regulating domestic surrogacy.
The Bill provides for the setting up of an Assisted Human Reproduction Regulatory Authority (AHRRA) that must, among its many functions, approve the parties' surrogacy agreement before any treatment in a clinic will be permitted. However, despite all parties having received implications counselling and independent legal advice regarding the agreement by this time, the AHRRA's pre-conception 'approval' of their agreement will be limited to the approval of treatment, not legal parentage of the surrogate-born child.
The Bill provides that the gestational surrogate will be the child's legal mother at birth (the Bill only proposes to regulate gestational surrogacy). The intended parents can only apply to the court seeking a parental order transferring legal parentage from the surrogate a minimum of 28 days after the birth of the child. The surrogate must consent to this transfer of parental rights or she will remain the child's legal mother, and there appears to be nothing that the intended parents can do about this. Part seven makes it clear that the surrogate's consent can only be dispensed with by the court if she is either deceased or cannot be located.
This requirement around consent is a retrograde step when compared to the original draft of the Bill that was published as far back as 2017. In the General Scheme of the Assisted Human Reproduction Bill 2017, it was provided that the court could waive the requirement for the surrogate's consent to a parental order 'for any other reason the court considers to be relevant' which, if it had been retained in the current Bill, would at least have offered a potential life-line to intended parents who might find themselves in a predicament where the surrogate refuses to consent to a parental order. Indeed, one wonders whether this provision was intentionally removed from the Bill to make domestic surrogacy as perilous an undertaking as possible for Irish intended parents.
The Bill was drafted by the Department of Health and, as regards surrogacy, little has changed from the provisions in the General Scheme in 2017. This is surprising when one considers developments that took place in the interim period between the General Scheme and the Bill. In 2019, the two Law Commissions in the UK published a Consultation Paper proposing a move away from the 'Post-Birth Parental Order' model for regulating domestic surrogacy arrangements in that jurisdiction to a 'Pre-Conception Approval' model for determining legal parentage in favour of intended parents at birth.
However, it is clear from the above discussion that the post-birth aspects of the regulatory model proposed in the Irish Bill mirror unsatisfactory aspects of the current UK model, particularly in the area of post-birth consent. In 2020, Professor Conor O'Mahony, Ireland's special rapporteur on child protection, submitted 'A Review of Children's Rights and Best Interests in the context of Donor-Assisted Human Reproduction and Surrogacy in Irish Law', which also proposed a pre-conception approval model for determining legal parentage in cases of domestic surrogacy in Ireland.
It is worth noting that a pre-conception model for approving legal parentage of the surrogate-born child in favour of the intended parents might not only encourage them to avail of domestic surrogacy rather than going abroad, but it would also establish the child's right to family life with its intended parents immediately at birth. Further, this would not conflict with the surrogate's right to manage her pregnancy the same as any other woman because legal parentage would only arise in favour of the intended parents by operation of law at birth.
Nonetheless, the Bill does not allow for this approach intended parents will have to soldier on after their agreement is approved by the AHRRA in the hope that the surrogate will be willing to consent to the transfer of legal parentage to them by a court after she gives birth. While evidence indicates that the vast majority of surrogates do not view themselves as the mother of the child they have gestated for the intended parents, this is likely to be of little comfort to intended parents when deciding whether or not to embark on a pathway to parenting that involves substantial emotional investment, some financial investment, various pre and post-birth legal and administrative processes, and a degree of risk regarding the ultimate legal parentage of the surrogate-born child.
It is unclear why the State is wedded to the post-birth parental order model for regulating legal parentage in the context of domestic surrogacy. It is certainly not required by the Constitution or case law from the Irish superior courts, because in 2014 the Supreme Court made it clear that the regulation of surrogacy arrangements is a complex matter of social and public policy to be dealt with by the Irish Parliament, and that the principle of 'mater semper certa est (motherhood is certain)' is not part of the common law of Ireland.
Nonetheless, it is possible that a further, significant development influenced the State's decision the report of the United Nations (UN) 'Special Rapporteur on the sale and sexual exploitation of children'. In her report in 2018, the then UN Special Rapporteur advised nations that 'to prevent the sale of children in the context of altruistic surrogacy' and avoid a breach of the UN Convention on the Rights of the Child 'Optional Protocol on the sale of children, child prostitution and child pornography', the surrogate must 'retain parentage and parental responsibility at birth', and be under no legal obligation to transfer the child.
