Ethics of Surrogacy and Third-Party Reproduction

Definitions & Types - Womb Wonders

• Surrogacy: An arrangement where a woman (surrogate mother) agrees to carry and deliver a child for another person or couple (intended parents/IPs).
• Third-Party Reproduction (TPR): Involves individuals other than the IPs to help conceive. Includes gamete donation (sperm, egg), embryo donation, and surrogacy.
• Types of Surrogacy:
  • Traditional Surrogacy: Surrogate’s egg is fertilized (usually by IP’s sperm). Surrogate is genetically related to the child.
  • Gestational Surrogacy (GS): Embryo (created using IPs' or donor gametes) is implanted in the surrogate. Surrogate has no genetic link to the child.
    • Altruistic Surrogacy: Surrogate receives no financial compensation beyond reimbursement for medical and other reasonable expenses.
    • Commercial Surrogacy: Surrogate is paid a fee for carrying the pregnancy. (Largely restricted/banned in India).

⭐ India's Surrogacy (Regulation) Act, 2021 permits only altruistic gestational surrogacy for eligible Indian couples, with strict criteria for both IPs and surrogate mothers. Commercial surrogacy is prohibited.

Ethical Dilemmas in Surrogacy - Moral Maze

• Autonomy Clash: Surrogate's bodily integrity vs. IPs' procreative rights.
• Informed Consent: Comprehensive (physical, psychological, social risks) for surrogate.
• Exploitation: Financial/emotional coercion risk, especially for vulnerable women.
• Child's Best Interests: Paramount; includes identity, parentage clarity.
• Commodification: Ethical concerns: child as product, womb as service.
• Legal Maze: Parentage, rights, responsibilities post-birth.

⭐ India's Surrogacy (Regulation) Act, 2021, permits only altruistic surrogacy, banning commercial surrogacy to prevent exploitation.

Indian Legal Landscape - Lawful Loins

• Surrogacy (Regulation) Act, 2021:
  • Altruistic surrogacy only; commercial banned.
  • Intending Couple: Indian, married ≥5 yrs; F 23-50, M 26-55 yrs; proven infertility.
  • Surrogate: Close relative, married, own child, 25-35 yrs, once; medically/psychologically fit.
  • Parental order by Magistrate Court.
  • Mandatory insurance for surrogate (36 months).
• Assisted Reproductive Technology (Regulation) Act, 2021 (ART Act):
  • Regulates ART clinics/banks; National/State ART & Surrogacy Boards.
  • ART-born child rights protected (deemed biological).
  • Written informed consent; donor anonymity.
  • Sex selection prohibited.

⭐ Commercial surrogacy: punishable up to 10 yrs jail & ₹10 lakhs fine.

Ethics of Gamete/Embryo Donation - Seed & Soil Saga

• Informed Consent: Essential for donors & recipients; covers procedures, risks, rights.
• Anonymity vs. Disclosure: Balancing donor privacy with DCI's right to know. Regulated anonymity common.
• Donor Screening: Mandatory for genetic issues, STIs (HIV, HBV, HCV) for safety.
• Psychological Counseling: Recommended for all parties; addresses emotional/social aspects.
• Donation Limits: Caps on offspring per donor (ICMR) to prevent consanguinity.
• Commercialization: Altruistic donation preferred; sale of gametes/embryos restricted.
• Embryo Donation: Ethical handling of surplus embryos: donation, research, or discard (consent vital).
• "Seed & Soil": "Seed" (gamete/embryo) ethics: donor choice, genetic health. "Soil" (recipient) ethics: maternal well-being, psychosocial stability.

⭐ ART (Regulation) Act, 2021, mandates donor screening for communicable diseases and relevant genetic disorders.

High‑Yield Points - ⚡ Biggest Takeaways

• Surrogacy Regulation Act (India): Permits only altruistic surrogacy for infertile Indian couples (married 5 years).
• Commercial surrogacy is banned.
• Intending couple needs Certificate of Essentiality & Eligibility.
• Surrogate: Close relative, married, own child, 25-35 years, once a lifetime.
• Child: Legal rights as biological child of intending couple.
• ART Regulation Act, 2021: Governs ART clinics/banks, promotes ethical practice.
• Informed consent: Mandatory for all parties (surrogate, couple, donors).