The booming ‘business’ of renting wombs to produce babies will drive a beautiful alternative like adoption underground which instead we ought to encourage seeing the need of thousands of abandoned and orphaned children that crave for parental care
A recent Internet advertisement posted by a Medical Tourism Corporation made me fume. It brazenly advertised surrogate motherhood options available in India, bellowing that it costs “a fourth of what it would cost in the United States”. It slobbered over the fact that “surrogacy in India has few legal hassles and India’s laws allow the surrogate mother to sign away her rights as soon as the baby is delivered”.
The patronisation of India as a cheap place to get ‘takeaway’ babies sounded abhorrent and ethically questionable. I consulted two protagonists representing differing points of view. The first, Prof Uma Chakravarti, a historian and an academic doyen among women activists; the second Dr RS Sharma, Deputy Director-General in the Reproductive Health and Nutrition Division in ICMR who was actively involved with assembling the 2005 guidelines for Assisted Reproductive Technology clinics and later the draft ART Regulation Bill and Rules, 2008.
Let us hear what Ms Chakravarti had to say. She basically raised four issues: First, we in India staunchly protect our national identity and take umbrage at the first signs of exploitation by the white man. We bristle at a whiff of racism or veiled dominance and are quick to lash out on grounds of sovereignty, independence and freedom. Why then do we allow commercial exploitation of Third World women’s wombs by baby seekers from the first world?
Second the surrogate mother is expected to enter into an agreement which is contractual and legally enforceable. While the law gives her the normal right to terminate the pregnancy and refund all the expenses incurred by the biological parents, this is easier said than done: In the case of illiterate and uneducated women with no economic independence reneging on the contract would be next to impossible.
Third, dangling Rs 100,000 before a poor family would lead to women getting coerced into unwanted pregnancies for money. The plethora of consent forms and protective clauses cannot belie the fact that poor women are already exploited in umpteen ways and thumbing or signing a piece of paper does not constitute the exercise of independent choice. Oversight committees cannot get inside male dominated homes where the woman has no choice but to acquiesce to patriarchal diktats.
Finally, the whole business of surrogacy will drive a beautiful alternative like adoption underground which instead we ought to encourage seeing the need of thousands of abandoned and orphaned children that crave for parental care. Counselling about the goodness of adoption is unlikely to appeal to ART seekers once the road-map is clear before them.
Dr Sharma did not directly allay these doubts but gave convincing justification for regulating the whole business of ART. This is what he explained: Infertility can be placed at 10 to 15 per cent among the reproductive health seekers in hospital settings. Most of them approach infertility clinics that lack technological expertise and infrastructure. The clinics exploit anxious couples by charging exorbitant rates for even inexpensive procedures. In order to regulate and supervise the existing clinics and contain the mushroom growth of substandard infertility clinics ICMR issued the 2005 guidelines.
Several countries in Europe and West Asia had issued ART guidelines. So had Japan and USA done so. ICMR’s guidelines aimed at filling the lacuna that existed in India. Publicised widely they were discussed in six major cities where over 4,000 participants including doctors, scientists, public servants, legal experts and infertile couples voiced their opinions. Both the National Human Rights Commission and the National Commission for Women had reviewed these guidelines before they were notified.
In 2008 a draft Bill was formulated on which public comments have again been sought before taking it to the Law Ministry and Parliament. The Bill sets out a national framework for the regulation and supervision of ART. The process for registration of ART clinics, their standards and duties have been laid out explicitly. A National Advisory Board and similar set ups in each State would exercise the powers of a civil court to extend supervision and oversight over implementation. The system for sourcing and storage of gametes and embryos, the regulation of research, the rights and duties of donors and patients and the determination of the status of the child have been detailed comprehensively. Most couples using the ART clinics would not be foreigners but millions of Indians. The accompanying Rules spell out detailed requirements of infrastructure, staff, counseling, donation and cryopreservation.
Medical specialists that service an unregistered ART facility or contravene the provisions of the Act would be punishable with three years imprisonment. More importantly the offences are all cognisable, non-bailable and non-compoundable. The outcries about the non-bailable provisions have already created enough of a flurry among practitioners-a pointer to the Bill’s potency in preventing medical malpractice, Sharma added.
No doubt the debate will go on .This is not a perfect world but considering everything on balance, much more will be gained than lost by supporting the Bill to make it law.