According to the UN Special Rapporteur, the surrogate's choice after the birth to transfer the child to the intending parents must be a gratuitous act, based on her own post-birth intentions, rather than on any legal or contractual obligation. Indeed, this might be the reason the Bill provides that the surrogate's post-birth consent can only be dispensed with by a court in the two abovementioned, extreme circumstances. If so, then the Bill is according too much weight to international law to the detriment of the constitutional rights of the child.
Indeed, Ireland has not yet even ratified the Optional Protocol on the sale of children, child prostitution and child pornography. However, children's rights are expressly protected in Article 42A of the Irish Constitution. Thus, it is imperative that a child-centred reason for waiving the need for the surrogate's consent to a parental order should be provided in the Bill.
In the context of an adoption, Section 31 of the Adoption Act 2010, as amended, allows the High Court to dispense with the need for the natural mother's consent where she fails, neglects or refuses to give her consent to the making of an adoption order. However, before doing so the High Court must have regard to 'the rights, whether under the Constitution or otherwise, of the persons concerned (including the natural and imprescriptible rights of the child)' under Article 42A.
One such 'natural and imprescriptible' constitutional right of a surrogate-born child might surely be a right to the enjoyment of family life with its intended parents, at least one of whom will be genetically related to the child according to the Bill, and both of whom are responsible for its birth by initiating the surrogacy arrangement? If legislation can allow a natural mother's consent to an adoption to be dispensed with in the manner above, surely it should similarly allow a gestational surrogate's consent to possibly be dispensed with on the same grounds?
In its current form, the approach to domestic surrogacy in the Health (Assisted Human Reproduction) Bill 2022 is restrictive and risk-laden, and thus unlikely to encourage many intended parents to avail themselves of surrogacy in Ireland. Many will most likely continue to go to commercial surrogacy jurisdictions where their legal parentage can be recognised at birth. In that regard, it should be noted that while the Bill contains no provisions on recognising the parentage of children born via international surrogacy, a parliamentary committee is currently exploring options for legislating in this area.
Here is the original post:
Regulating domestic surrogacy in Ireland: Is the process too perilous for intended parents? - BioNews
- World Health Organization reference values for human semen characteristics [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Economic consequences of overweight and obesity in infertility: a framework for evaluating the costs and outcomes of fertility care [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Maternal metabolism and obesity: modifiable determinants of pregnancy outcome [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Brain imaging studies of appetite in the context of obesity and the menstrual cycle [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Options for fertility preservation in prepubertal boys [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Xenografting of testicular tissue from an infant human donor results in accelerated testicular maturation [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Karyotype of miscarriages in relation to maternal weight [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Endoglandular trophoblast, an alternative route of trophoblast invasion? Analysis with novel confrontation co-culture models [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Regulation of extravillous trophoblast invasion by uterine natural killer cells is dependent on gestational age [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional regulation of thymic stromal lymphopoietin on proliferation and invasion of trophoblasts in human first-trimester pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Home self-administration of vaginal misoprostol for medical abortion at 50-63 days compared with gestation of below 50 days [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Prospective study of the forearm bone mineral density of long-term users of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional attenuation of human sperm by novel, non-surfactant spermicides: precise targeting of membrane physiology without affecting structure [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- The risk of post-molar gestational trophoblastic neoplasia is higher in heterozygous than in homozygous complete hydatidiform moles [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Cumulative ongoing pregnancy rate achieved with oocyte vitrification and cleavage stage transfer without embryo selection in a standard infertility program [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Pregnancy outcome in female childhood cancer survivors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Offering excess oocyte aspiration and vitrification to patients undergoing stimulated artificial insemination cycles can reduce the multiple pregnancy risk and accumulate oocytes for later use [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Who should pay for assisted reproductive techniques? Answers from patients, professionals and the general public in Germany [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Long-term cryostorage of sperm in a human sperm bank does not damage progressive motility concentration [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Screening for biomarkers of spermatogonia within the human testis: a whole genome approach [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoiding transgenerational risks of mitochondrial DNA disorders: a morally acceptable reason for sex selection? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Cross border reproductive care in six European countries [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Morphometric dimensions of the human sperm head depend on the staining method used [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- ESX1 gene expression as a robust marker of residual spermatogenesis in azoospermic men [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Innovative virtual reality measurements for embryonic growth and development [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Consecutive or non-consecutive recurrent miscarriage: is there any difference in carrier status? