Monday, February 25, 2013

CANADA AND INDIA: Academic studies on the ethics of reproductive tourism

Reproductive tourism, people crossing international borders to purchase assisted reproductive technologies is a multi-million dollar industry. But there are legal and ethical problems when citizens of wealthy countries travel to poorer countries to purchase the services of a surrogate mother.

The fastest growth country for ART, and certainly the largest market for providing surrogate mothers is India. Some reports value the Indian ART industry between $500 million and $3 billion.

In an academic paper, "Ethical concerns for maternal surrogacy and reproductive tourism" in the Journal of Medical Ethics, Professor Raywat Deonandan of the Interdisciplinary School of Health Sciences at the University of Ottawa, with students Samantha Green and Amanda van Beinum, identify specific ethical challenges posed by this emerging new industry.

The authors identify the tension between business ethics and medical ethics as being at the heart of the industry’s ethical problem, along with an insufficiently broad definition of “informed consent.” When desperately poor, illiterate and vulnerable village women are entering into complicated contracts to sell their reproductive health to wealthy foreigners, some physical and social risks are not fully communicated to them, such as their risk of estrangement from their communities, or the risk of domestic unease with their spouses and existing children.

The research points out that there is no ethical framework for establishing rights and responsibilities; In a business deal each party is only concerned about their own best interests only; but in a a medical deal, the clinic is morally responsible for everyone’s interests, including both the surrogate’s and the client’s.

The extent to which Indian ART clinics cater to the needs of non-Indians has always been difficult to determine, as is any sort of measurement of how many foreigners travel to India specifically to seek out ART services, especially maternal surrogacy services.

In another recent paper, “Measuring reproductive tourism through an analysis of Indian ART clinic websites” in International Journal of General Medicine, Professor Deonandan and students Mirhad Loncar, Prinon Rahman and Sabrina Omar analyzed the official websites of 159 Indian ART clinics to determine how many were actively seeking a foreign clientele. 86% of the clinics made some mention of reproductive tourism services, with 47% offering surrogates to clients.

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