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- A longitudinal study of contraception and pregnancies in the same women followed for a quarter of a century [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Large prospective, pregnancy and infant follow-up trial assures the health of 1000 fetuses conceived after treatment with the GnRH antagonist ganirelix during controlled ovarian stimulation [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Altered aquaporin expression in women with polycystic ovary syndrome: hyperandrogenism in follicular fluid inhibits aquaporin-9 in granulosa cells through the phosphatidylinositol 3-kinase pathway [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Fast-release orodispersible tramadol as analgesia in hysterosalpingography with a metal cannula or a balloon catheter [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Xenotransplantation of cryopreserved human ovarian tissue into murine back muscle [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological adjustment, knowledge and unmet information needs in women undergoing PGD [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological well-being and sexarche in women with polycystic ovary syndrome [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Is human fecundity declining in Western countries? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current achievements and future research directions in ovarian tissue culture, in vitro follicle development and transplantation: implications for fertility preservation [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Human studies on genetics of the age at natural menopause: a systematic review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Beyond oxygen: complex regulation and activity of hypoxia inducible factors in pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current knowledge of the aetiology of human tubal ectopic pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Economic contraction and birth outcomes: an integrative review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Teratogenic mechanisms of medical drugs [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Levels of semenogelin in human spermatozoa decrease during capacitation: involvement of reactive oxygen species and zinc [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Apoptosis and meiotic segregation in ejaculated sperm from Robertsonian translocation carrier patients [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- In humans, zona pellucida glycoprotein-1 binds to spermatozoa and induces acrosomal exocytosis [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Variants of the EPPIN gene affect the risk of idiopathic male infertility in the Han-Chinese population [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Epidermal clitoral inclusion cysts: not a rare complication of female genital mutilation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- PCOSMIC: a multi-centre randomized trial in women with PolyCystic Ovary Syndrome evaluating Metformin for Infertility with Clomiphene [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Single versus double intrauterine insemination in multi-follicular ovarian hyperstimulation cycles: a randomized trial [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Soluble HLA-G is an independent factor for the prediction of pregnancy outcome after ART: a German multi-centre study [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Obstetric outcomes after transfer of vitrified blastocysts [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Occasional involvement of the ovary in Ewing sarcoma [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Development and preliminary validation of the fertility status awareness tool: FertiSTAT [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Xenotransplantation of human ovarian tissue to nude mice: comparison between four grafting sites [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Involvement of CFTR in oviductal HCO3- secretion and its effect on soluble adenylate cyclase-dependent early embryo development [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Effect of endometriosis on the protein expression pattern of follicular fluid from patients submitted to controlled ovarian hyperstimulation for in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Activin A regulates trophoblast cell adhesive properties: implications for implantation failure in women with endometriosis-associated infertility [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Clinical significance of sperm DNA damage in assisted reproduction outcome [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Fall in implantation rates following ICSI with sperm with high DNA fragmentation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Ultra-conservative fertility-sparing strategy for bilateral borderline ovarian tumours: an 11-year follow-up [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Fertility after autologous ovine uterine-tubal-ovarian transplantation by vascular anastomosis to the external iliac vessels [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Uterus transplantation in the baboon: methodology and long-term function after auto-transplantation [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Transfer of a selected single blastocyst optimizes the chance of a healthy term baby: a retrospective population based study in Australia 2004-2007 [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Disclosure patterns of mode of conception among mothers and fathers-5-year follow-up of the Copenhagen Multi-centre Psychosocial Infertility (COMPI) cohort [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- A decade of sperm washing: clinical correlates of successful insemination outcome [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Sperm DNA integrity in cancer patients before and after cytotoxic treatment [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Speriolin is a novel human and mouse sperm centrosome protein [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- No influence of body mass index on first trimester fetal growth [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- HLA sharing among couples appears unrelated to idiopathic recurrent fetal loss in Saudi Arabia [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]